SCOTCH PLYWOOD COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SCOTCH PLYWOOD COMPANY,INC.
401k plan membership statisitcs for SCOTCH PLYWOOD COMPANY,INC.
| Measure | Date | Value |
|---|
| 2022: SCOTCH PLYWOOD COMPANY,INC. 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-06-01 | 956 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 931 |
| Total of all active and inactive participants | 2022-06-01 | 931 |
| 2021: SCOTCH PLYWOOD COMPANY,INC. 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-06-01 | 943 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 956 |
| Total of all active and inactive participants | 2021-06-01 | 956 |
| 2020: SCOTCH PLYWOOD COMPANY,INC. 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-06-01 | 976 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 943 |
| Total of all active and inactive participants | 2020-06-01 | 943 |
| 2019: SCOTCH PLYWOOD COMPANY,INC. 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-06-01 | 968 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 976 |
| Total of all active and inactive participants | 2019-06-01 | 976 |
| 2018: SCOTCH PLYWOOD COMPANY,INC. 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-06-01 | 950 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 968 |
| Total of all active and inactive participants | 2018-06-01 | 968 |
| 2017: SCOTCH PLYWOOD COMPANY,INC. 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-06-01 | 962 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 950 |
| Total of all active and inactive participants | 2017-06-01 | 950 |
| 2016: SCOTCH PLYWOOD COMPANY,INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-06-01 | 949 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 962 |
| Total of all active and inactive participants | 2016-06-01 | 962 |
| 2015: SCOTCH PLYWOOD COMPANY,INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 960 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 949 |
| Total of all active and inactive participants | 2015-06-01 | 949 |
| 2014: SCOTCH PLYWOOD COMPANY,INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-06-01 | 931 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 960 |
| Total of all active and inactive participants | 2014-06-01 | 960 |
| 2013: SCOTCH PLYWOOD COMPANY,INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-06-01 | 920 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 931 |
| Total of all active and inactive participants | 2013-06-01 | 931 |
| 2012: SCOTCH PLYWOOD COMPANY,INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-06-01 | 924 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 920 |
| Total of all active and inactive participants | 2012-06-01 | 920 |
| Total participants | 2012-06-01 | 920 |
| 2011: SCOTCH PLYWOOD COMPANY,INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-06-01 | 962 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 924 |
| Total of all active and inactive participants | 2011-06-01 | 924 |
| Total participants | 2011-06-01 | 924 |
| 2009: SCOTCH PLYWOOD COMPANY,INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-06-01 | 1,008 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 958 |
| Total of all active and inactive participants | 2009-06-01 | 958 |
| Total participants | 2009-06-01 | 958 |
| 2008: SCOTCH PLYWOOD COMPANY,INC. 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-06-01 | 1,251 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-06-01 | 1,008 |
| Total of all active and inactive participants | 2008-06-01 | 1,008 |
| Total participants | 2008-06-01 | 1,008 |
| 2007: SCOTCH PLYWOOD COMPANY,INC. 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-06-01 | 1,251 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-06-01 | 1,251 |
| Total of all active and inactive participants | 2007-06-01 | 1,251 |
| Total participants | 2007-06-01 | 1,251 |
| 2022: SCOTCH PLYWOOD COMPANY,INC. 2022 form 5500 responses |
|---|
| 2022-06-01 | Type of plan entity | Single employer plan |
| 2022-06-01 | Plan funding arrangement – Insurance | Yes |
| 2022-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: SCOTCH PLYWOOD COMPANY,INC. 2021 form 5500 responses |
|---|
| 2021-06-01 | Type of plan entity | Single employer plan |
| 2021-06-01 | Plan funding arrangement – Insurance | Yes |
| 2021-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: SCOTCH PLYWOOD COMPANY,INC. 2020 form 5500 responses |
|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SCOTCH PLYWOOD COMPANY,INC. 2019 form 5500 responses |
|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SCOTCH PLYWOOD COMPANY,INC. 2018 form 5500 responses |
|---|
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Plan funding arrangement – Insurance | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: SCOTCH PLYWOOD COMPANY,INC. 2017 form 5500 responses |
|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: SCOTCH PLYWOOD COMPANY,INC. 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: SCOTCH PLYWOOD COMPANY,INC. 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: SCOTCH PLYWOOD COMPANY,INC. 2014 form 5500 responses |
|---|
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Plan funding arrangement – Insurance | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: SCOTCH PLYWOOD COMPANY,INC. 2013 form 5500 responses |
|---|
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Submission has been amended | Yes |
| 2013-06-01 | Plan funding arrangement – Insurance | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: SCOTCH PLYWOOD COMPANY,INC. 2012 form 5500 responses |
|---|
| 2012-06-01 | Type of plan entity | Single employer plan |
| 2012-06-01 | Submission has been amended | No |
| 2012-06-01 | This submission is the final filing | No |
| 2012-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-06-01 | Plan is a collectively bargained plan | No |
| 2012-06-01 | Plan funding arrangement – Insurance | Yes |
| 2012-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: SCOTCH PLYWOOD COMPANY,INC. 2011 form 5500 responses |
|---|
| 2011-06-01 | Type of plan entity | Single employer plan |
| 2011-06-01 | Submission has been amended | No |
| 2011-06-01 | This submission is the final filing | No |
| 2011-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-06-01 | Plan is a collectively bargained plan | No |
| 2011-06-01 | Plan funding arrangement – Insurance | Yes |
| 2011-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SCOTCH PLYWOOD COMPANY,INC. 2009 form 5500 responses |
|---|
| 2009-06-01 | Type of plan entity | Single employer plan |
| 2009-06-01 | Submission has been amended | No |
| 2009-06-01 | This submission is the final filing | No |
| 2009-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-06-01 | Plan is a collectively bargained plan | No |
| 2009-06-01 | Plan funding arrangement – Insurance | Yes |
| 2009-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: SCOTCH PLYWOOD COMPANY,INC. 2008 form 5500 responses |
|---|
| 2008-06-01 | Type of plan entity | Single employer plan |
| 2008-06-01 | Submission has been amended | No |
| 2008-06-01 | This submission is the final filing | No |
| 2008-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-06-01 | Plan is a collectively bargained plan | No |
| 2008-06-01 | Plan funding arrangement – Insurance | Yes |
| 2008-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: SCOTCH PLYWOOD COMPANY,INC. 2007 form 5500 responses |
|---|
| 2007-06-01 | Type of plan entity | Single employer plan |
| 2007-06-01 | Submission has been amended | No |
| 2007-06-01 | This submission is the final filing | No |
| 2007-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-06-01 | Plan is a collectively bargained plan | No |
| 2007-06-01 | Plan funding arrangement – Insurance | Yes |
| 2007-06-01 | Plan benefit arrangement – Insurance | Yes |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50048908 |
| Policy instance | 6 |
| Insurance contract or identification number | 50048908 | | Number of Individuals Covered | 544 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $20,723 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | VOLUNTANRY GROUP TERM LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $138,150 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,723 | | Insurance broker organization code? | 3 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50048908 |
| Policy instance | 5 |
| Insurance contract or identification number | 50048908 | | Number of Individuals Covered | 544 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $1,998 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | VOLUNTARY AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $13,322 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,998 | | Insurance broker organization code? | 3 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50048908 |
| Policy instance | 4 |
| Insurance contract or identification number | 50048908 | | Number of Individuals Covered | 453 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $8,573 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $57,154 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,573 | | Insurance broker organization code? | 3 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50048908 |
| Policy instance | 3 |
| Insurance contract or identification number | 50048908 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $5,874 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,158 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,874 | | Insurance broker organization code? | 3 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50048908 |
| Policy instance | 2 |
| Insurance contract or identification number | 50048908 | | Number of Individuals Covered | 535 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $16,038 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $106,921 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,038 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 804 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 819 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 752025 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 752025 | | Number of Individuals Covered | 412 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-06-01 | | Total amount of commissions paid to insurance broker | USD $17,684 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $67,951 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,842 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 965053 |
| Policy instance | 3 |
| Insurance contract or identification number | LK 965053 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-06-01 | | Total amount of commissions paid to insurance broker | USD $7,850 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,164 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,925 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967365 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX967365 | | Number of Individuals Covered | 475 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-06-01 | | Total amount of commissions paid to insurance broker | USD $16,784 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $83,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,392 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968884 |
| Policy instance | 5 |
| Insurance contract or identification number | OK 968884 | | Number of Individuals Covered | 477 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-06-01 | | Total amount of commissions paid to insurance broker | USD $1,428 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $7,142 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $714 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968884 |
| Policy instance | 5 |
| Insurance contract or identification number | OK 968884 | | Number of Individuals Covered | 502 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-06-01 | | Total amount of commissions paid to insurance broker | USD $697 | | Total amount of fees paid to insurance company | USD $224 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $6,972 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $697 | | Amount paid for insurance broker fees | 224 | | Additional information about fees paid to insurance broker | SALES AND SERVICE | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967365 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX967365 | | Number of Individuals Covered | 502 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-06-01 | | Total amount of commissions paid to insurance broker | USD $8,223 | | Total amount of fees paid to insurance company | USD $2,421 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,227 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,223 | | Amount paid for insurance broker fees | 2421 | | Additional information about fees paid to insurance broker | SALES AND SERVICE | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 965053 |
| Policy instance | 3 |
| Insurance contract or identification number | LK 965053 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-06-01 | | Total amount of commissions paid to insurance broker | USD $3,788 | | Total amount of fees paid to insurance company | USD $835 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,788 | | Amount paid for insurance broker fees | 835 | | Additional information about fees paid to insurance broker | SALES AND SERVICE | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 752025 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 752025 | | Number of Individuals Covered | 425 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-06-01 | | Total amount of commissions paid to insurance broker | USD $8,619 | | Total amount of fees paid to insurance company | USD $2,107 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $66,303 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,619 | | Amount paid for insurance broker fees | 2107 | | Additional information about fees paid to insurance broker | SALES AND SERVICE | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 768 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968884 |
| Policy instance | 5 |
| Insurance contract or identification number | OK 968884 | | Number of Individuals Covered | 523 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-06-01 | | Total amount of commissions paid to insurance broker | USD $749 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $7,486 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $749 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967365 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX967365 | | Number of Individuals Covered | 523 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-06-01 | | Total amount of commissions paid to insurance broker | USD $8,861 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $88,608 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,861 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 965053 |
| Policy instance | 3 |
| Insurance contract or identification number | LK 965053 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-06-01 | | Total amount of commissions paid to insurance broker | USD $4,172 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,815 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,172 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 752025 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 752025 | | Number of Individuals Covered | 445 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-06-01 | | Total amount of commissions paid to insurance broker | USD $9,165 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $70,497 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,165 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 798 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968884 |
| Policy instance | 5 |
| Insurance contract or identification number | OK 968884 | | Number of Individuals Covered | 517 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-06-01 | | Total amount of commissions paid to insurance broker | USD $746 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $7,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $746 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967365 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX967365 | | Number of Individuals Covered | 517 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-06-01 | | Total amount of commissions paid to insurance broker | USD $8,797 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $87,974 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,797 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 965053 |
| Policy instance | 3 |
| Insurance contract or identification number | LK 965053 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-06-01 | | Total amount of commissions paid to insurance broker | USD $4,238 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,238 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 752025 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 752025 | | Number of Individuals Covered | 439 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-06-01 | | Total amount of commissions paid to insurance broker | USD $9,132 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $70,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,132 | | Insurance broker organization code? | 3 |
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| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 781 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 758 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 752025 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 752025 | | Number of Individuals Covered | 441 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-06-01 | | Total amount of commissions paid to insurance broker | USD $9,123 | | Total amount of fees paid to insurance company | USD $1,001 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $70,176 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,123 | | Amount paid for insurance broker fees | 1001 | | Additional information about fees paid to insurance broker | SALES & SERVICE | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T INSURANCE SERVICES I |
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 965053 |
| Policy instance | 3 |
| Insurance contract or identification number | LK 965053 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-06-01 | | Total amount of commissions paid to insurance broker | USD $4,345 | | Total amount of fees paid to insurance company | USD $454 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,345 | | Amount paid for insurance broker fees | 454 | | Additional information about fees paid to insurance broker | SALES & SERVICE. | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T INSURANCE SERVICES I |
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967365 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX967365 | | Number of Individuals Covered | 520 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-06-01 | | Total amount of commissions paid to insurance broker | USD $9,076 | | Total amount of fees paid to insurance company | USD $1,348 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $90,760 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,076 | | Amount paid for insurance broker fees | 1348 | | Additional information about fees paid to insurance broker | SALES & SERVICE. | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T INSURANCE SERVICES I |
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968884 |
| Policy instance | 5 |
| Insurance contract or identification number | OK 968884 | | Number of Individuals Covered | 520 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-06-01 | | Total amount of commissions paid to insurance broker | USD $752 | | Total amount of fees paid to insurance company | USD $111 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $7,516 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $752 | | Amount paid for insurance broker fees | 111 | | Additional information about fees paid to insurance broker | SALES & SERVICE. | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T INSURANCE SERVICES I |
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| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5467518 |
| Policy instance | 2 |
| Insurance contract or identification number | 5467518 | | Number of Individuals Covered | 498 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $15,210 | | Total amount of fees paid to insurance company | USD $9,109 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $168,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,210 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T-BLUE RIDGE BURKE |
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| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 749 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5467518 |
| Policy instance | 2 |
| Insurance contract or identification number | 5467518 | | Number of Individuals Covered | 484 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $15,779 | | Total amount of fees paid to insurance company | USD $49 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $172,860 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,779 | | Amount paid for insurance broker fees | 49 | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T-OTT & COMPANY |
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| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 706 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | FLEXIBLE SPENDING ACCOUNT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5467518 |
| Policy instance | 2 |
| Insurance contract or identification number | 5467518 | | Number of Individuals Covered | 491 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $16,457 | | Total amount of fees paid to insurance company | USD $13,094 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $180,764 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,457 | | Amount paid for insurance broker fees | 113 | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T BLUE RIDGE BURKE |
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| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 47097 |
| Policy instance | 1 |
| Insurance contract or identification number | 47097 | | Number of Individuals Covered | 329 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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