KEPPEL AMFELS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-03-01 | 418 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-03-01 | 447 |
| Number of retired or separated participants receiving benefits | 2022-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-03-01 | 0 |
| Total of all active and inactive participants | 2022-03-01 | 447 |
| Number of employers contributing to the scheme | 2022-03-01 | 0 |
| 2021: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-03-01 | 351 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-03-01 | 418 |
| Number of retired or separated participants receiving benefits | 2021-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-03-01 | 0 |
| Total of all active and inactive participants | 2021-03-01 | 418 |
| Number of employers contributing to the scheme | 2021-03-01 | 0 |
| 2020: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-03-01 | 353 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 351 |
| Number of retired or separated participants receiving benefits | 2020-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-03-01 | 0 |
| Total of all active and inactive participants | 2020-03-01 | 351 |
| Number of employers contributing to the scheme | 2020-03-01 | 0 |
| 2019: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-03-01 | 234 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 306 |
| Total of all active and inactive participants | 2019-03-01 | 306 |
| 2018: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-03-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 234 |
| Total of all active and inactive participants | 2018-03-01 | 234 |
| 2017: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 652 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 232 |
| Total of all active and inactive participants | 2017-03-01 | 232 |
| 2016: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 601 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 652 |
| Total of all active and inactive participants | 2016-03-01 | 652 |
| 2015: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 678 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 601 |
| Total of all active and inactive participants | 2015-03-01 | 601 |
| 2014: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 674 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 678 |
| Total of all active and inactive participants | 2014-03-01 | 678 |
| 2013: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 665 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 674 |
| Total of all active and inactive participants | 2013-03-01 | 674 |
| 2012: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 528 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 665 |
| Total of all active and inactive participants | 2012-03-01 | 665 |
| 2011: KEPPEL AMFELS LLC EMPLOYEE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 650 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 528 |
| Number of retired or separated participants receiving benefits | 2011-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-03-01 | 0 |
| Total of all active and inactive participants | 2011-03-01 | 528 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 585074 |
| Policy instance | 3 |
| Insurance contract or identification number | 585074 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $6,538 | | Total amount of fees paid to insurance company | USD $2,575 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,478 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,538 | | Amount paid for insurance broker fees | 2575 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL110008904 |
| Policy instance | 2 |
| Insurance contract or identification number | ESL110008904 | | Number of Individuals Covered | 364 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $6,126 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $61,272 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,063 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 893306G |
| Policy instance | 1 |
| Insurance contract or identification number | 893306G | | Number of Individuals Covered | 447 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $9,477 | | Total amount of fees paid to insurance company | USD $9,224 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $184,481 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,477 | | Amount paid for insurance broker fees | 9224 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 585074 |
| Policy instance | 3 |
| Insurance contract or identification number | 585074 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $9,022 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,074 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,022 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 893306G |
| Policy instance | 1 |
| Insurance contract or identification number | 893306G | | Number of Individuals Covered | 418 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $11,992 | | Total amount of fees paid to insurance company | USD $21,340 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $193,207 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,992 | | Amount paid for insurance broker fees | 21340 | | Additional information about fees paid to insurance broker | FEES, BONUS | | Insurance broker organization code? | 3 |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL110008904 |
| Policy instance | 2 |
| Insurance contract or identification number | ESL110008904 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $5,734 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $57,350 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,867 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5957794 |
| Policy instance | 2 |
| Insurance contract or identification number | 5957794 | | Number of Individuals Covered | 220 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $7,825 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $78,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,825 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL110008902 |
| Policy instance | 1 |
| Insurance contract or identification number | ESL110008902 | | Number of Individuals Covered | 307 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $4,380 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $43,803 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,190 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 22390 |
| Policy instance | 3 |
| Insurance contract or identification number | 22390 | | Number of Individuals Covered | 351 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $21,832 | | Total amount of fees paid to insurance company | USD $295 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $229,743 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,832 | | Amount paid for insurance broker fees | 295 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 2 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $8,665 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,415 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,312 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 1 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 306 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $10,524 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $120,035 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,933 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 3 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $488 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,123 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $468 | | Insurance broker organization code? | 3 |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL110008902 |
| Policy instance | 4 |
| Insurance contract or identification number | ESL110008902 | | Number of Individuals Covered | 293 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $3,078 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $30,789 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,539 | | Insurance broker organization code? | 3 |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NIS130402 |
| Policy instance | 5 |
| Insurance contract or identification number | NIS130402 | | Number of Individuals Covered | 295 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $282,001 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5957794 |
| Policy instance | 6 |
| Insurance contract or identification number | 5957794 | | Number of Individuals Covered | 237 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $5,789 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,505 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,789 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 2 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-02-01 | | Total amount of commissions paid to insurance broker | USD $6,654 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,337 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 1 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $8,744 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,978 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,083 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 3 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $316 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $301 | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 947-3267 |
| Policy instance | 4 |
| Insurance contract or identification number | 947-3267 | | Number of Individuals Covered | 211 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $7,419 | | Welfare Benefit Premiums Paid to Carrier | USD $256,138 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 7419 | | Additional information about fees paid to insurance broker | OTHER FEES | | Insurance broker organization code? | 3 |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL110008901 |
| Policy instance | 5 |
| Insurance contract or identification number | ESL110008901 | | Number of Individuals Covered | 211 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $1,696 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $16,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $848 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755113 |
| Policy instance | 6 |
| Insurance contract or identification number | 755113 | | Number of Individuals Covered | 87 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $4,565 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,565 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755113 |
| Policy instance | 7 |
| Insurance contract or identification number | 755113 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $467 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,670 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $467 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3608866 |
| Policy instance | 8 |
| Insurance contract or identification number | E3608866 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $101 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | OTHER INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $2,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53 | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3586476 |
| Policy instance | 9 |
| Insurance contract or identification number | E3586476 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $220 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $4,693 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $92 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 2 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-02-01 | | Total amount of commissions paid to insurance broker | USD $6,436 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,573 | | Insurance broker organization code? | 3 | | Insurance broker name | BOWEN, MICLETTE & BRITT INSURANCE |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 3 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-02-01 | | Total amount of commissions paid to insurance broker | USD $178 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,135 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $131 | | Insurance broker organization code? | 3 | | Insurance broker name | BOWEN, MICLETTE & BRITT INSURANCE |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 947-4644 |
| Policy instance | 4 |
| Insurance contract or identification number | 947-4644 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $200,181 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL110008900 |
| Policy instance | 5 |
| Insurance contract or identification number | ESL110008900 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $1,704 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $17,041 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $852 | | Insurance broker organization code? | 3 | | Insurance broker name | GPA |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755113 |
| Policy instance | 6 |
| Insurance contract or identification number | 755113 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $4,232 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $42,324 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,512 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 1 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-02-01 | | Total amount of commissions paid to insurance broker | USD $7,795 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $73,870 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,010 | | Insurance broker organization code? | 3 | | Insurance broker name | BOWEN, MICLETTE & BRITT INSURANCE |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 4 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-02-01 | | Total amount of commissions paid to insurance broker | USD $1,620 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,796 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,620 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 227558 |
| Policy instance | 6 |
| Insurance contract or identification number | 227558 | | Number of Individuals Covered | 194 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $10,609 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $100,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,609 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN FRED |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 3 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-02-01 | | Total amount of commissions paid to insurance broker | USD $15,312 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $118,181 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,312 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 2 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 261 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-02-01 | | Total amount of commissions paid to insurance broker | USD $10,601 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $131,503 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,601 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66974-1 |
| Policy instance | 1 |
| Insurance contract or identification number | 66974-1 | | Number of Individuals Covered | 601 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $560,004 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 ) |
| Policy contract number | OTSIHCRS0010 |
| Policy instance | 5 |
| Insurance contract or identification number | OTSIHCRS0010 | | Number of Individuals Covered | 592 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $4,590 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $45,911 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,295 | | Insurance broker organization code? | 3 | | Insurance broker name | GPA |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 227558 |
| Policy instance | 6 |
| Insurance contract or identification number | 227558 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $10,597 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $98,348 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,597 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN FRED |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 4 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-02-01 | | Total amount of commissions paid to insurance broker | USD $1,652 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,017 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,652 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 3 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 241 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-02-01 | | Total amount of commissions paid to insurance broker | USD $14,430 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $104,515 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,430 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 2 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 678 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-02-01 | | Total amount of commissions paid to insurance broker | USD $8,182 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $106,048 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,182 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 ) |
| Policy contract number | OTSHICRS0010-14 |
| Policy instance | 5 |
| Insurance contract or identification number | OTSHICRS0010-14 | | Number of Individuals Covered | 602 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $4,402 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $44,022 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,201 | | Insurance broker organization code? | 3 | | Insurance broker name | GPA |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66974-1 |
| Policy instance | 1 |
| Insurance contract or identification number | 66974-1 | | Number of Individuals Covered | 602 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $11,225 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $500,529 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 11225 | | Additional information about fees paid to insurance broker | OVERWRITE FEE | | Insurance broker organization code? | 3 | | Insurance broker name | GPA |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66974-1 |
| Policy instance | 1 |
| Insurance contract or identification number | 66974-1 | | Number of Individuals Covered | 540 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $380,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 227558 |
| Policy instance | 6 |
| Insurance contract or identification number | 227558 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $9,017 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $93,365 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,017 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN FRED |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 949-5928 |
| Policy instance | 5 |
| Insurance contract or identification number | 949-5928 | | Number of Individuals Covered | 540 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $6,146 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $61,486 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,073 | | Insurance broker organization code? | 3 | | Insurance broker name | GPA |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 3 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 239 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-02-01 | | Total amount of commissions paid to insurance broker | USD $10,824 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $72,161 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,824 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 4 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-02-01 | | Total amount of commissions paid to insurance broker | USD $915 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,099 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $915 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 2 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 674 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-02-01 | | Total amount of commissions paid to insurance broker | USD $7,320 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,999 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,320 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66974-1 |
| Policy instance | 1 |
| Insurance contract or identification number | 66974-1 | | Number of Individuals Covered | 499 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $338,060 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 3 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2013-01-01 | | Total amount of commissions paid to insurance broker | USD $9,792 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,792 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 4 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2012-02-01 | | Insurance policy end date | 2013-02-01 | | Total amount of commissions paid to insurance broker | USD $983 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $983 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 2 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 665 | | Insurance policy start date | 2011-12-31 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $6,935 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76,931 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,935 | | Insurance broker organization code? | 3 | | Insurance broker name | LANDON K OVERBY |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66974-1 |
| Policy instance | 1 |
| Insurance contract or identification number | 66974-1 | | Number of Individuals Covered | 428 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $309,377 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 2 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 528 | | Insurance policy start date | 2010-12-31 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $5,734 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,433 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 3 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2012-01-01 | | Total amount of commissions paid to insurance broker | USD $8,327 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 4 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 35 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-02-01 | | Total amount of commissions paid to insurance broker | USD $623 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,152 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022388 |
| Policy instance | 2 |
| Insurance contract or identification number | 022388 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2011-01-01 | | Total amount of commissions paid to insurance broker | USD $9,691 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,607 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022389 |
| Policy instance | 1 |
| Insurance contract or identification number | 022389 | | Number of Individuals Covered | 20 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 022390 |
| Policy instance | 3 |
| Insurance contract or identification number | 022390 | | Number of Individuals Covered | 650 | | Insurance policy start date | 2009-12-31 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $7,309 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 66974-1 |
| Policy instance | 4 |
| Insurance contract or identification number | 66974-1 | | Number of Individuals Covered | 557 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Welfare Benefit Premiums Paid to Carrier | USD $358,314 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
