DAVID MCDERMOTT CHEVROLET, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T
401k plan membership statisitcs for DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T
| Measure | Date | Value |
|---|
| 2018: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 88 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 0 |
| 2017: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 61 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 88 |
| Total of all active and inactive participants | 2017-01-01 | 88 |
| 2016: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 60 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 61 |
| Total of all active and inactive participants | 2016-01-01 | 61 |
| 2015: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 53 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 60 |
| Total of all active and inactive participants | 2015-01-01 | 60 |
| 2014: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 49 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 53 |
| Total of all active and inactive participants | 2014-01-01 | 53 |
| 2013: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 45 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 49 |
| Total of all active and inactive participants | 2013-01-01 | 49 |
| 2012: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 50 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 45 |
| Total of all active and inactive participants | 2012-01-01 | 45 |
| 2011: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 50 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 50 |
| Total of all active and inactive participants | 2011-01-01 | 50 |
| 2010: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 44 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 50 |
| Total of all active and inactive participants | 2010-01-01 | 50 |
| 2009: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 43 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 44 |
| Total of all active and inactive participants | 2009-01-01 | 44 |
| Measure | Date | Value |
|---|
| 2018 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $646,614 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $646,614 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $563,907 |
| Total contributions received or receivable from participants | 2018-12-31 | $175,585 |
| Net income (gross income less expenses) | 2018-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $471,029 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $82,707 |
| 2017 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $696,721 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $696,721 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $598,976 |
| Total contributions received or receivable from participants | 2017-12-31 | $232,151 |
| Net income (gross income less expenses) | 2017-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $464,570 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $97,745 |
| 2016 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $860,712 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $860,712 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $765,117 |
| Total contributions received or receivable from participants | 2016-12-31 | $198,379 |
| Net income (gross income less expenses) | 2016-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $662,333 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $95,595 |
| 2015 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $524,283 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $524,283 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $524,283 |
| Total contributions received or receivable from participants | 2015-12-31 | $186,934 |
| Net income (gross income less expenses) | 2015-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $337,349 |
| 2014 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $571,383 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $571,383 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $571,383 |
| Total contributions received or receivable from participants | 2014-12-31 | $167,150 |
| Net income (gross income less expenses) | 2014-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $404,233 |
| 2013 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $492,855 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $492,855 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $492,855 |
| Total contributions received or receivable from participants | 2013-12-31 | $140,260 |
| Net income (gross income less expenses) | 2013-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $352,595 |
| 2012 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $586,841 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $586,841 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $586,841 |
| Total contributions received or receivable from participants | 2012-12-31 | $144,148 |
| Net income (gross income less expenses) | 2012-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $442,693 |
| 2011 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $512,522 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $512,522 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $512,522 |
| Total plan assets at end of year | 2011-12-31 | $0 |
| Total plan assets at beginning of year | 2011-12-31 | $0 |
| Total contributions received or receivable from participants | 2011-12-31 | $163,340 |
| Net income (gross income less expenses) | 2011-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $349,182 |
| 2010 : DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $495,984 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $495,984 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $449,798 |
| Total plan assets at end of year | 2010-12-31 | $0 |
| Total plan assets at beginning of year | 2010-12-31 | $0 |
| Total contributions received or receivable from participants | 2010-12-31 | $162,048 |
| Net income (gross income less expenses) | 2010-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $333,936 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $46,186 |
| 2018: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | This submission is the final filing | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: DAVID MCDERMOTT CHEVROLET, INC. EMPLOYEE BENEFIT T 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 947-4424 |
| Policy instance | 3 |
| Insurance contract or identification number | 947-4424 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $7,970 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NWL01178CT-04 |
| Policy instance | 2 |
| Insurance contract or identification number | NWL01178CT-04 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $173,304 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKJQ |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKJQ | | Number of Individuals Covered | 66 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $242 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,056 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $242 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NWL01178CT-04 |
| Policy instance | 2 |
| Insurance contract or identification number | NWL01178CT-04 | | Number of Individuals Covered | 56 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $181,878 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 947-4424 |
| Policy instance | 3 |
| Insurance contract or identification number | 947-4424 | | Number of Individuals Covered | 56 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $8,764 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKJQ |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKJQ | | Number of Individuals Covered | 88 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $582 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,344 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $582 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | DIVERSIFIED GROUP BROKERAGE CORP. |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NWL01178CT-03 |
| Policy instance | 2 |
| Insurance contract or identification number | NWL01178CT-03 | | Number of Individuals Covered | 48 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $157,504 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 949-6601 |
| Policy instance | 3 |
| Insurance contract or identification number | 949-6601 | | Number of Individuals Covered | 56 | | 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 $242 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $8,055 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 242 | | Insurance broker organization code? | 5 | | Insurance broker name | DIVERSIFIED ADMINISTRATION CORP |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKJQ |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKJQ | | Number of Individuals Covered | 60 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $282 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,128 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $282 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | DIVERSIFIED GROUP BROKERAGE CORP. |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 949-6601 |
| Policy instance | 3 |
| Insurance contract or identification number | 949-6601 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | 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 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $7,616 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NWL01178CT-02 |
| Policy instance | 2 |
| Insurance contract or identification number | NWL01178CT-02 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | 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 $138,999 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKJQ |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKJQ | | Number of Individuals Covered | 53 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $268 | | Total amount of fees paid to insurance company | USD $20 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $268 | | Amount paid for insurance broker fees | 20 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | DIVERSIFIED GROUP BROKERAGE CORP. |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | NWL01178C |
| Policy instance | 2 |
| Insurance contract or identification number | NWL01178C | | Number of Individuals Covered | 43 | | 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 $103,357 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKJQ |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKJQ | | Number of Individuals Covered | 49 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $225 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $225 | | Insurance broker name | DIVERSIFIED ADMINISTRATION CORPORAT |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKJQ |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKJQ | | Number of Individuals Covered | 45 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $233 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $933 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $233 | | Insurance broker name | DIVERSIFIED ADMINISTRATION CORPORAT |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | JS396 |
| Policy instance | 2 |
| Insurance contract or identification number | JS396 | | Number of Individuals Covered | 42 | | 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 $69,764 | | 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 $103,184 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 52377 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | GOWRIE, BRETT & YOUNG |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | JS396 |
| Policy instance | 2 |
| Insurance contract or identification number | JS396 | | Number of Individuals Covered | 50 | | 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 $81,867 | | 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 $102,344 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G00605276 |
| Policy instance | 1 |
| Insurance contract or identification number | G00605276 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $254 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,271 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | JS396 |
| Policy instance | 2 |
| Insurance contract or identification number | JS396 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $45,934 | | 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 $81,941 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 38869 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | GOWRIE, BRETT & YOUNG |
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| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G00605276 |
| Policy instance | 1 |
| Insurance contract or identification number | G00605276 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $252 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,262 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $252 | | Insurance broker name | DIVERSIFIED ADMINISTRATION CORPORAT |
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