PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD
| Measure | Date | Value |
|---|
| 2021: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 164 |
| Total of all active and inactive participants | 2021-01-01 | 164 |
| Total participants | 2021-01-01 | 164 |
| 2020: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 218 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 197 |
| Total of all active and inactive participants | 2020-01-01 | 197 |
| Total participants | 2020-01-01 | 197 |
| 2019: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 262 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 218 |
| Total of all active and inactive participants | 2019-01-01 | 218 |
| Total participants | 2019-01-01 | 218 |
| 2018: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 262 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 262 |
| Total of all active and inactive participants | 2018-01-01 | 262 |
| Total participants | 2018-01-01 | 262 |
| 2017: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 273 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 262 |
| Total of all active and inactive participants | 2017-01-01 | 262 |
| Total participants | 2017-01-01 | 262 |
| 2016: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 311 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 273 |
| Total of all active and inactive participants | 2016-01-01 | 273 |
| Total participants | 2016-01-01 | 273 |
| 2015: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 337 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 311 |
| Total of all active and inactive participants | 2015-01-01 | 311 |
| Total participants | 2015-01-01 | 311 |
| 2014: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 367 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 337 |
| Total of all active and inactive participants | 2014-01-01 | 337 |
| Total participants | 2014-01-01 | 337 |
| 2013: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 388 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 367 |
| Total of all active and inactive participants | 2013-01-01 | 367 |
| Total participants | 2013-01-01 | 367 |
| 2012: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 452 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 388 |
| Number of other retired or separated participants entitled to future benefits | 2012-10-01 | 0 |
| Total of all active and inactive participants | 2012-10-01 | 388 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-10-01 | 0 |
| Total participants | 2012-10-01 | 388 |
| Number of participants with account balances | 2012-10-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-10-01 | 0 |
| 2011: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 510 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 467 |
| Total of all active and inactive participants | 2011-01-01 | 467 |
| Total participants | 2011-01-01 | 467 |
| 2009: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 563 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 510 |
| Number of retired or separated participants receiving benefits | 2009-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-10-01 | 0 |
| Total of all active and inactive participants | 2009-10-01 | 510 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-10-01 | 0 |
| Total participants | 2009-10-01 | 510 |
| Number of participants with account balances | 2009-10-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-10-01 | 0 |
| 2021: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Submission has been amended | Yes |
| 2012-10-01 | This submission is the final filing | No |
| 2012-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2012-10-01 | Plan is a collectively bargained plan | No |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS- LTD 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | Submission has been amended | No |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-10-01 | Plan is a collectively bargained plan | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
| Policy contract number | LTD 1301-0310 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD 1301-0310 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,273 | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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? | No | | Commission paid to Insurance Broker | USD $3,273 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
| Policy contract number | LTD 1301-0310 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD 1301-0310 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $3,959 | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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? | No | | Commission paid to Insurance Broker | USD $3,959 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
| Policy contract number | LTD 1301-0310 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD 1301-0310 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,307 | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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? | No | | Commission paid to Insurance Broker | USD $4,307 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
| Policy contract number | LTD13010310 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD13010310 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $6,415 | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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? | No | | Commission paid to Insurance Broker | USD $6,415 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
| Policy contract number | LTD 1301-0310 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD 1301-0310 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,928 | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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? | No | | Commission paid to Insurance Broker | USD $6,928 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | IKON BENEFITS GROUP, INC. |
|
| UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
| Policy contract number | LTD 1301-0310 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD 1301-0310 | | Number of Individuals Covered | 311 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $8,383 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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? | No | | Commission paid to Insurance Broker | USD $8,383 | | Amount paid for insurance broker fees | 8383 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | IKON BENEFITS GROUP, INC. |
|
| UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
| Policy contract number | LTD 1301-0310 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD 1301-0310 | | Number of Individuals Covered | 337 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $9,132 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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? | No | | Commission paid to Insurance Broker | USD $9,132 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | IKON BENEFITS GROUP, INC. |
|
| UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
| Policy contract number | LTD-1301-0310 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD-1301-0310 | | Number of Individuals Covered | 367 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $9,413 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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? | No | | Commission paid to Insurance Broker | USD $9,413 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | IKON BENEFITS GROUP, INC. |
|
| TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 ) |
| Policy contract number | LTD-0310001 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD-0310001 | | Number of Individuals Covered | 388 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,604 | | Health Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,604 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | IKON BENEFITS GROUP, INC. |
|
| TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 ) |
| Policy contract number | LTD-0310001 |
| Policy instance | 2 |
| Insurance contract or identification number | LTD-0310001 | | Number of Individuals Covered | 452 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $7,392 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,304 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | IKON BENEFITS GROUP, INC. |
|
| TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 ) |
| Policy contract number | LTD0310001 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD0310001 | | Number of Individuals Covered | 467 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $7,519 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 ) |
| Policy contract number | LTD-0310001 |
| Policy instance | 3 |
| Insurance contract or identification number | LTD-0310001 | | Number of Individuals Covered | 508 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $7,726 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,726 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH SALDANA , INC. |
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