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ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 401k Plan overview

Plan NameENCANTO RESTAURANTS, INC. LONG TERM DISABILITY
Plan identification number 501

ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

ENCANTO RESTAURANTS, INC. has sponsored the creation of one or more 401k plans.

Company Name:ENCANTO RESTAURANTS, INC.
Employer identification number (EIN):660587862
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01
5012021-05-01
5012020-05-01
5012017-05-01AIDALIZ SANTIAGO PEREZ
5012016-05-01AIDALIZ SANTIAGO PEREZ
5012015-05-01AIDALIZ SANTIAGO PEREZ
5012015-04-01AIDALIZ SANTIAGO PEREZ
5012014-04-01AIDALIZ SANTIAGO PEREZ
5012013-04-01AIDALIZ SANTIAGO PEREZ
5012013-03-01AIDALIZ SANTIAGO PEREZ
5012012-03-01AIDALIZ SANTIAGO PEREZ
5012011-03-01AIDALIZ SANTIAGO PEREZ
5012010-03-01AIDALIZ SANTIAGO PEREZ
5012010-02-01AIDALIZ SANTIAGO PEREZ
5012009-02-01AIDALIZ SANTIAGO PEREZ
5012009-02-01AIDALIZ SANTIAGO PEREZ
5012009-02-01AIDALIZ SANTIAGO PEREZ

Plan Statistics for ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY

401k plan membership statisitcs for ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY

Measure Date Value
2022: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2022 401k membership
Total participants, beginning-of-year2022-05-01353
Total number of active participants reported on line 7a of the Form 55002022-05-01343
Total of all active and inactive participants2022-05-01343
2021: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2021 401k membership
Total participants, beginning-of-year2021-05-01453
Total number of active participants reported on line 7a of the Form 55002021-05-01353
Total of all active and inactive participants2021-05-01353
2020: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2020 401k membership
Total participants, beginning-of-year2020-05-01432
Total number of active participants reported on line 7a of the Form 55002020-05-01453
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01453
2017: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2017 401k membership
Total participants, beginning-of-year2017-05-01458
Total number of active participants reported on line 7a of the Form 55002017-05-01450
Total of all active and inactive participants2017-05-01450
Total participants2017-05-01450
2016: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2016 401k membership
Total participants, beginning-of-year2016-05-01452
Total number of active participants reported on line 7a of the Form 55002016-05-01458
Total of all active and inactive participants2016-05-01458
Total participants2016-05-01458
2015: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year2015-05-01465
Total number of active participants reported on line 7a of the Form 55002015-05-01452
Total of all active and inactive participants2015-05-01452
Total participants2015-05-01452
Total participants, beginning-of-year2015-04-01465
Total number of active participants reported on line 7a of the Form 55002015-04-01537
Total of all active and inactive participants2015-04-01537
Total participants2015-04-01537
2014: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year2014-04-01465
Total number of active participants reported on line 7a of the Form 55002014-04-01465
Total of all active and inactive participants2014-04-01465
Total participants2014-04-01465
2013: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year2013-04-01604
Total number of active participants reported on line 7a of the Form 55002013-04-01537
Total of all active and inactive participants2013-04-01537
Total participants2013-04-01537
Total participants, beginning-of-year2013-03-01610
Total number of active participants reported on line 7a of the Form 55002013-03-01610
Total of all active and inactive participants2013-03-01610
Total participants2013-03-01610
2012: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year2012-03-01808
Total number of active participants reported on line 7a of the Form 55002012-03-01604
Total of all active and inactive participants2012-03-01604
Total participants2012-03-01604
2011: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year2011-03-01808
Total number of active participants reported on line 7a of the Form 55002011-03-01541
Total of all active and inactive participants2011-03-01541
Total participants2011-03-01541
2010: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2010 401k membership
Total participants, beginning-of-year2010-03-01795
Total number of active participants reported on line 7a of the Form 55002010-03-01808
Total of all active and inactive participants2010-03-01808
Total participants2010-03-01808
Total participants, beginning-of-year2010-02-01795
Total number of active participants reported on line 7a of the Form 55002010-02-01795
Total of all active and inactive participants2010-02-01795
Total participants2010-02-01795
2009: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year2009-02-01534
Total number of active participants reported on line 7a of the Form 55002009-02-01536
Total of all active and inactive participants2009-02-01536
Total participants2009-02-01536

Form 5500 Responses for ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY

2022: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – InsuranceYes
2021: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2017: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-03-01Type of plan entitySingle employer plan
2013-03-01Submission has been amendedNo
2013-03-01This submission is the final filingNo
2013-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-03-01Plan is a collectively bargained planNo
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Submission has been amendedNo
2012-03-01This submission is the final filingNo
2012-03-01This return/report is a short plan year return/report (less than 12 months)No
2012-03-01Plan is a collectively bargained planNo
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Submission has been amendedNo
2011-03-01This submission is the final filingNo
2011-03-01This return/report is a short plan year return/report (less than 12 months)No
2011-03-01Plan is a collectively bargained planNo
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2010: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2010 form 5500 responses
2010-03-01Type of plan entitySingle employer plan
2010-03-01Submission has been amendedYes
2010-03-01This submission is the final filingNo
2010-03-01This return/report is a short plan year return/report (less than 12 months)No
2010-03-01Plan is a collectively bargained planNo
2010-03-01Plan funding arrangement – InsuranceYes
2010-03-01Plan benefit arrangement – InsuranceYes
2010-02-01Type of plan entitySingle employer plan
2010-02-01Submission has been amendedYes
2010-02-01This submission is the final filingNo
2010-02-01This return/report is a short plan year return/report (less than 12 months)Yes
2010-02-01Plan is a collectively bargained planNo
2010-02-01Plan funding arrangement – InsuranceYes
2010-02-01Plan benefit arrangement – InsuranceYes
2009: ENCANTO RESTAURANTS, INC. LONG TERM DISABILITY 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 )
Policy contract numberLTDR2-1505001
Policy instance 1
Insurance contract or identification numberLTDR2-1505001
Number of Individuals Covered343
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $2,458
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $2,458
Insurance broker organization code?3
TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 )
Policy contract numberLTDR2-1505001
Policy instance 1
Insurance contract or identification numberLTDR2-1505001
Number of Individuals Covered353
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $2,640
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $2,640
Insurance broker organization code?3
TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 )
Policy contract numberLTDR2-1505001
Policy instance 1
Insurance contract or identification numberLTDR2-1505001
Number of Individuals Covered453
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $2,853
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $1,922
Insurance broker organization code?3
TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 )
Policy contract numberLTDR2-1505001-0
Policy instance 1
Insurance contract or identification numberLTDR2-1505001-0
Number of Individuals Covered450
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $2,619
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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
TRIPLE-S, VIDA, INC. (National Association of Insurance Commissioners NAIC id number: 73814 )
Policy contract numberLTDR2-1505001-0
Policy instance 1
Insurance contract or identification numberLTDR2-1505001-0
Number of Individuals Covered452
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $2,174
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $2,174
Insurance broker organization code?3
Insurance broker nameCHRISTIANSEN INSURANCE, INC.
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract numberLTD-1003-0196
Policy instance 1
Insurance contract or identification numberLTD-1003-0196
Number of Individuals Covered537
Insurance policy start date2015-04-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $620
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $620
Insurance broker organization code?3
Insurance broker nameCHRISTIANSEN INSURANCE, INC.
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1003-0196
Policy instance 1
Insurance contract or identification number1003-0196
Number of Individuals Covered465
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $7,721
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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
Amount paid for insurance broker fees7721
Insurance broker organization code?3
Insurance broker nameCHRISTIANSEN INSURANCE, INC.
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1003-0196
Policy instance 1
Insurance contract or identification number1003-0196
Number of Individuals Covered537
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $7,718
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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
Amount paid for insurance broker fees7718
Insurance broker organization code?3
Insurance broker nameCHRISTIANSEN INSURANCE INC.
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1003-0196
Policy instance 1
Insurance contract or identification number1003-0196
Number of Individuals Covered537
Insurance policy start date2013-03-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $579
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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
Amount paid for insurance broker fees579
Insurance broker organization code?3
Insurance broker nameCHRISTIANSEN INSURANCE, INC.
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1003-0196
Policy instance 1
Insurance contract or identification number1003-0196
Number of Individuals Covered604
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $7,025
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Amount paid for insurance broker fees7025
Insurance broker organization code?3
Insurance broker nameCHRISTIANSEN INSURANCE INC.
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number196
Policy instance 1
Insurance contract or identification number196
Number of Individuals Covered541
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $7,469
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number196
Policy instance 1
Insurance contract or identification number196
Number of Individuals Covered808
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $7,378
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,378
Insurance broker organization code?3
Insurance broker nameCHRISTIANSEN INSURANCE, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK961227
Policy instance 1
Insurance contract or identification numberOK961227
Number of Individuals Covered795
Insurance policy start date2010-02-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $192
Total amount of fees paid to insurance companyUSD $228
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $192
Additional information about fees paid to insurance brokerSALES & SERVICE OVERRIDE
Insurance broker organization code?3
Amount paid for insurance broker fees228
Insurance broker nameSIMONPIETRI INSURANCE AGENCY

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