401k Plan data: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN plan

NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 401k Plan overview

Plan Name	NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN
Plan identification number	505

NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Death benefits (include travel accident but not life insurance) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

NEW HAMPSHIRE PUBLIC DEFENDER OFFICE has sponsored the creation of one or more 401k plans.

Company Name: NEW HAMPSHIRE PUBLIC DEFENDER OFFICE

Employer identification number (EIN): 020388924

NAIC Classification: 541110
NAIC Description: Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2015-07-01 MARIE DOKOUPIL
505 2014-07-01 KAREN M ANDERSON
505 2013-07-01 KAREN M ANDERSON

Plan id#	Filing Submission Date	Name of Administrator
505	2015-07-01	MARIE DOKOUPIL
505	2014-07-01	KAREN M ANDERSON
505	2013-07-01	KAREN M ANDERSON

Plan Statistics for NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN

401k plan membership statisitcs for NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN

Measure Date Value
2015: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 87
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 0
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 0
2014: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 178
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 97
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 97
2013: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 100
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 178
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 178

Measure	Date	Value
2015: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	87
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	0
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	0
2014: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	178
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	97
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	97
2013: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	100
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	178
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	178

Form 5500 Responses for NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN

2015: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	Yes
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: NEW HAMPSHIRE PUBLIC DEFENDER VOLUNTARY LIFE PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	First time form 5500 has been submitted	Yes
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

403070

Policy instance

Insurance contract or identification number	403070
Number of Individuals Covered	87
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $5,365
Total amount of fees paid to insurance company	USD $677
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	No
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 $35,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,091
Amount paid for insurance broker fees	412
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	USI INSURANCE SERVICES, LLC

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

403070

Policy instance

Insurance contract or identification number	403070
Number of Individuals Covered	97
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $5,615
Total amount of fees paid to insurance company	USD $751
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	No
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 $37,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,830
Amount paid for insurance broker fees	426
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	USI INSURANCE SERVICES, LLC

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )

Policy contract number

618177

Policy instance

Insurance contract or identification number	618177
Number of Individuals Covered	178
Insurance policy start date	2013-07-01
Insurance policy end date	2013-10-31
Total amount of commissions paid to insurance broker	USD $1,860
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	No
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 $12,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,860
Insurance broker organization code?	3
Insurance broker name	CRONIN, GERVINO AND WARLICK, INC.

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

403070

Policy instance

Insurance contract or identification number	403070
Number of Individuals Covered	105
Insurance policy start date	2013-11-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $4,116
Total amount of fees paid to insurance company	USD $636
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	No
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 $25,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,116
Amount paid for insurance broker fees	636
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	CRONIN, GERVINO AND WARLICK, INC.

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Company Name:	NEW HAMPSHIRE PUBLIC DEFENDER OFFICE
Employer identification number (EIN):	020388924
NAIC Classification:	541110
NAIC Description:	Offices of Lawyers