ALLEGRO ASSOCIATES, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2020: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-15 | 0 |
| Number of retired or separated participants receiving benefits | 2020-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-12-15 | 0 |
| Total of all active and inactive participants | 2020-12-15 | 0 |
| 2019: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2019-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-12-15 | 0 |
| Total of all active and inactive participants | 2019-12-15 | 1 |
| 2018: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2018-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-12-15 | 0 |
| Total of all active and inactive participants | 2018-12-15 | 1 |
| 2017: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2017-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-12-15 | 0 |
| Total of all active and inactive participants | 2017-12-15 | 1 |
| 2016: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2016-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-12-15 | 0 |
| Total of all active and inactive participants | 2016-12-15 | 1 |
| 2015: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2015-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-12-15 | 0 |
| Total of all active and inactive participants | 2015-12-15 | 1 |
| 2014: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2014-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-12-15 | 0 |
| Total of all active and inactive participants | 2014-12-15 | 1 |
| 2013: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2013-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-12-15 | 0 |
| Total of all active and inactive participants | 2013-12-15 | 1 |
| 2012: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2012-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-12-15 | 0 |
| Total of all active and inactive participants | 2012-12-15 | 1 |
| 2011: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2011-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-12-15 | 0 |
| Total of all active and inactive participants | 2011-12-15 | 1 |
| 2010: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2010-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-12-15 | 0 |
| Total of all active and inactive participants | 2010-12-15 | 1 |
| 2009: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-12-15 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-12-15 | 1 |
| Number of retired or separated participants receiving benefits | 2009-12-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-12-15 | 0 |
| Total of all active and inactive participants | 2009-12-15 | 1 |
| Measure | Date | Value |
|---|
| 2021 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-12-14 | $0 |
| Total plan liabilities at beginning of year | 2021-12-14 | $218,077 |
| Total income from all sources | 2021-12-14 | $-222,372 |
| Expenses. Total of all expenses incurred | 2021-12-14 | $-222,372 |
| Total plan assets at end of year | 2021-12-14 | $0 |
| Total plan assets at beginning of year | 2021-12-14 | $218,077 |
| Expenses. Other expenses not covered elsewhere | 2021-12-14 | $-222,372 |
| Noncash contributions received | 2021-12-14 | $-222,372 |
| Net income (gross income less expenses) | 2021-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-14 | $0 |
| 2020 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-12-14 | $218,077 |
| Total plan liabilities at beginning of year | 2020-12-14 | $209,394 |
| Total income from all sources | 2020-12-14 | $0 |
| Expenses. Total of all expenses incurred | 2020-12-14 | $0 |
| Total plan assets at end of year | 2020-12-14 | $218,077 |
| Total plan assets at beginning of year | 2020-12-14 | $209,394 |
| Net income (gross income less expenses) | 2020-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-14 | $0 |
| 2019 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-14 | $209,394 |
| Total plan liabilities at beginning of year | 2019-12-14 | $207,926 |
| Total income from all sources | 2019-12-14 | $0 |
| Expenses. Total of all expenses incurred | 2019-12-14 | $0 |
| Total plan assets at end of year | 2019-12-14 | $209,394 |
| Total plan assets at beginning of year | 2019-12-14 | $207,926 |
| Net income (gross income less expenses) | 2019-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-14 | $0 |
| 2017 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-12-14 | $202,547 |
| Total plan liabilities at beginning of year | 2017-12-14 | $198,978 |
| Total income from all sources | 2017-12-14 | $2,145 |
| Expenses. Total of all expenses incurred | 2017-12-14 | $2,145 |
| Total plan assets at end of year | 2017-12-14 | $202,547 |
| Total plan assets at beginning of year | 2017-12-14 | $198,978 |
| Expenses. Other expenses not covered elsewhere | 2017-12-14 | $2,145 |
| Net income (gross income less expenses) | 2017-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-14 | $0 |
| Total contributions received or receivable from employer(s) | 2017-12-14 | $2,145 |
| 2016 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-12-14 | $198,978 |
| Total plan liabilities at beginning of year | 2016-12-14 | $191,751 |
| Total income from all sources | 2016-12-14 | $0 |
| Expenses. Total of all expenses incurred | 2016-12-14 | $0 |
| Total plan assets at end of year | 2016-12-14 | $198,978 |
| Total plan assets at beginning of year | 2016-12-14 | $191,751 |
| Net income (gross income less expenses) | 2016-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-14 | $0 |
| 2015 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-12-14 | $191,751 |
| Total plan liabilities at beginning of year | 2015-12-14 | $191,751 |
| Total income from all sources | 2015-12-14 | $0 |
| Expenses. Total of all expenses incurred | 2015-12-14 | $0 |
| Total plan assets at end of year | 2015-12-14 | $191,751 |
| Total plan assets at beginning of year | 2015-12-14 | $191,751 |
| Net income (gross income less expenses) | 2015-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-14 | $0 |
| 2014 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2014 401k financial data |
|---|
| Total plan liabilities at end of year | 2014-12-14 | $191,751 |
| Total plan liabilities at beginning of year | 2014-12-14 | $196,462 |
| Total income from all sources | 2014-12-14 | $0 |
| Expenses. Total of all expenses incurred | 2014-12-14 | $0 |
| Total plan assets at end of year | 2014-12-14 | $191,751 |
| Total plan assets at beginning of year | 2014-12-14 | $196,462 |
| Net income (gross income less expenses) | 2014-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-14 | $0 |
| 2013 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2013 401k financial data |
|---|
| Total plan liabilities at end of year | 2013-12-14 | $196,462 |
| Total plan liabilities at beginning of year | 2013-12-14 | $196,457 |
| Total income from all sources | 2013-12-14 | $1,330 |
| Expenses. Total of all expenses incurred | 2013-12-14 | $1,330 |
| Total plan assets at end of year | 2013-12-14 | $196,462 |
| Total plan assets at beginning of year | 2013-12-14 | $196,457 |
| Net income (gross income less expenses) | 2013-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-14 | $0 |
| Total contributions received or receivable from employer(s) | 2013-12-14 | $1,330 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-14 | $1,330 |
| 2012 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2012 401k financial data |
|---|
| Total plan liabilities at end of year | 2012-12-14 | $196,457 |
| Total plan liabilities at beginning of year | 2012-12-14 | $158,551 |
| Total income from all sources | 2012-12-14 | $40,142 |
| Expenses. Total of all expenses incurred | 2012-12-14 | $40,142 |
| Total plan assets at end of year | 2012-12-14 | $196,457 |
| Total plan assets at beginning of year | 2012-12-14 | $158,551 |
| Expenses. Other expenses not covered elsewhere | 2012-12-14 | $40,142 |
| Other income received | 2012-12-14 | $17 |
| Net income (gross income less expenses) | 2012-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-14 | $0 |
| Total contributions received or receivable from employer(s) | 2012-12-14 | $40,125 |
| 2011 : ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2011 401k financial data |
|---|
| Total plan liabilities at end of year | 2011-12-14 | $158,551 |
| Total plan liabilities at beginning of year | 2011-12-14 | $137,212 |
| Total income from all sources | 2011-12-14 | $1 |
| Expenses. Total of all expenses incurred | 2011-12-14 | $1 |
| Total plan assets at end of year | 2011-12-14 | $158,551 |
| Total plan assets at beginning of year | 2011-12-14 | $137,212 |
| Expenses. Other expenses not covered elsewhere | 2011-12-14 | $1 |
| Other income received | 2011-12-14 | $1 |
| Net income (gross income less expenses) | 2011-12-14 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-14 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-14 | $0 |
| Total contributions received or receivable from employer(s) | 2011-12-14 | $0 |
| 2020: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-12-15 | Type of plan entity | Single employer plan |
| 2020-12-15 | Submission has been amended | No |
| 2020-12-15 | This submission is the final filing | Yes |
| 2020-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-12-15 | Plan is a collectively bargained plan | No |
| 2020-12-15 | Plan funding arrangement – Insurance | Yes |
| 2020-12-15 | Plan funding arrangement – Trust | Yes |
| 2020-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2020-12-15 | Plan benefit arrangement - Trust | Yes |
| 2019: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-12-15 | Type of plan entity | Single employer plan |
| 2019-12-15 | Submission has been amended | No |
| 2019-12-15 | This submission is the final filing | No |
| 2019-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-12-15 | Plan is a collectively bargained plan | No |
| 2019-12-15 | Plan funding arrangement – Insurance | Yes |
| 2019-12-15 | Plan funding arrangement – Trust | Yes |
| 2019-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2019-12-15 | Plan benefit arrangement - Trust | Yes |
| 2018: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-12-15 | Type of plan entity | Single employer plan |
| 2018-12-15 | Submission has been amended | No |
| 2018-12-15 | This submission is the final filing | No |
| 2018-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-12-15 | Plan is a collectively bargained plan | No |
| 2018-12-15 | Plan funding arrangement – Insurance | Yes |
| 2018-12-15 | Plan funding arrangement – Trust | Yes |
| 2018-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2018-12-15 | Plan benefit arrangement - Trust | Yes |
| 2017: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-12-15 | Type of plan entity | Single employer plan |
| 2017-12-15 | Submission has been amended | No |
| 2017-12-15 | This submission is the final filing | No |
| 2017-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-12-15 | Plan is a collectively bargained plan | No |
| 2017-12-15 | Plan funding arrangement – Insurance | Yes |
| 2017-12-15 | Plan funding arrangement – Trust | Yes |
| 2017-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2017-12-15 | Plan benefit arrangement - Trust | Yes |
| 2016: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-12-15 | Type of plan entity | Single employer plan |
| 2016-12-15 | Submission has been amended | No |
| 2016-12-15 | This submission is the final filing | No |
| 2016-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-12-15 | Plan is a collectively bargained plan | No |
| 2016-12-15 | Plan funding arrangement – Insurance | Yes |
| 2016-12-15 | Plan funding arrangement – Trust | Yes |
| 2016-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2016-12-15 | Plan benefit arrangement - Trust | Yes |
| 2015: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-12-15 | Type of plan entity | Single employer plan |
| 2015-12-15 | Submission has been amended | No |
| 2015-12-15 | This submission is the final filing | No |
| 2015-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-12-15 | Plan is a collectively bargained plan | No |
| 2015-12-15 | Plan funding arrangement – Insurance | Yes |
| 2015-12-15 | Plan funding arrangement – Trust | Yes |
| 2015-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2015-12-15 | Plan benefit arrangement - Trust | Yes |
| 2014: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-12-15 | Type of plan entity | Single employer plan |
| 2014-12-15 | Submission has been amended | No |
| 2014-12-15 | This submission is the final filing | No |
| 2014-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-12-15 | Plan is a collectively bargained plan | No |
| 2014-12-15 | Plan funding arrangement – Insurance | Yes |
| 2014-12-15 | Plan funding arrangement – Trust | Yes |
| 2014-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2014-12-15 | Plan benefit arrangement - Trust | Yes |
| 2013: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-12-15 | Type of plan entity | Single employer plan |
| 2013-12-15 | Submission has been amended | No |
| 2013-12-15 | This submission is the final filing | No |
| 2013-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-12-15 | Plan is a collectively bargained plan | No |
| 2013-12-15 | Plan funding arrangement – Insurance | Yes |
| 2013-12-15 | Plan funding arrangement – Trust | Yes |
| 2013-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2013-12-15 | Plan benefit arrangement - Trust | Yes |
| 2012: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-12-15 | Type of plan entity | Single employer plan |
| 2012-12-15 | Submission has been amended | No |
| 2012-12-15 | This submission is the final filing | No |
| 2012-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-12-15 | Plan is a collectively bargained plan | No |
| 2012-12-15 | Plan funding arrangement – Insurance | Yes |
| 2012-12-15 | Plan funding arrangement – Trust | Yes |
| 2012-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2012-12-15 | Plan benefit arrangement - Trust | Yes |
| 2011: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-12-15 | Type of plan entity | Single employer plan |
| 2011-12-15 | Submission has been amended | Yes |
| 2011-12-15 | This submission is the final filing | No |
| 2011-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-12-15 | Plan is a collectively bargained plan | No |
| 2011-12-15 | Plan funding arrangement – Insurance | Yes |
| 2011-12-15 | Plan funding arrangement – Trust | Yes |
| 2011-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2011-12-15 | Plan benefit arrangement - Trust | Yes |
| 2010: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-12-15 | Type of plan entity | Single employer plan |
| 2010-12-15 | Submission has been amended | No |
| 2010-12-15 | This submission is the final filing | No |
| 2010-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-12-15 | Plan is a collectively bargained plan | No |
| 2010-12-15 | Plan funding arrangement – Insurance | Yes |
| 2010-12-15 | Plan funding arrangement – Trust | Yes |
| 2010-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2010-12-15 | Plan benefit arrangement - Trust | Yes |
| 2009: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-12-15 | Type of plan entity | Single employer plan |
| 2009-12-15 | Submission has been amended | No |
| 2009-12-15 | This submission is the final filing | No |
| 2009-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-12-15 | Plan is a collectively bargained plan | No |
| 2009-12-15 | Plan funding arrangement – Trust | Yes |
| 2009-12-15 | Plan benefit arrangement – Insurance | Yes |
| 2009-12-15 | Plan benefit arrangement - Trust | Yes |
| 2008: ALLEGRO ASSOCIATES, LLC WELFARE BENEFIT PLAN 2008 form 5500 responses |
|---|
| 2008-12-15 | Type of plan entity | Single employer plan |
| 2008-12-15 | Submission has been amended | No |
| 2008-12-15 | This submission is the final filing | No |
| 2008-12-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-12-15 | Plan is a collectively bargained plan | No |
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2020-12-15 | | Insurance policy end date | 2021-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 5 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Insurance policy start date | 2020-12-15 | | Insurance policy end date | 2021-12-14 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2019-12-15 | | Insurance policy end date | 2020-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2019-12-15 | | Insurance policy end date | 2020-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-12-15 | | Insurance policy end date | 2019-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-12-15 | | Insurance policy end date | 2019-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2016-12-15 | | Insurance policy end date | 2017-12-14 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Insurance policy start date | 2016-12-15 | | Insurance policy end date | 2017-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-12-15 | | Insurance policy end date | 2016-12-14 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-12-15 | | Insurance policy end date | 2016-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | RAYMOND G. ANKER |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-12-15 | | Insurance policy end date | 2015-12-14 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-12-15 | | Insurance policy end date | 2015-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | RAYMOND G. ANKER |
|
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-12-15 | | Insurance policy end date | 2014-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | RAYMOND G. ANKER |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-12-15 | | Insurance policy end date | 2014-12-14 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-12-15 | | Insurance policy end date | 2013-12-14 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-12-15 | | Insurance policy end date | 2013-12-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,330 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1330 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | RAYMOND G. ANKER |
|
| PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
| Policy contract number | VF51595540 |
| Policy instance | 2 |
| Insurance contract or identification number | VF51595540 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-12-15 | | Insurance policy end date | 2012-12-14 | | Total amount of commissions paid to insurance broker | USD $300 | | Total amount of fees paid to insurance company | USD $1,330 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | FA-566-5278 |
| Policy instance | 1 |
| Insurance contract or identification number | FA-566-5278 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-12-15 | | Insurance policy end date | 2012-12-14 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 5278 |
| Policy instance | 1 |
| Insurance contract or identification number | 5278 | | Number of Individuals Covered | 637354 | | Insurance policy start date | 2010-12-15 | | Insurance policy end date | 2011-12-14 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ANNUITY | | 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 |
|
