DARRIGO BROS. CO. OF CALIFORNIA has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan D'ARRIGO BROS. CO., OF CALIFORNIA GROUP
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 501 | 2022-11-01 | MARLA HENRY | 2024-01-09 | | |
| 501 | 2022-05-01 | MARLA HENRY | 2023-03-07 | | |
| 501 | 2021-05-01 | MARLA HENRY | 2022-08-25 | | |
| 501 | 2020-05-01 | MARLA HENRY | 2021-08-23 | | |
| 501 | 2019-05-01 | MARLA HENRY | 2020-08-28 | | |
| 501 | 2018-05-01 | MARLA HENRY | 2019-08-16 | | |
| 501 | 2017-05-01 | | | | |
| 501 | 2016-05-01 | | | | |
| 501 | 2015-05-01 | MARLA VAN CLEVE | | | |
| 501 | 2014-05-01 | MARLA VAN CLEVE | | | |
| 501 | 2013-05-01 | MARLA VAN CLEVE,PAYROLL,HR DIRECTOR | | E.J. CULLIGAN,VP FINANCE,CONTROLLER | 2014-11-19 |
| 501 | 2012-05-01 | MARLA VAN CLEVE,PAYROLL,HR DIRECTOR | | E.J. CULLIGAN,VP FINANCE,CONTROLLER | 2013-11-20 |
| 501 | 2011-05-01 | MARLA VAN CLEVE,PAYROLL,HR DIRECTOR | | | |
| 501 | 2010-05-01 | MARLA VAN CLEVE,PAYROLL,HR DIRECTOR | | | |
| 501 | 2009-05-01 | MARLA VAN CLEVE,PAYROLL,HR DIRECTOR | | E.J.CULLIGAN, VP FINANCE,CONTROLLER | 2011-01-20 |
| 501 | 2009-05-01 | MARLA VAN CLEVE,PAYROLL,HR DIRECTOR | | E.J.CULLIGAN, VP FINANCE,CONTROLLER | 2011-01-20 |
401k plan membership statisitcs for D'ARRIGO BROS. CO., OF CALIFORNIA GROUP
| Measure | Date | Value |
|---|
| 2022: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-11-01 | 296 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-11-01 | 317 |
| Number of retired or separated participants receiving benefits | 2022-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-11-01 | 0 |
| Total of all active and inactive participants | 2022-11-01 | 317 |
| Number of employers contributing to the scheme | 2022-11-01 | 0 |
| Total participants, beginning-of-year | 2022-05-01 | 286 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 296 |
| Number of retired or separated participants receiving benefits | 2022-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-05-01 | 0 |
| Total of all active and inactive participants | 2022-05-01 | 296 |
| Number of employers contributing to the scheme | 2022-05-01 | 0 |
| 2021: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-05-01 | 273 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 286 |
| Number of retired or separated participants receiving benefits | 2021-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-05-01 | 0 |
| Total of all active and inactive participants | 2021-05-01 | 286 |
| Number of employers contributing to the scheme | 2021-05-01 | 0 |
| 2020: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-05-01 | 274 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 273 |
| Number of retired or separated participants receiving benefits | 2020-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
| Total of all active and inactive participants | 2020-05-01 | 273 |
| Number of employers contributing to the scheme | 2020-05-01 | 0 |
| 2019: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-05-01 | 269 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 274 |
| Number of retired or separated participants receiving benefits | 2019-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-05-01 | 0 |
| Total of all active and inactive participants | 2019-05-01 | 274 |
| Number of employers contributing to the scheme | 2019-05-01 | 0 |
| 2018: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-05-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 269 |
| Number of retired or separated participants receiving benefits | 2018-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-05-01 | 0 |
| Total of all active and inactive participants | 2018-05-01 | 269 |
| Number of employers contributing to the scheme | 2018-05-01 | 0 |
| 2017: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-05-01 | 240 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 264 |
| Number of retired or separated participants receiving benefits | 2017-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-05-01 | 0 |
| Total of all active and inactive participants | 2017-05-01 | 264 |
| 2016: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 242 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 248 |
| Number of retired or separated participants receiving benefits | 2016-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-05-01 | 0 |
| Total of all active and inactive participants | 2016-05-01 | 248 |
| 2015: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 226 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 242 |
| Number of retired or separated participants receiving benefits | 2015-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-05-01 | 0 |
| Total of all active and inactive participants | 2015-05-01 | 242 |
| 2014: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 219 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 225 |
| Number of retired or separated participants receiving benefits | 2014-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-05-01 | 0 |
| Total of all active and inactive participants | 2014-05-01 | 225 |
| 2013: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 219 |
| Number of retired or separated participants receiving benefits | 2013-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-05-01 | 0 |
| Total of all active and inactive participants | 2013-05-01 | 219 |
| 2012: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 214 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 213 |
| Total of all active and inactive participants | 2012-05-01 | 213 |
| Total participants | 2012-05-01 | 213 |
| 2011: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 211 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 212 |
| Number of other retired or separated participants entitled to future benefits | 2011-05-01 | 2 |
| Total of all active and inactive participants | 2011-05-01 | 214 |
| Total participants | 2011-05-01 | 214 |
| 2010: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-05-01 | 208 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 211 |
| Total of all active and inactive participants | 2010-05-01 | 211 |
| Total participants | 2010-05-01 | 211 |
| 2009: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-05-01 | 201 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 208 |
| Number of retired or separated participants receiving benefits | 2009-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-05-01 | 0 |
| Total of all active and inactive participants | 2009-05-01 | 208 |
| 2022: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2022 form 5500 responses |
|---|
| 2022-11-01 | Type of plan entity | Single employer plan |
| 2022-11-01 | Plan funding arrangement – Insurance | Yes |
| 2022-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-05-01 | Type of plan entity | Single employer plan |
| 2022-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2022-05-01 | Plan funding arrangement – Insurance | Yes |
| 2022-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2021 form 5500 responses |
|---|
| 2021-05-01 | Type of plan entity | Single employer plan |
| 2021-05-01 | Plan funding arrangement – Insurance | Yes |
| 2021-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2020 form 5500 responses |
|---|
| 2020-05-01 | Type of plan entity | Single employer plan |
| 2020-05-01 | Plan funding arrangement – Insurance | Yes |
| 2020-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2019 form 5500 responses |
|---|
| 2019-05-01 | Type of plan entity | Single employer plan |
| 2019-05-01 | Plan funding arrangement – Insurance | Yes |
| 2019-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2018 form 5500 responses |
|---|
| 2018-05-01 | Type of plan entity | Single employer plan |
| 2018-05-01 | Plan funding arrangement – Insurance | Yes |
| 2018-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2017 form 5500 responses |
|---|
| 2017-05-01 | Type of plan entity | Single employer plan |
| 2017-05-01 | Plan funding arrangement – Insurance | Yes |
| 2017-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2016 form 5500 responses |
|---|
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | Submission has been amended | No |
| 2016-05-01 | This submission is the final filing | No |
| 2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-05-01 | Plan is a collectively bargained plan | No |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2015 form 5500 responses |
|---|
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | Submission has been amended | No |
| 2015-05-01 | This submission is the final filing | No |
| 2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-05-01 | Plan is a collectively bargained plan | No |
| 2015-05-01 | Plan funding arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2014 form 5500 responses |
|---|
| 2014-05-01 | Type of plan entity | Single employer plan |
| 2014-05-01 | Submission has been amended | No |
| 2014-05-01 | This submission is the final filing | No |
| 2014-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-05-01 | Plan is a collectively bargained plan | No |
| 2014-05-01 | Plan funding arrangement – Insurance | Yes |
| 2014-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2013 form 5500 responses |
|---|
| 2013-05-01 | Type of plan entity | Single employer plan |
| 2013-05-01 | Submission has been amended | No |
| 2013-05-01 | This submission is the final filing | No |
| 2013-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-05-01 | Plan is a collectively bargained plan | No |
| 2013-05-01 | Plan funding arrangement – Insurance | Yes |
| 2013-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2012 form 5500 responses |
|---|
| 2012-05-01 | Type of plan entity | Single employer plan |
| 2012-05-01 | Plan funding arrangement – Insurance | Yes |
| 2012-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2011 form 5500 responses |
|---|
| 2011-05-01 | Type of plan entity | Single employer plan |
| 2011-05-01 | Plan funding arrangement – Insurance | Yes |
| 2011-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2010 form 5500 responses |
|---|
| 2010-05-01 | Type of plan entity | Single employer plan |
| 2010-05-01 | Plan funding arrangement – Insurance | Yes |
| 2010-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: D'ARRIGO BROS. CO., OF CALIFORNIA GROUP 2009 form 5500 responses |
|---|
| 2009-05-01 | Type of plan entity | Single employer plan |
| 2009-05-01 | Submission has been amended | No |
| 2009-05-01 | This submission is the final filing | No |
| 2009-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-05-01 | Plan is a collectively bargained plan | No |
| 2009-05-01 | Plan funding arrangement – Insurance | Yes |
| 2009-05-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0C7BV |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0C7BV | | Number of Individuals Covered | 317 | | Insurance policy start date | 2022-11-01 | | Insurance policy end date | 2023-10-31 | | Total amount of commissions paid to insurance broker | USD $27,161 | | Total amount of fees paid to insurance company | USD $1,989 | | 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 | EMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $271,615 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,161 | | Amount paid for insurance broker fees | 1989 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 425533 |
| Policy instance | 1 |
| Insurance contract or identification number | 425533 | | Number of Individuals Covered | 296 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $8,926 | | Total amount of fees paid to insurance company | USD $3,017 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $99,477 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,543 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 425533 |
| Policy instance | 1 |
| Insurance contract or identification number | 425533 | | Number of Individuals Covered | 286 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $23,262 | | Total amount of fees paid to insurance company | USD $5,459 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $272,969 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,614 | | Amount paid for insurance broker fees | 5459 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 425533 |
| Policy instance | 1 |
| Insurance contract or identification number | 425533 | | Number of Individuals Covered | 273 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $22,504 | | Total amount of fees paid to insurance company | USD $2,698 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $260,260 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,013 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 425533 |
| Policy instance | 1 |
| Insurance contract or identification number | 425533 | | Number of Individuals Covered | 274 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $22,108 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $253,214 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,661 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 425533 |
| Policy instance | 2 |
| Insurance contract or identification number | 425533 | | Number of Individuals Covered | 264 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $14,457 | | Total amount of fees paid to insurance company | USD $4,738 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $99,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,922 | | Amount paid for insurance broker fees | 4738 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | SACO INSURANCE SERVICE, INC. |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1031719 |
| Policy instance | 1 |
| Insurance contract or identification number | 1031719 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $5,876 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $131,774 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,076 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | ROGERS BENEFIT GROUP, INC. |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1031719 |
| Policy instance | 1 |
| Insurance contract or identification number | 1031719 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $10,524 | | Total amount of fees paid to insurance company | USD $5,676 | | 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 | ACCIDENTAL DEATH AND 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 $226,771 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,524 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5676 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker name | ROGERS BENEFIT GROUP, INC. |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1031719 |
| Policy instance | 1 |
| Insurance contract or identification number | 1031719 | | Number of Individuals Covered | 225 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $10,027 | | Total amount of fees paid to insurance company | USD $5,277 | | 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 | ACCIDENTAL DEATH AND 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 $208,520 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,027 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5277 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker name | ROGERS BENEFIT GROUP, INC. |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1031719 |
| Policy instance | 1 |
| Insurance contract or identification number | 1031719 | | Number of Individuals Covered | 219 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $18,985 | | 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 | | 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 $197,155 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,782 | | Insurance broker organization code? | 3 | | Insurance broker name | ROGERS BENEFIT GROUP INC |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1031719 |
| Policy instance | 2 |
| Insurance contract or identification number | 1031719 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $12,485 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,794 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,387 | | Insurance broker organization code? | 3 | | Insurance broker name | ROGERS BENEFIT GROUP INC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 393254 |
| Policy instance | 1 |
| Insurance contract or identification number | 393254 | | Number of Individuals Covered | 215 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2012-12-01 | | Total amount of commissions paid to insurance broker | USD $2,524 | | 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 $93,436 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,524 | | Insurance broker organization code? | 3 | | Insurance broker name | SACO INSURANCE SERVICE INC. |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 393254 |
| Policy instance | 1 |
| Insurance contract or identification number | 393254 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $9,805 | | Total amount of fees paid to insurance company | USD $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 $186,072 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 393254 |
| Policy instance | 1 |
| Insurance contract or identification number | 393254 | | Number of Individuals Covered | 211 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $9,655 | | Total amount of fees paid to insurance company | USD $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 $177,897 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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