MOBILE COMMUNITY ACTION, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN
401k plan membership statisitcs for MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN
Measure | Date | Value |
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2016: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-06-01 | 343 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 0 |
Number of retired or separated participants receiving benefits | 2016-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-06-01 | 0 |
Total of all active and inactive participants | 2016-06-01 | 0 |
2015: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-06-01 | 383 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 343 |
Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
Total of all active and inactive participants | 2015-06-01 | 343 |
2014: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-06-01 | 261 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 383 |
Number of retired or separated participants receiving benefits | 2014-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-06-01 | 0 |
Total of all active and inactive participants | 2014-06-01 | 383 |
2013: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-06-01 | 402 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 261 |
Number of retired or separated participants receiving benefits | 2013-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-06-01 | 0 |
Total of all active and inactive participants | 2013-06-01 | 261 |
2012: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-06-01 | 417 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 402 |
Number of retired or separated participants receiving benefits | 2012-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-06-01 | 0 |
Total of all active and inactive participants | 2012-06-01 | 402 |
2011: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 417 |
Number of retired or separated participants receiving benefits | 2011-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-06-01 | 0 |
Total of all active and inactive participants | 2011-06-01 | 417 |
2010: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2010-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2010-06-01 | 0 |
Total of all active and inactive participants | 2010-06-01 | 100 |
2009: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2009-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-06-01 | 0 |
Total of all active and inactive participants | 2009-06-01 | 100 |
2008: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2008 401k membership |
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Total participants, beginning-of-year | 2008-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2008-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2008-06-01 | 0 |
Total of all active and inactive participants | 2008-06-01 | 100 |
2007: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2007 401k membership |
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Total participants, beginning-of-year | 2007-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2007-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2007-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2007-06-01 | 0 |
Total of all active and inactive participants | 2007-06-01 | 100 |
2006: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2006 401k membership |
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Total participants, beginning-of-year | 2006-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2006-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2006-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2006-06-01 | 0 |
Total of all active and inactive participants | 2006-06-01 | 100 |
2005: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2005 401k membership |
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Total participants, beginning-of-year | 2005-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2005-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2005-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2005-06-01 | 0 |
Total of all active and inactive participants | 2005-06-01 | 100 |
2004: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2004 401k membership |
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Total participants, beginning-of-year | 2004-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2004-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2004-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2004-06-01 | 0 |
Total of all active and inactive participants | 2004-06-01 | 100 |
2003: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2003 401k membership |
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Total participants, beginning-of-year | 2003-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2003-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2003-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2003-06-01 | 0 |
Total of all active and inactive participants | 2003-06-01 | 100 |
2002: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2002 401k membership |
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Total participants, beginning-of-year | 2002-06-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2002-06-01 | 100 |
Number of retired or separated participants receiving benefits | 2002-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2002-06-01 | 0 |
Total of all active and inactive participants | 2002-06-01 | 100 |
2016: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2016 form 5500 responses |
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2016-06-01 | Type of plan entity | Single employer plan |
2016-06-01 | Submission has been amended | No |
2016-06-01 | This submission is the final filing | Yes |
2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-06-01 | Plan is a collectively bargained plan | No |
2016-06-01 | Plan funding arrangement – Insurance | Yes |
2016-06-01 | Plan benefit arrangement – Insurance | Yes |
2015: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2015 form 5500 responses |
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2015-06-01 | Type of plan entity | Single employer plan |
2015-06-01 | Submission has been amended | No |
2015-06-01 | This submission is the final filing | No |
2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-06-01 | Plan is a collectively bargained plan | No |
2015-06-01 | Plan funding arrangement – Insurance | Yes |
2015-06-01 | Plan benefit arrangement – Insurance | Yes |
2014: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2014 form 5500 responses |
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2014-06-01 | Type of plan entity | Single employer plan |
2014-06-01 | Submission has been amended | No |
2014-06-01 | This submission is the final filing | No |
2014-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-06-01 | Plan is a collectively bargained plan | No |
2014-06-01 | Plan funding arrangement – Insurance | Yes |
2014-06-01 | Plan benefit arrangement – Insurance | Yes |
2013: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2013 form 5500 responses |
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2013-06-01 | Type of plan entity | Single employer plan |
2013-06-01 | Submission has been amended | No |
2013-06-01 | This submission is the final filing | No |
2013-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-06-01 | Plan is a collectively bargained plan | No |
2013-06-01 | Plan funding arrangement – Insurance | Yes |
2013-06-01 | Plan benefit arrangement – Insurance | Yes |
2012: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2012 form 5500 responses |
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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: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2011 form 5500 responses |
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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 |
2010: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2010 form 5500 responses |
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2010-06-01 | Type of plan entity | Single employer plan |
2010-06-01 | Submission has been amended | No |
2010-06-01 | This submission is the final filing | No |
2010-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-06-01 | Plan is a collectively bargained plan | No |
2010-06-01 | Plan funding arrangement – Insurance | Yes |
2010-06-01 | Plan benefit arrangement – Insurance | Yes |
2009: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2009 form 5500 responses |
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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: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2008 form 5500 responses |
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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: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2007 form 5500 responses |
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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 |
2006: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2006 form 5500 responses |
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2006-06-01 | Type of plan entity | Single employer plan |
2006-06-01 | Submission has been amended | No |
2006-06-01 | This submission is the final filing | No |
2006-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2006-06-01 | Plan is a collectively bargained plan | No |
2006-06-01 | Plan funding arrangement – Insurance | Yes |
2006-06-01 | Plan benefit arrangement – Insurance | Yes |
2005: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2005 form 5500 responses |
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2005-06-01 | Type of plan entity | Single employer plan |
2005-06-01 | Submission has been amended | No |
2005-06-01 | This submission is the final filing | No |
2005-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2005-06-01 | Plan is a collectively bargained plan | No |
2005-06-01 | Plan funding arrangement – Insurance | Yes |
2005-06-01 | Plan benefit arrangement – Insurance | Yes |
2004: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2004 form 5500 responses |
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2004-06-01 | Type of plan entity | Single employer plan |
2004-06-01 | Submission has been amended | No |
2004-06-01 | This submission is the final filing | No |
2004-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2004-06-01 | Plan is a collectively bargained plan | No |
2004-06-01 | Plan funding arrangement – Insurance | Yes |
2004-06-01 | Plan benefit arrangement – Insurance | Yes |
2003: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2003 form 5500 responses |
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2003-06-01 | Type of plan entity | Single employer plan |
2003-06-01 | Submission has been amended | No |
2003-06-01 | This submission is the final filing | No |
2003-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2003-06-01 | Plan is a collectively bargained plan | No |
2003-06-01 | Plan funding arrangement – Insurance | Yes |
2003-06-01 | Plan benefit arrangement – Insurance | Yes |
2002: MOBILE COMMUNITY ACTION INC. LIFE AND AD&D PLAN 2002 form 5500 responses |
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2002-06-01 | Type of plan entity | Single employer plan |
2002-06-01 | First time form 5500 has been submitted | Yes |
2002-06-01 | Submission has been amended | No |
2002-06-01 | This submission is the final filing | No |
2002-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2002-06-01 | Plan is a collectively bargained plan | No |
2002-06-01 | Plan funding arrangement – Insurance | Yes |
2002-06-01 | Plan benefit arrangement – Insurance | Yes |
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 261 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $4,763 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $44,697 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,897 | Insurance broker organization code? | 3 | Insurance broker name | KAI M CHAMBERS |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 402 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $4,413 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $43,092 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,598 | Insurance broker organization code? | 3 | Insurance broker name | KAI M CHAMBERS |
|
CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 417 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $5,919 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $42,293 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,428 | Insurance broker organization code? | 3 | Insurance broker name | KAI M CHAMBERS |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2009-06-01 | Insurance policy end date | 2010-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2008-06-01 | Insurance policy end date | 2009-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2007-06-01 | Insurance policy end date | 2008-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2006-06-01 | Insurance policy end date | 2007-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2005-06-01 | Insurance policy end date | 2006-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2004-06-01 | Insurance policy end date | 2005-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2003-06-01 | Insurance policy end date | 2004-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | 4406X2 |
Policy instance | 1 |
Insurance contract or identification number | 4406X2 | Number of Individuals Covered | 100 | Insurance policy start date | 2002-06-01 | Insurance policy end date | 2003-05-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, SUPPLEMENTAL AD&D, DEPENDENT LIFE, DEPENDENT AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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