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QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameQUAPAW COMPANY EMPLOYEE BENEFIT PLAN
Plan identification number 503

QUAPAW COMPANY EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

QUAPAW COMPANY, INC has sponsored the creation of one or more 401k plans.

Company Name:QUAPAW COMPANY, INC
Employer identification number (EIN):730592341
NAIC Classification:212310
NAIC Description: Stone Mining and Quarrying

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QUAPAW COMPANY EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032020-01-01
5032019-01-01
5032018-01-01ROBERT CHILDRESS ROBERT CHILDRESS2019-05-13
5032017-01-01ROBERT CHILDRESS ROBERT CHILDRESS2018-05-17
5032016-01-01ROBERT CHILDRESS ROBERT CHILDRESS2017-04-20
5032015-01-01ROBERT CHILDRESS ROBERT CHILDRESS2016-04-21
5032014-01-01ROBERT CHILDRESS
5032013-01-01ROBERT CHILDRESS ROBERT CHILDRESS2014-06-13
5032012-01-01ROBERT CHILDRESS ROBERT CHILDRESS2013-06-17
5032011-01-01ROBERT CHILDRESS
5032009-01-01ROBERT CHILDRESS ROBERT CHILDRESS2010-06-16

Plan Statistics for QUAPAW COMPANY EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for QUAPAW COMPANY EMPLOYEE BENEFIT PLAN

Measure Date Value
2020: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0143
Total number of active participants reported on line 7a of the Form 55002020-01-010
Total of all active and inactive participants2020-01-010
Total participants2020-01-010
2019: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0153
Total number of active participants reported on line 7a of the Form 55002019-01-0143
Total of all active and inactive participants2019-01-0143
Total participants2019-01-0143
2018: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0157
Total number of active participants reported on line 7a of the Form 55002018-01-0153
Total of all active and inactive participants2018-01-0153
Total participants2018-01-0153
2017: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0166
Total number of active participants reported on line 7a of the Form 55002017-01-0157
Total of all active and inactive participants2017-01-0157
Total participants2017-01-0157
2016: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0164
Total number of active participants reported on line 7a of the Form 55002016-01-0166
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0166
2015: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0160
Total number of active participants reported on line 7a of the Form 55002015-01-0164
Total of all active and inactive participants2015-01-0164
Total participants2015-01-0164
2014: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0148
Total number of active participants reported on line 7a of the Form 55002014-01-0160
Total of all active and inactive participants2014-01-0160
Total participants2014-01-0160
2013: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0152
Total number of active participants reported on line 7a of the Form 55002013-01-0148
Total of all active and inactive participants2013-01-0148
Total participants2013-01-0148
2012: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0154
Total number of active participants reported on line 7a of the Form 55002012-01-0152
Total of all active and inactive participants2012-01-0152
Total participants2012-01-0152
2011: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0161
Total number of active participants reported on line 7a of the Form 55002011-01-0152
Number of retired or separated participants receiving benefits2011-01-012
Total of all active and inactive participants2011-01-0154
Total participants2011-01-0154
2009: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0156
Total number of active participants reported on line 7a of the Form 55002009-01-0155
Number of retired or separated participants receiving benefits2009-01-011
Total of all active and inactive participants2009-01-0156
Total participants2009-01-0156

Financial Data on QUAPAW COMPANY EMPLOYEE BENEFIT PLAN

Measure Date Value
2020 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2020 401k financial data
Total income from all sources2020-06-30$330,437
Expenses. Total of all expenses incurred2020-06-30$354,518
Benefits paid (including direct rollovers)2020-06-30$345,647
Total plan assets at end of year2020-06-30$0
Total plan assets at beginning of year2020-06-30$24,081
Total contributions received or receivable from participants2020-06-30$26,806
Expenses. Other expenses not covered elsewhere2020-06-30$8,871
Other income received2020-06-30$12
Net income (gross income less expenses)2020-06-30$-24,081
Net plan assets at end of year (total assets less liabilities)2020-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-06-30$24,081
Total contributions received or receivable from employer(s)2020-06-30$303,619
2019 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2019 401k financial data
Total income from all sources2019-12-31$974,452
Expenses. Total of all expenses incurred2019-12-31$967,435
Benefits paid (including direct rollovers)2019-12-31$950,827
Total plan assets at end of year2019-12-31$24,081
Total plan assets at beginning of year2019-12-31$17,064
Total contributions received or receivable from participants2019-12-31$62,030
Expenses. Other expenses not covered elsewhere2019-12-31$16,608
Other income received2019-12-31$30
Net income (gross income less expenses)2019-12-31$7,017
Net plan assets at end of year (total assets less liabilities)2019-12-31$24,081
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$17,064
Total contributions received or receivable from employer(s)2019-12-31$912,392
2018 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$702,714
Expenses. Total of all expenses incurred2018-12-31$770,037
Benefits paid (including direct rollovers)2018-12-31$752,308
Total plan assets at end of year2018-12-31$17,064
Total plan assets at beginning of year2018-12-31$84,387
Total contributions received or receivable from participants2018-12-31$64,338
Expenses. Other expenses not covered elsewhere2018-12-31$17,729
Other income received2018-12-31$23
Net income (gross income less expenses)2018-12-31$-67,323
Net plan assets at end of year (total assets less liabilities)2018-12-31$17,064
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$84,387
Total contributions received or receivable from employer(s)2018-12-31$638,353
2017 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$883,410
Expenses. Total of all expenses incurred2017-12-31$838,805
Benefits paid (including direct rollovers)2017-12-31$819,547
Total plan assets at end of year2017-12-31$84,387
Total plan assets at beginning of year2017-12-31$39,782
Total contributions received or receivable from participants2017-12-31$63,255
Expenses. Other expenses not covered elsewhere2017-12-31$19,258
Other income received2017-12-31$17
Net income (gross income less expenses)2017-12-31$44,605
Net plan assets at end of year (total assets less liabilities)2017-12-31$84,387
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$39,782
Total contributions received or receivable from employer(s)2017-12-31$820,138
2016 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total income from all sources2016-12-31$560,964
Expenses. Total of all expenses incurred2016-12-31$566,256
Benefits paid (including direct rollovers)2016-12-31$545,880
Total plan assets at end of year2016-12-31$39,782
Total plan assets at beginning of year2016-12-31$45,074
Total contributions received or receivable from participants2016-12-31$62,805
Expenses. Other expenses not covered elsewhere2016-12-31$20,376
Other income received2016-12-31$14
Net income (gross income less expenses)2016-12-31$-5,292
Net plan assets at end of year (total assets less liabilities)2016-12-31$39,782
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$45,074
Total contributions received or receivable from employer(s)2016-12-31$498,145
2015 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total income from all sources2015-12-31$764,085
Expenses. Total of all expenses incurred2015-12-31$760,132
Benefits paid (including direct rollovers)2015-12-31$740,623
Total plan assets at end of year2015-12-31$45,074
Total plan assets at beginning of year2015-12-31$41,121
Total contributions received or receivable from participants2015-12-31$74,766
Expenses. Other expenses not covered elsewhere2015-12-31$19,509
Other income received2015-12-31$16
Net income (gross income less expenses)2015-12-31$3,953
Net plan assets at end of year (total assets less liabilities)2015-12-31$45,074
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$41,121
Total contributions received or receivable from employer(s)2015-12-31$689,303
2014 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2014 401k financial data
Total income from all sources2014-12-31$660,141
Expenses. Total of all expenses incurred2014-12-31$660,709
Benefits paid (including direct rollovers)2014-12-31$641,253
Total plan assets at end of year2014-12-31$41,121
Total plan assets at beginning of year2014-12-31$41,689
Total contributions received or receivable from participants2014-12-31$59,297
Expenses. Other expenses not covered elsewhere2014-12-31$19,456
Other income received2014-12-31$10
Net income (gross income less expenses)2014-12-31$-568
Net plan assets at end of year (total assets less liabilities)2014-12-31$41,121
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$41,689
Total contributions received or receivable from employer(s)2014-12-31$600,834
2013 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2013 401k financial data
Total income from all sources2013-12-31$539,845
Expenses. Total of all expenses incurred2013-12-31$551,680
Benefits paid (including direct rollovers)2013-12-31$538,698
Total plan assets at end of year2013-12-31$41,689
Total plan assets at beginning of year2013-12-31$53,524
Total contributions received or receivable from participants2013-12-31$45,730
Expenses. Other expenses not covered elsewhere2013-12-31$12,982
Other income received2013-12-31$13
Net income (gross income less expenses)2013-12-31$-11,835
Net plan assets at end of year (total assets less liabilities)2013-12-31$41,689
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$53,524
Total contributions received or receivable from employer(s)2013-12-31$494,102
2012 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$659,000
Expenses. Total of all expenses incurred2012-12-31$611,979
Benefits paid (including direct rollovers)2012-12-31$597,332
Total plan assets at end of year2012-12-31$53,524
Total plan assets at beginning of year2012-12-31$6,503
Total contributions received or receivable from participants2012-12-31$53,535
Expenses. Other expenses not covered elsewhere2012-12-31$14,647
Other income received2012-12-31$16
Net income (gross income less expenses)2012-12-31$47,021
Net plan assets at end of year (total assets less liabilities)2012-12-31$53,524
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$6,503
Total contributions received or receivable from employer(s)2012-12-31$605,449
2011 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$950,255
Expenses. Total of all expenses incurred2011-12-31$995,829
Benefits paid (including direct rollovers)2011-12-31$980,271
Total plan assets at end of year2011-12-31$6,503
Total plan assets at beginning of year2011-12-31$52,077
Total contributions received or receivable from participants2011-12-31$48,399
Expenses. Other expenses not covered elsewhere2011-12-31$15,558
Other income received2011-12-31$17
Net income (gross income less expenses)2011-12-31$-45,574
Net plan assets at end of year (total assets less liabilities)2011-12-31$6,503
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$52,077
Total contributions received or receivable from employer(s)2011-12-31$901,839
2010 : QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$1,317,869
Expenses. Total of all expenses incurred2010-12-31$1,275,431
Benefits paid (including direct rollovers)2010-12-31$1,260,371
Total plan assets at end of year2010-12-31$52,077
Total plan assets at beginning of year2010-12-31$9,639
Total contributions received or receivable from participants2010-12-31$31,784
Expenses. Other expenses not covered elsewhere2010-12-31$15,060
Other income received2010-12-31$34
Net income (gross income less expenses)2010-12-31$42,438
Net plan assets at end of year (total assets less liabilities)2010-12-31$52,077
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$9,639
Total contributions received or receivable from employer(s)2010-12-31$1,286,051

Form 5500 Responses for QUAPAW COMPANY EMPLOYEE BENEFIT PLAN

2020: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement - TrustYes
2015: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement - TrustYes
2014: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement - TrustYes
2013: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement - TrustYes
2012: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement - TrustYes
2011: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement - TrustYes
2009: QUAPAW COMPANY EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number28493
Policy instance 1
Insurance contract or identification number28493
Number of Individuals Covered41
Insurance policy start date2020-01-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $14,823
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 BenefitNo
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
Welfare Benefit Premiums Paid to CarrierUSD $108,697
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,118
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered43
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $28,493
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 BenefitNo
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
Welfare Benefit Premiums Paid to CarrierUSD $208,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,370
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered53
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $30,215
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 BenefitNo
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
Welfare Benefit Premiums Paid to CarrierUSD $221,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,658
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered57
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $35,112
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 BenefitNo
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
Welfare Benefit Premiums Paid to CarrierUSD $257,477
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,781
Insurance broker organization code?3
Insurance broker nameLARRY HAWKINS, DBA FEW, INC

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