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ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN
Plan identification number 501

ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

ALLIANCE MAINTENANCE, INC. has sponsored the creation of one or more 401k plans.

Company Name:ALLIANCE MAINTENANCE, INC.
Employer identification number (EIN):731344797
NAIC Classification:561720
NAIC Description:Janitorial Services

Additional information about ALLIANCE MAINTENANCE, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 2016-01-05
Company Identification Number: 4873320
Legal Registered Office Address: 2 SKILLMAN ST
Kings
BROOKLYN
United States of America (USA)
11205

More information about ALLIANCE MAINTENANCE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-12-26EDWARD NEIL BOYD2019-06-18
5012016-12-26EDWARD NEIL BOYD
5012015-12-26EDWARD NEIL BOYD
5012014-12-26EDWARD NEIL BOYD
5012013-12-26EDWARD NEIL BOYD
5012012-12-26EDWARD NEIL BOYD
5012011-12-26EDWARD NEIL BOYD
5012009-12-26EDWARD NEIL BOYD
5012008-12-26

Plan Statistics for ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN

Measure Date Value
2017: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-262
Total number of active participants reported on line 7a of the Form 55002017-12-260
Number of retired or separated participants receiving benefits2017-12-260
Number of other retired or separated participants entitled to future benefits2017-12-260
Total of all active and inactive participants2017-12-260
2016: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-262
Total number of active participants reported on line 7a of the Form 55002016-12-262
Number of retired or separated participants receiving benefits2016-12-260
Number of other retired or separated participants entitled to future benefits2016-12-260
Total of all active and inactive participants2016-12-262
2015: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-262
Total number of active participants reported on line 7a of the Form 55002015-12-262
Number of retired or separated participants receiving benefits2015-12-260
Number of other retired or separated participants entitled to future benefits2015-12-260
Total of all active and inactive participants2015-12-262
2014: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-12-262
Total number of active participants reported on line 7a of the Form 55002014-12-262
Number of retired or separated participants receiving benefits2014-12-260
Number of other retired or separated participants entitled to future benefits2014-12-260
Total of all active and inactive participants2014-12-262
2013: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-12-262
Total number of active participants reported on line 7a of the Form 55002013-12-262
Number of retired or separated participants receiving benefits2013-12-260
Number of other retired or separated participants entitled to future benefits2013-12-260
Total of all active and inactive participants2013-12-262
2012: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-12-262
Total number of active participants reported on line 7a of the Form 55002012-12-262
Number of retired or separated participants receiving benefits2012-12-260
Number of other retired or separated participants entitled to future benefits2012-12-260
Total of all active and inactive participants2012-12-262
2011: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-12-262
Total number of active participants reported on line 7a of the Form 55002011-12-262
Number of retired or separated participants receiving benefits2011-12-260
Number of other retired or separated participants entitled to future benefits2011-12-260
Total of all active and inactive participants2011-12-262
2009: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-12-261
Total number of active participants reported on line 7a of the Form 55002009-12-261
Number of retired or separated participants receiving benefits2009-12-260
Number of other retired or separated participants entitled to future benefits2009-12-260
Total of all active and inactive participants2009-12-261

Financial Data on ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN

Measure Date Value
2017 : ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-25$478,356
Total plan liabilities at beginning of year2017-12-25$456,642
Total income from all sources2017-12-25$0
Expenses. Total of all expenses incurred2017-12-25$0
Total plan assets at end of year2017-12-25$478,356
Total plan assets at beginning of year2017-12-25$456,642
Net income (gross income less expenses)2017-12-25$0
Net plan assets at end of year (total assets less liabilities)2017-12-25$0
Net plan assets at beginning of year (total assets less liabilities)2017-12-25$0
2016 : ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-25$456,642
Total plan liabilities at beginning of year2016-12-25$442,931
Total income from all sources2016-12-25$0
Expenses. Total of all expenses incurred2016-12-25$0
Total plan assets at end of year2016-12-25$456,642
Total plan assets at beginning of year2016-12-25$442,931
Net income (gross income less expenses)2016-12-25$0
Net plan assets at end of year (total assets less liabilities)2016-12-25$0
Net plan assets at beginning of year (total assets less liabilities)2016-12-25$0
2015 : ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-25$442,931
Total plan liabilities at beginning of year2015-12-25$431,352
Total income from all sources2015-12-25$0
Expenses. Total of all expenses incurred2015-12-25$0
Total plan assets at end of year2015-12-25$442,931
Total plan assets at beginning of year2015-12-25$431,352
Net income (gross income less expenses)2015-12-25$0
Net plan assets at end of year (total assets less liabilities)2015-12-25$0
Net plan assets at beginning of year (total assets less liabilities)2015-12-25$0
2014 : ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-25$431,352
Total plan liabilities at beginning of year2014-12-25$783,758
Total income from all sources2014-12-25$0
Expenses. Total of all expenses incurred2014-12-25$0
Total plan assets at end of year2014-12-25$431,352
Total plan assets at beginning of year2014-12-25$783,758
Net income (gross income less expenses)2014-12-25$0
Net plan assets at end of year (total assets less liabilities)2014-12-25$0
Net plan assets at beginning of year (total assets less liabilities)2014-12-25$0
2013 : ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-25$783,758
Total plan liabilities at beginning of year2013-12-25$677,556
Total income from all sources2013-12-25$9,412
Expenses. Total of all expenses incurred2013-12-25$9,412
Total plan assets at end of year2013-12-25$783,758
Total plan assets at beginning of year2013-12-25$677,556
Expenses. Other expenses not covered elsewhere2013-12-25$8,022
Net income (gross income less expenses)2013-12-25$0
Net plan assets at end of year (total assets less liabilities)2013-12-25$0
Net plan assets at beginning of year (total assets less liabilities)2013-12-25$0
Total contributions received or receivable from employer(s)2013-12-25$9,412
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-25$1,390
2012 : ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-25$677,556
Total plan liabilities at beginning of year2012-12-25$666,608
Total income from all sources2012-12-25$9,941
Expenses. Total of all expenses incurred2012-12-25$9,941
Total plan assets at end of year2012-12-25$677,556
Total plan assets at beginning of year2012-12-25$666,608
Expenses. Other expenses not covered elsewhere2012-12-25$8,581
Other income received2012-12-25$2
Net income (gross income less expenses)2012-12-25$0
Net plan assets at end of year (total assets less liabilities)2012-12-25$0
Net plan assets at beginning of year (total assets less liabilities)2012-12-25$0
Total contributions received or receivable from employer(s)2012-12-25$9,939
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-25$1,360
2011 : ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-25$584,835
Total plan liabilities at beginning of year2011-12-25$523,988
Total income from all sources2011-12-25$251,360
Expenses. Total of all expenses incurred2011-12-25$251,360
Total plan assets at end of year2011-12-25$584,835
Total plan assets at beginning of year2011-12-25$523,988
Expenses. Other expenses not covered elsewhere2011-12-25$250,000
Net income (gross income less expenses)2011-12-25$0
Net plan assets at end of year (total assets less liabilities)2011-12-25$0
Net plan assets at beginning of year (total assets less liabilities)2011-12-25$0
Total contributions received or receivable from employer(s)2011-12-25$251,360
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-25$1,360

Form 5500 Responses for ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN

2017: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-12-26Type of plan entitySingle employer plan
2017-12-26Submission has been amendedNo
2017-12-26This submission is the final filingYes
2017-12-26This return/report is a short plan year return/report (less than 12 months)Yes
2017-12-26Plan is a collectively bargained planNo
2017-12-26Plan funding arrangement – InsuranceYes
2017-12-26Plan funding arrangement – TrustYes
2017-12-26Plan benefit arrangement – InsuranceYes
2017-12-26Plan benefit arrangement - TrustYes
2016: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-12-26Type of plan entitySingle employer plan
2016-12-26Submission has been amendedNo
2016-12-26This submission is the final filingNo
2016-12-26This return/report is a short plan year return/report (less than 12 months)No
2016-12-26Plan is a collectively bargained planNo
2016-12-26Plan funding arrangement – InsuranceYes
2016-12-26Plan funding arrangement – TrustYes
2016-12-26Plan benefit arrangement – InsuranceYes
2016-12-26Plan benefit arrangement - TrustYes
2015: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-12-26Type of plan entitySingle employer plan
2015-12-26Submission has been amendedNo
2015-12-26This submission is the final filingNo
2015-12-26This return/report is a short plan year return/report (less than 12 months)No
2015-12-26Plan is a collectively bargained planNo
2015-12-26Plan funding arrangement – InsuranceYes
2015-12-26Plan funding arrangement – TrustYes
2015-12-26Plan benefit arrangement – InsuranceYes
2015-12-26Plan benefit arrangement - TrustYes
2014: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-12-26Type of plan entitySingle employer plan
2014-12-26Submission has been amendedNo
2014-12-26This submission is the final filingNo
2014-12-26This return/report is a short plan year return/report (less than 12 months)No
2014-12-26Plan is a collectively bargained planNo
2014-12-26Plan funding arrangement – InsuranceYes
2014-12-26Plan funding arrangement – TrustYes
2014-12-26Plan benefit arrangement – InsuranceYes
2014-12-26Plan benefit arrangement - TrustYes
2013: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-12-26Type of plan entitySingle employer plan
2013-12-26Submission has been amendedNo
2013-12-26This submission is the final filingNo
2013-12-26This return/report is a short plan year return/report (less than 12 months)No
2013-12-26Plan is a collectively bargained planNo
2013-12-26Plan funding arrangement – InsuranceYes
2013-12-26Plan funding arrangement – TrustYes
2013-12-26Plan benefit arrangement – InsuranceYes
2013-12-26Plan benefit arrangement - TrustYes
2012: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-12-26Type of plan entitySingle employer plan
2012-12-26Submission has been amendedNo
2012-12-26This submission is the final filingNo
2012-12-26This return/report is a short plan year return/report (less than 12 months)No
2012-12-26Plan is a collectively bargained planNo
2012-12-26Plan funding arrangement – InsuranceYes
2012-12-26Plan funding arrangement – TrustYes
2012-12-26Plan benefit arrangement – InsuranceYes
2012-12-26Plan benefit arrangement - TrustYes
2011: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-12-26Type of plan entitySingle employer plan
2011-12-26Submission has been amendedNo
2011-12-26This submission is the final filingNo
2011-12-26This return/report is a short plan year return/report (less than 12 months)No
2011-12-26Plan is a collectively bargained planNo
2011-12-26Plan funding arrangement – InsuranceYes
2011-12-26Plan funding arrangement – TrustYes
2011-12-26Plan benefit arrangement – InsuranceYes
2011-12-26Plan benefit arrangement - TrustYes
2009: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-12-26Type of plan entitySingle employer plan
2009-12-26Submission has been amendedNo
2009-12-26This submission is the final filingNo
2009-12-26This return/report is a short plan year return/report (less than 12 months)No
2009-12-26Plan is a collectively bargained planNo
2009-12-26Plan funding arrangement – InsuranceYes
2009-12-26Plan funding arrangement – TrustYes
2009-12-26Plan benefit arrangement – InsuranceYes
2009-12-26Plan benefit arrangement - TrustYes
2008: ALLIANCE MAINTENANCE, INC. WELFARE BENEFIT PLAN 2008 form 5500 responses
2008-12-26Type of plan entitySingle employer plan
2008-12-26Submission has been amendedNo
2008-12-26This submission is the final filingNo
2008-12-26This return/report is a short plan year return/report (less than 12 months)No
2008-12-26Plan is a collectively bargained planNo

Insurance Providers Used on plan

NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number705830700
Policy instance 1
Insurance contract or identification number705830700
Number of Individuals Covered0
Insurance policy start date2017-12-26
Insurance policy end date2018-02-21
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number705830700
Policy instance 1
Insurance contract or identification number705830700
Number of Individuals Covered2
Insurance policy start date2015-12-26
Insurance policy end date2016-12-25
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number705830700
Policy instance 1
Insurance contract or identification number705830700
Number of Individuals Covered2
Insurance policy start date2014-12-26
Insurance policy end date2015-12-25
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SECURITY LIFE OF DENVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68713 )
Policy contract number610075973
Policy instance 1
Insurance contract or identification number610075973
Number of Individuals Covered2
Insurance policy start date2013-12-26
Insurance policy end date2014-12-25
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
Insurance broker name
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number705830700
Policy instance 2
Insurance contract or identification number705830700
Number of Individuals Covered2
Insurance policy start date2013-12-26
Insurance policy end date2014-12-25
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number705830700
Policy instance 2
Insurance contract or identification number705830700
Number of Individuals Covered2
Insurance policy start date2012-12-26
Insurance policy end date2013-12-25
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSCOTT DUNCAN
SECURITY LIFE OF DENVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68713 )
Policy contract number610075973
Policy instance 1
Insurance contract or identification number610075973
Number of Individuals Covered2
Insurance policy start date2012-12-26
Insurance policy end date2013-12-25
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,390
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1390
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?5
Insurance broker nameSCOTT DUNCAN
SECURITY LIFE OF DENVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68713 )
Policy contract number610075973
Policy instance 1
Insurance contract or identification number610075973
Number of Individuals Covered1
Insurance policy start date2011-12-26
Insurance policy end date2012-12-25
Total amount of commissions paid to insurance brokerUSD $637
Total amount of fees paid to insurance companyUSD $1,360
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number705830700
Policy instance 2
Insurance contract or identification number705830700
Number of Individuals Covered1
Insurance policy start date2011-12-26
Insurance policy end date2012-12-25
Total amount of commissions paid to insurance brokerUSD $72
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SECURITY LIFE OF DENVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68713 )
Policy contract number610075973
Policy instance 1
Insurance contract or identification number610075973
Number of Individuals Covered1
Insurance policy start date2010-12-29
Insurance policy end date2011-12-25
Total amount of commissions paid to insurance brokerUSD $387
Total amount of fees paid to insurance companyUSD $1,360
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedANNUITY
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
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number763018X
Policy instance 2
Insurance contract or identification number763018X
Number of Individuals Covered763018
Insurance policy start date2010-12-26
Insurance policy end date2011-12-25
Total amount of commissions paid to insurance brokerUSD $4,900
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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
Other welfare benefits providedANNUITY
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

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