401k Plan data: INSPERITY WELFARE BENEFITS PLAN plan

INSPERITY WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	INSPERITY WELFARE BENEFITS PLAN
Plan identification number	504

INSPERITY WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

INSPERITY HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name: INSPERITY HOLDINGS, INC.

Employer identification number (EIN): 760178498

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Additional information about INSPERITY HOLDINGS, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1998-10-15

Company Identification Number: 0012345706

Legal Registered Office Address: 19001 CRESCENT SPRINGS DR

KINGWOOD
United States of America (USA)
77339

More information about INSPERITY HOLDINGS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INSPERITY WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2022-01-01
504 2021-01-01
504 2020-01-01
504 2019-01-01
504 2018-01-01
504 2017-01-01 JAMES ALLISON
504 2016-01-01 RICHARD RAWSON
504 2015-01-01 RICHARD RAWSON
504 2014-01-01 RICHARD RAWSON
504 2013-01-01 RICHARD RAWSON
504 2012-01-01 RICHARD RAWSON
504 2011-01-01 RICHARD RAWSON
504 2009-01-01 RICHARD RAWSON

Plan Statistics for INSPERITY WELFARE BENEFITS PLAN

401k plan membership statisitcs for INSPERITY WELFARE BENEFITS PLAN

Measure Date Value
2022: INSPERITY WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 243,753
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 316,242
Total of all active and inactive participants 2022-01-01 316,242
2021: INSPERITY WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 217,228
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 243,753
Total of all active and inactive participants 2021-01-01 243,753
2020: INSPERITY WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 214,083
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 217,228
Total of all active and inactive participants 2020-01-01 217,228
2019: INSPERITY WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 197,455
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 214,083
Total of all active and inactive participants 2019-01-01 214,083
2018: INSPERITY WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 171,402
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 197,455
Total of all active and inactive participants 2018-01-01 197,455
2017: INSPERITY WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 156,545
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 171,402
Total of all active and inactive participants 2017-01-01 171,402
Total participants 2017-01-01 171,402
2016: INSPERITY WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 139,731
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 156,545
Total of all active and inactive participants 2016-01-01 156,545
Total participants 2016-01-01 156,545
2015: INSPERITY WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 124,982
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 139,731
Total of all active and inactive participants 2015-01-01 139,731
Total participants 2015-01-01 139,731
2014: INSPERITY WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 96,447
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 124,982
Total of all active and inactive participants 2014-01-01 124,982
Total participants 2014-01-01 124,982
2013: INSPERITY WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 93,864
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 96,447
Total of all active and inactive participants 2013-01-01 96,447
Total participants 2013-01-01 96,447
2012: INSPERITY WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 91,668
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 93,864
Total of all active and inactive participants 2012-01-01 93,864
Total participants 2012-01-01 93,864
2011: INSPERITY WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 83,849
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 91,668
Total of all active and inactive participants 2011-01-01 91,668
Total participants 2011-01-01 91,668
2009: INSPERITY WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 89,829
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 80,792
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 80,792
Total participants 2009-01-01 80,792

Measure	Date	Value
2022: INSPERITY WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	243,753
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	316,242
Total of all active and inactive participants	2022-01-01	316,242
2021: INSPERITY WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	217,228
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	243,753
Total of all active and inactive participants	2021-01-01	243,753
2020: INSPERITY WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	214,083
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	217,228
Total of all active and inactive participants	2020-01-01	217,228
2019: INSPERITY WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	197,455
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	214,083
Total of all active and inactive participants	2019-01-01	214,083
2018: INSPERITY WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	171,402
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	197,455
Total of all active and inactive participants	2018-01-01	197,455
2017: INSPERITY WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	156,545
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	171,402
Total of all active and inactive participants	2017-01-01	171,402
Total participants	2017-01-01	171,402
2016: INSPERITY WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	139,731
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	156,545
Total of all active and inactive participants	2016-01-01	156,545
Total participants	2016-01-01	156,545
2015: INSPERITY WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	124,982
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	139,731
Total of all active and inactive participants	2015-01-01	139,731
Total participants	2015-01-01	139,731
2014: INSPERITY WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	96,447
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	124,982
Total of all active and inactive participants	2014-01-01	124,982
Total participants	2014-01-01	124,982
2013: INSPERITY WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	93,864
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	96,447
Total of all active and inactive participants	2013-01-01	96,447
Total participants	2013-01-01	96,447
2012: INSPERITY WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	91,668
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	93,864
Total of all active and inactive participants	2012-01-01	93,864
Total participants	2012-01-01	93,864
2011: INSPERITY WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	83,849
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	91,668
Total of all active and inactive participants	2011-01-01	91,668
Total participants	2011-01-01	91,668
2009: INSPERITY WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	89,829
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	80,792
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	80,792
Total participants	2009-01-01	80,792

Form 5500 Responses for INSPERITY WELFARE BENEFITS PLAN

2022: INSPERITY WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: INSPERITY WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: INSPERITY WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: INSPERITY WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: INSPERITY WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: INSPERITY WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: INSPERITY WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: INSPERITY WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: INSPERITY WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: INSPERITY WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: INSPERITY WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: INSPERITY WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: INSPERITY WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0241093

Policy instance

Insurance contract or identification number	0241093
Number of Individuals Covered	1355
Insurance policy start date	2022-11-01
Insurance policy end date	2022-12-31
Total amount of fees paid to insurance company	USD $27
Other welfare benefits provided	GROUP ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $8,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	27
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	11768
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $498,218
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,721,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $498,218
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	273869
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $729,267
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $14,585,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $729,267
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	16059
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $97,427
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $1,899,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $97,427
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK980001

Policy instance

Insurance contract or identification number	SLK980001
Number of Individuals Covered	91676
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,507,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLI980027

Policy instance

Insurance contract or identification number	FLI980027
Number of Individuals Covered	27380
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $585,887
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,896,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $585,887
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

701648

Policy instance

Insurance contract or identification number	701648
Number of Individuals Covered	316242
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $2,525,884
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

0241092

Policy instance

Insurance contract or identification number	0241092
Number of Individuals Covered	1404
Insurance policy start date	2022-11-01
Insurance policy end date	2022-12-31
Total amount of fees paid to insurance company	USD $27
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $37,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	27
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	28340
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $981,582
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,561,906
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $981,582
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	10559
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $445,029
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,996,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $445,029
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	243183
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $662,861
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $12,258,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $662,861
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	13310
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $56,199
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $1,099,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $56,199
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK980001

Policy instance

Insurance contract or identification number	SLK980001
Number of Individuals Covered	81750
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $50,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,462,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $50,000
Insurance broker organization code?	3

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	25901
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $881,385
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,331,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $881,385
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	9202
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $373,780
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,674,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $373,780
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	216621
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $624,330
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $11,491,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $624,330
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	12348
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $71,213
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $1,265,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $71,211
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK980001

Policy instance

Insurance contract or identification number	SLK980001
Number of Individuals Covered	74361
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $50,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,217,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $50,000
Insurance broker organization code?	3

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	24603
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $809,913
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,986,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $809,913
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	8210
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $341,950
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,987,018
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $341,950
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	213664
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $603,719
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $11,080,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $603,719
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	12145
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $67,470
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $1,183,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $67,470
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK980001

Policy instance

Insurance contract or identification number	SLK980001
Number of Individuals Covered	75095
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $50,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,787,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $50,000
Insurance broker organization code?	3

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	21938
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $694,152
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,775,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $694,152
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	6999
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $270,463
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,783,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $270,463
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	197223
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $548,391
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $9,794,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $548,391
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	10530
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $53,635
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $948,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $53,635
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK980001

Policy instance

Insurance contract or identification number	SLK980001
Number of Individuals Covered	72810
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $60,989
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,089,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $60,989
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK980001

Policy instance

Insurance contract or identification number	SLK980001
Number of Individuals Covered	66366
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $50,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,378,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $50,000
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	8259
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $49,502
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $889,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $49,502
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	171194
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $482,756
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $8,628,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $482,756
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	5303
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $255,523
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,581,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $255,523
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	18215
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $672,377
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,207,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $672,377
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	16323
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $610,591
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,936,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $610,591
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	4755
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of fees paid to insurance company	USD $20,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,939,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	20000
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	139643
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $348,407
Total amount of fees paid to insurance company	USD $28,493
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $6,970,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $348,407
Amount paid for insurance broker fees	28493
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	7622
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $34,971
Total amount of fees paid to insurance company	USD $13,146
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $699,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,971
Amount paid for insurance broker fees	13146
Insurance broker organization code?	3
Insurance broker name	TOWERS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK980001

Policy instance

Insurance contract or identification number	SLK980001
Number of Individuals Covered	58099
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of fees paid to insurance company	USD $20,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,298,726
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	20000
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	124835
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $309,019
Total amount of fees paid to insurance company	USD $17,500
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $6,193,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $309,019
Amount paid for insurance broker fees	17500
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	15998
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $578,141
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,420,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $578,141
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	7634
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $34,277
Total amount of fees paid to insurance company	USD $10,480
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $685,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,277
Amount paid for insurance broker fees	10480
Insurance broker organization code?	3
Insurance broker name	TOWERS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK980001

Policy instance

Insurance contract or identification number	SLK980001
Number of Individuals Covered	54221
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,930,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	4835
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of fees paid to insurance company	USD $17,500
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,201,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	17500
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	20267
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $499,205
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,825,909
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $499,205
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	7116
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $25,299
Total amount of fees paid to insurance company	USD $8,943
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $505,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,299
Amount paid for insurance broker fees	8943
Insurance broker organization code?	3
Insurance broker name	TOWERS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	96447
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $261,210
Total amount of fees paid to insurance company	USD $10,000
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $5,237,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $261,210
Amount paid for insurance broker fees	10000
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	47822
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $173,011
Total amount of fees paid to insurance company	USD $10,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,579,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $173,011
Amount paid for insurance broker fees	10000
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	46124
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $261,070
Total amount of fees paid to insurance company	USD $10,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,897,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $261,070
Amount paid for insurance broker fees	10000
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	20955
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $485,830
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,488,037
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $485,830
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	93864
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $277,932
Total amount of fees paid to insurance company	USD $10,000
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $5,128,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $277,932
Amount paid for insurance broker fees	10000
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	7379
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $33,682
Total amount of fees paid to insurance company	USD $3,588
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $621,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,682
Amount paid for insurance broker fees	3588
Insurance broker organization code?	3
Insurance broker name	TOWERS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	7765
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $39,998
Total amount of fees paid to insurance company	USD $6,901
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $631,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	91668
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $303,755
Total amount of fees paid to insurance company	USD $47,705
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $4,847,153
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	44550
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $430,481
Total amount of fees paid to insurance company	USD $100,000
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,729,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	22059
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $473,144
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,832,235
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK823223

Policy instance

Insurance contract or identification number	OK823223
Number of Individuals Covered	8222
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $31,685
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $611,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,438
Insurance broker organization code?	3
Insurance broker name	TOWERS WATSON PENNSYLVANIA

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

L104500

Policy instance

Insurance contract or identification number	L104500
Number of Individuals Covered	23423
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $445,976
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,152,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $296,998
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SLK030024

Policy instance

Insurance contract or identification number	SLK030024
Number of Individuals Covered	41161
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $225,838
Total amount of fees paid to insurance company	USD $8,698
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,315,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $54,138
Insurance broker organization code?	3
Amount paid for insurance broker fees	8698
Insurance broker name	TOWERS WATSON PENNSYLVANIA

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX051416

Policy instance

Insurance contract or identification number	FLX051416
Number of Individuals Covered	83849
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $221,342
Total amount of fees paid to insurance company	USD $656
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $4,309,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $75,678
Insurance broker organization code?	3
Amount paid for insurance broker fees	656
Insurance broker name	TOWERS WATSON PENNSYLVANIA

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Company Name:	INSPERITY HOLDINGS, INC.
Employer identification number (EIN):	760178498
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1998-10-15
Company Identification Number:	0012345706
Legal Registered Office Address:	19001 CRESCENT SPRINGS DR KINGWOOD United States of America (USA) 77339