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MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 401k Plan overview

Plan NameMAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE
Plan identification number 504

MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

MAVERICK CAPITAL, LTD. has sponsored the creation of one or more 401k plans.

Company Name:MAVERICK CAPITAL, LTD.
Employer identification number (EIN):752482446
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Additional information about MAVERICK CAPITAL, LTD.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1993-05-13
Company Identification Number: 0006837710
Legal Registered Office Address: 1900 N PEARL ST STE 2000

DALLAS
United States of America (USA)
75201

More information about MAVERICK CAPITAL, LTD.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-08-01C. CHAD CHISOLM2024-01-23
5042021-08-01C. CHAD CHISOLM2023-01-31
5042020-08-01C. CHAD CHISOLM2021-12-10
5042019-08-01C. CHAD CHISOLM2021-02-05
5042018-08-01CHAD CHISOLM2019-12-17
5042017-08-01
5042016-08-01C. CHAD CHISOLM C. CHAD CHISOLM2018-01-29
5042015-08-01C. CHAD CHISOLM C. CHAD CHISOLM2017-01-19
5042014-08-01C. CHAD CHISOLM
5042013-08-01C. CHAD CHISOLM
5042012-08-01CHAD CHISOLM CHAD CHISOLM2014-05-05
5042011-08-01C. CHAD CHISOLM C. CHAD CHISOLM2013-01-24
5042010-08-01C CHAD CHISOLM
5042009-01-01CHAD CHISOLM CHAD CHISOLM2010-07-15

Plan Statistics for MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE

401k plan membership statisitcs for MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE

Measure Date Value
2022: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2022 401k membership
Total participants, beginning-of-year2022-08-01128
Total number of active participants reported on line 7a of the Form 55002022-08-01101
Number of retired or separated participants receiving benefits2022-08-010
Number of other retired or separated participants entitled to future benefits2022-08-010
Total of all active and inactive participants2022-08-01101
Number of employers contributing to the scheme2022-08-010
2021: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-08-01134
Total number of active participants reported on line 7a of the Form 55002021-08-01128
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01128
Number of employers contributing to the scheme2021-08-010
2020: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-08-01135
Total number of active participants reported on line 7a of the Form 55002020-08-01134
Number of retired or separated participants receiving benefits2020-08-010
Number of other retired or separated participants entitled to future benefits2020-08-010
Total of all active and inactive participants2020-08-01134
Number of employers contributing to the scheme2020-08-010
2019: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-08-01137
Total number of active participants reported on line 7a of the Form 55002019-08-01135
Number of retired or separated participants receiving benefits2019-08-010
Number of other retired or separated participants entitled to future benefits2019-08-010
Total of all active and inactive participants2019-08-01135
Number of employers contributing to the scheme2019-08-010
2018: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-08-01130
Total number of active participants reported on line 7a of the Form 55002018-08-01137
Number of retired or separated participants receiving benefits2018-08-010
Number of other retired or separated participants entitled to future benefits2018-08-010
Total of all active and inactive participants2018-08-01137
Number of employers contributing to the scheme2018-08-010
2017: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-08-01128
Total number of active participants reported on line 7a of the Form 55002017-08-01130
Number of retired or separated participants receiving benefits2017-08-010
Number of other retired or separated participants entitled to future benefits2017-08-010
Total of all active and inactive participants2017-08-01130
Number of employers contributing to the scheme2017-08-010
2016: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-08-01124
Total number of active participants reported on line 7a of the Form 55002016-08-01128
Number of retired or separated participants receiving benefits2016-08-010
Number of other retired or separated participants entitled to future benefits2016-08-010
Total of all active and inactive participants2016-08-01128
2015: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-08-01143
Total number of active participants reported on line 7a of the Form 55002015-08-01124
Number of retired or separated participants receiving benefits2015-08-010
Number of other retired or separated participants entitled to future benefits2015-08-010
Total of all active and inactive participants2015-08-01124
2014: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-08-01151
Total number of active participants reported on line 7a of the Form 55002014-08-01143
Number of retired or separated participants receiving benefits2014-08-010
Number of other retired or separated participants entitled to future benefits2014-08-010
Total of all active and inactive participants2014-08-01143
2013: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-08-01151
Total number of active participants reported on line 7a of the Form 55002013-08-01137
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-010
Total of all active and inactive participants2013-08-01137
2012: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-08-01159
Total number of active participants reported on line 7a of the Form 55002012-08-01151
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-010
Total of all active and inactive participants2012-08-01151
2011: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-08-01154
Total number of active participants reported on line 7a of the Form 55002011-08-01160
Number of retired or separated participants receiving benefits2011-08-010
Number of other retired or separated participants entitled to future benefits2011-08-010
Total of all active and inactive participants2011-08-01160
2010: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-08-01158
Total number of active participants reported on line 7a of the Form 55002010-08-01154
Number of retired or separated participants receiving benefits2010-08-010
Number of other retired or separated participants entitled to future benefits2010-08-010
Total of all active and inactive participants2010-08-01154
2009: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-01171
Total number of active participants reported on line 7a of the Form 55002009-01-01163
Total of all active and inactive participants2009-01-01163
Total participants2009-01-01163

Form 5500 Responses for MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE

2022: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2022 form 5500 responses
2022-08-01Type of plan entitySingle employer plan
2022-08-01Plan funding arrangement – InsuranceYes
2022-08-01Plan benefit arrangement – InsuranceYes
2021: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – InsuranceYes
2020: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – InsuranceYes
2019: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – InsuranceYes
2018: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – InsuranceYes
2017: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes
2014: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes
2011: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedNo
2011-08-01This submission is the final filingNo
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes
2010: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Submission has been amendedNo
2010-08-01This submission is the final filingNo
2010-08-01This return/report is a short plan year return/report (less than 12 months)No
2010-08-01Plan is a collectively bargained planNo
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – InsuranceYes
2009: MAVERICK CAPITAL LTD. BUSINESS TRAVEL ACCIDENT INSURANCE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU0284690
Policy instance 1
Insurance contract or identification numberGTU0284690
Number of Individuals Covered101
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $2,095
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $10,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,095
Amount paid for insurance broker fees0
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU0284690
Policy instance 1
Insurance contract or identification numberGTU0284690
Number of Individuals Covered126
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $2,095
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $10,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,095
Amount paid for insurance broker fees0
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU0284690
Policy instance 1
Insurance contract or identification numberGTU0284690
Number of Individuals Covered134
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $2,095
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $10,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,095
Amount paid for insurance broker fees0
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU0284690
Policy instance 1
Insurance contract or identification numberGTU0284690
Number of Individuals Covered128
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $2,095
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $10,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,095
Amount paid for insurance broker fees0
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU0284690
Policy instance 1
Insurance contract or identification numberGTU0284690
Number of Individuals Covered128
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $2,095
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $10,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,095
Amount paid for insurance broker fees0
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU0284690
Policy instance 1
Insurance contract or identification numberGTU0284690
Number of Individuals Covered129
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $2,200
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $11,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,200
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number9906-01-77
Policy instance 1
Insurance contract or identification number9906-01-77
Number of Individuals Covered124
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $2,276
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $15,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,276
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number9906-01-77
Policy instance 1
Insurance contract or identification number9906-01-77
Number of Individuals Covered143
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $2,349
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $15,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,349
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99060177
Policy instance 1
Insurance contract or identification number99060177
Number of Individuals Covered137
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $2,435
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $16,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,435
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99060177
Policy instance 1
Insurance contract or identification number99060177
Number of Individuals Covered151
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $2,571
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,571
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99060177
Policy instance 1
Insurance contract or identification number99060177
Number of Individuals Covered160
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $2,571
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number9906-01-77
Policy instance 1
Insurance contract or identification number9906-01-77
Number of Individuals Covered154
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $2,571
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number9906-01-77
Policy instance 1
Insurance contract or identification number9906-01-77
Number of Individuals Covered158
Insurance policy start date2009-12-08
Insurance policy end date2010-08-01
Total amount of commissions paid to insurance brokerUSD $1,736
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $11,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,736
Insurance broker organization code?3
Insurance broker nameANCO INS. SERVICES OF HOUSTON,

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