AUSTIN ENGINEERING USA SERVICES, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WESTECH EMPLOYEE HEALTH BENEFIT PLAN
Measure | Date | Value |
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2021: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 125 |
Total of all active and inactive participants | 2021-01-01 | 125 |
Total participants | 2021-01-01 | 125 |
2020: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 114 |
Total of all active and inactive participants | 2020-01-01 | 114 |
Total participants | 2020-01-01 | 114 |
2019: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 157 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
Total of all active and inactive participants | 2019-01-01 | 157 |
Total participants | 2019-01-01 | 157 |
2018: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 145 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 142 |
Total of all active and inactive participants | 2018-01-01 | 142 |
Total participants | 2018-01-01 | 142 |
2017: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 105 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 145 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
Total of all active and inactive participants | 2017-01-01 | 145 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
Total participants | 2017-01-01 | 145 |
2016: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 92 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 104 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 105 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
Total participants | 2016-01-01 | 105 |
2015: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 139 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 92 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 94 |
Total participants | 2015-01-01 | 94 |
2014: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 154 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 138 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 1 |
Total of all active and inactive participants | 2014-01-01 | 139 |
Number of employers contributing to the scheme | 2014-01-01 | 1 |
2013: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 172 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 153 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 1 |
Total of all active and inactive participants | 2013-01-01 | 154 |
Number of employers contributing to the scheme | 2013-01-01 | 1 |
2012: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 167 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 170 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 2 |
Total of all active and inactive participants | 2012-01-01 | 172 |
Number of employers contributing to the scheme | 2012-01-01 | 2 |
2011: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 149 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 164 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 3 |
Total of all active and inactive participants | 2011-01-01 | 167 |
Number of employers contributing to the scheme | 2011-01-01 | 2 |
2010: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 148 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 149 |
Total of all active and inactive participants | 2010-01-01 | 149 |
Number of employers contributing to the scheme | 2010-01-01 | 2 |
2009: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 153 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 145 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 3 |
Total of all active and inactive participants | 2009-01-01 | 148 |
Number of employers contributing to the scheme | 2009-01-01 | 2 |
2021: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Submission has been amended | No |
2021-01-01 | This submission is the final filing | No |
2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-01-01 | Plan is a collectively bargained plan | No |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | No |
2020-01-01 | This submission is the final filing | No |
2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-01-01 | Plan is a collectively bargained plan | No |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Multi-employer plan |
2019-01-01 | Submission has been amended | No |
2019-01-01 | This submission is the final filing | No |
2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-01-01 | Plan is a collectively bargained plan | No |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Multi-employer plan |
2018-01-01 | Submission has been amended | No |
2018-01-01 | This submission is the final filing | No |
2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-01-01 | Plan is a collectively bargained plan | No |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Submission has been amended | No |
2017-01-01 | This submission is the final filing | No |
2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-01-01 | Plan is a collectively bargained plan | No |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Multi-employer plan |
2014-01-01 | Plan is a collectively bargained plan | Yes |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Multi-employer plan |
2013-01-01 | Plan is a collectively bargained plan | Yes |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Multi-employer plan |
2012-01-01 | Plan is a collectively bargained plan | Yes |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Multi-employer plan |
2011-01-01 | Plan is a collectively bargained plan | Yes |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2010: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2010 form 5500 responses |
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2010-01-01 | Type of plan entity | Multi-employer plan |
2010-01-01 | Plan is a collectively bargained plan | Yes |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: WESTECH EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Multi-employer plan |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | Plan is a collectively bargained plan | Yes |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 3 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 32 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-02-01 | Total amount of commissions paid to insurance broker | USD $3,420 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | 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 Carrier | USD $24,947 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,420 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 2 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 125 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-02-01 | 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 | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ADD | 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 Carrier | USD $10,975 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 1 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 17 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-02-01 | Total amount of commissions paid to insurance broker | USD $851 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | 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 | Welfare Benefit Premiums Paid to Carrier | USD $5,675 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $851 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 1 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 26 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $1,477 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | 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 | Welfare Benefit Premiums Paid to Carrier | USD $9,845 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $260 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 2 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 133 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-02-01 | 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 | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ADD | 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 Carrier | USD $14,970 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 3 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 38 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $5,854 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | 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 Carrier | USD $39,094 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 2 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 26 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $1,477 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | 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 | Welfare Benefit Premiums Paid to Carrier | USD $9,845 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,216 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 1 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 157 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | 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 | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | 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 Carrier | USD $15,642 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 3 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 38 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $5,855 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | 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 Carrier | USD $39,029 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,691 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 1 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 26 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $9,845 | Total amount of fees paid to insurance company | USD $7,733 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | 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 | Welfare Benefit Premiums Paid to Carrier | USD $7,733 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $985 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 2 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 34 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $4,985 | 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 | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | 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 Carrier | USD $34,726 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,498 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 3 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 142 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | 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 | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ADD | 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 Carrier | USD $17,902 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 1 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 172 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $5,415 | 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 | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 Carrier | USD $51,434 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,415 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP, INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 1 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 92 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 Carrier | USD $19,885 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 2 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 30 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2015-01-01 | Total amount of commissions paid to insurance broker | USD $1,223 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,259 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,223 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 1 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 143 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-02-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $19,949 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 3 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 39 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2015-01-01 | Total amount of commissions paid to insurance broker | USD $5,108 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $31,161 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,108 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | SE3R1396 |
Policy instance | 4 |
Insurance contract or identification number | SE3R1396 | Number of Individuals Covered | 154 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $319,632 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 3 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 50 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2014-01-01 | Total amount of commissions paid to insurance broker | USD $5,133 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $34,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,133 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 2 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 41 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2014-01-01 | Total amount of commissions paid to insurance broker | USD $1,597 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,740 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,597 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 1 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 156 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-02-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $17,072 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 1 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 171 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2013-01-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $17,316 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 2 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 52 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2013-01-01 | Total amount of commissions paid to insurance broker | USD $1,326 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,635 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,326 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 3 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 59 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2013-01-01 | Total amount of commissions paid to insurance broker | USD $4,672 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $33,948 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,672 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | SE3R1339 |
Policy instance | 4 |
Insurance contract or identification number | SE3R1339 | Number of Individuals Covered | 172 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $313,441 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 ) |
Policy contract number | PX01080 |
Policy instance | 4 |
Insurance contract or identification number | PX01080 | Number of Individuals Covered | 173 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $342,766 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 3 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 63 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-02-01 | Total amount of commissions paid to insurance broker | USD $4,342 | Total amount of fees paid to insurance company | USD $217 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $31,740 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 2 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 54 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-02-01 | Total amount of commissions paid to insurance broker | USD $1,365 | Total amount of fees paid to insurance company | USD $68 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,837 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 1 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 161 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-02-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $114 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $16,501 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906932 |
Policy instance | 1 |
Insurance contract or identification number | 906932 | Number of Individuals Covered | 145 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-02-01 | Total amount of commissions paid to insurance broker | USD $9 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $16,166 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906873 |
Policy instance | 2 |
Insurance contract or identification number | 906873 | Number of Individuals Covered | 57 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-02-01 | Total amount of commissions paid to insurance broker | USD $2,140 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,583 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,140 | Insurance broker organization code? | 3 | Insurance broker name | COVENANT INSURANCE GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 906874 |
Policy instance | 3 |
Insurance contract or identification number | 906874 | Number of Individuals Covered | 65 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-02-01 | Total amount of commissions paid to insurance broker | USD $5,264 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $32,290 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,264 | Insurance broker name | COVENANT INSURANCE GROUP |
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PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 ) |
Policy contract number | PX01080 |
Policy instance | 4 |
Insurance contract or identification number | PX01080 | Number of Individuals Covered | 145 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $7,388 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $246,271 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,388 | Insurance broker name | CNIC HEALTH SOLUTIONS |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 098658 |
Policy instance | 5 |
Insurance contract or identification number | 098658 | Number of Individuals Covered | 149 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,475 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 098658 |
Policy instance | 6 |
Insurance contract or identification number | 098658 | Number of Individuals Covered | 20 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $114 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $763 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $114 | Insurance broker name | COVENANT INSURANCE GROUP |
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