THE ROCKEFELLER UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY
401k plan membership statisitcs for TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY
| Measure | Date | Value |
|---|
| 2023: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-02-01 | 1,786 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-02-01 | 1,469 |
| Number of retired or separated participants receiving benefits | 2023-02-01 | 15 |
| Total of all active and inactive participants | 2023-02-01 | 1,484 |
| Total participants | 2023-02-01 | 1,484 |
| 2022: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-02-01 | 1,679 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 1,786 |
| Number of retired or separated participants receiving benefits | 2022-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-02-01 | 0 |
| Total of all active and inactive participants | 2022-02-01 | 1,786 |
| Total participants | 2022-02-01 | 1,786 |
| 2021: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-02-01 | 1,726 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 1,679 |
| Number of retired or separated participants receiving benefits | 2021-02-01 | 0 |
| Total of all active and inactive participants | 2021-02-01 | 1,679 |
| Total participants | 2021-02-01 | 1,679 |
| 2020: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-02-01 | 1,641 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 1,726 |
| Total of all active and inactive participants | 2020-02-01 | 1,726 |
| Total participants | 2020-02-01 | 1,726 |
| 2019: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-02-01 | 1,634 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 1,641 |
| Total of all active and inactive participants | 2019-02-01 | 1,641 |
| Total participants | 2019-02-01 | 1,641 |
| 2018: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-02-01 | 1,640 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 1,605 |
| Number of retired or separated participants receiving benefits | 2018-02-01 | 15 |
| Total of all active and inactive participants | 2018-02-01 | 1,620 |
| Total participants | 2018-02-01 | 1,620 |
| 2017: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-02-01 | 1,636 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 1,640 |
| Total of all active and inactive participants | 2017-02-01 | 1,640 |
| Total participants | 2017-02-01 | 1,640 |
| 2016: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-02-01 | 1,598 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 1,636 |
| Total of all active and inactive participants | 2016-02-01 | 1,636 |
| Total participants | 2016-02-01 | 1,636 |
| 2015: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-02-01 | 1,557 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 1,598 |
| Total of all active and inactive participants | 2015-02-01 | 1,598 |
| Total participants | 2015-02-01 | 1,598 |
| 2014: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-02-01 | 1,575 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 1,557 |
| Number of retired or separated participants receiving benefits | 2014-02-01 | 0 |
| Total of all active and inactive participants | 2014-02-01 | 1,557 |
| Total participants | 2014-02-01 | 1,557 |
| 2013: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-02-01 | 1,551 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 1,575 |
| Number of retired or separated participants receiving benefits | 2013-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-02-01 | 0 |
| Total of all active and inactive participants | 2013-02-01 | 1,575 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-02-01 | 0 |
| Total participants | 2013-02-01 | 1,575 |
| 2012: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-02-01 | 1,538 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 1,551 |
| Number of retired or separated participants receiving benefits | 2012-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-02-01 | 0 |
| Total of all active and inactive participants | 2012-02-01 | 1,551 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-02-01 | 0 |
| Total participants | 2012-02-01 | 1,551 |
| 2011: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-02-01 | 1,538 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 1,551 |
| Number of retired or separated participants receiving benefits | 2011-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-02-01 | 0 |
| Total of all active and inactive participants | 2011-02-01 | 1,551 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-02-01 | 0 |
| Total participants | 2011-02-01 | 1,551 |
| 2010: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-02-01 | 1,798 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-02-01 | 1,538 |
| Number of retired or separated participants receiving benefits | 2010-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-02-01 | 0 |
| Total of all active and inactive participants | 2010-02-01 | 1,538 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-02-01 | 0 |
| Total participants | 2010-02-01 | 1,538 |
| 2009: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-02-01 | 1,772 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-02-01 | 1,798 |
| Number of retired or separated participants receiving benefits | 2009-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-02-01 | 0 |
| Total of all active and inactive participants | 2009-02-01 | 1,798 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-02-01 | 0 |
| Total participants | 2009-02-01 | 1,798 |
| Number of participants with account balances | 2009-02-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-02-01 | 0 |
| 2023: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2023 form 5500 responses |
|---|
| 2023-02-01 | Type of plan entity | Single employer plan |
| 2023-02-01 | Submission has been amended | No |
| 2023-02-01 | This submission is the final filing | No |
| 2023-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-02-01 | Plan is a collectively bargained plan | No |
| 2023-02-01 | Plan funding arrangement – Insurance | Yes |
| 2023-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2022 form 5500 responses |
|---|
| 2022-02-01 | Type of plan entity | Single employer plan |
| 2022-02-01 | Submission has been amended | No |
| 2022-02-01 | This submission is the final filing | No |
| 2022-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-02-01 | Plan is a collectively bargained plan | No |
| 2022-02-01 | Plan funding arrangement – Insurance | Yes |
| 2022-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2021 form 5500 responses |
|---|
| 2021-02-01 | Type of plan entity | Single employer plan |
| 2021-02-01 | Submission has been amended | No |
| 2021-02-01 | This submission is the final filing | No |
| 2021-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-02-01 | Plan is a collectively bargained plan | No |
| 2021-02-01 | Plan funding arrangement – Insurance | Yes |
| 2021-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2020 form 5500 responses |
|---|
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Submission has been amended | No |
| 2020-02-01 | This submission is the final filing | No |
| 2020-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-02-01 | Plan is a collectively bargained plan | No |
| 2020-02-01 | Plan funding arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2019 form 5500 responses |
|---|
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | Submission has been amended | No |
| 2019-02-01 | This submission is the final filing | No |
| 2019-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-02-01 | Plan is a collectively bargained plan | No |
| 2019-02-01 | Plan funding arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2018 form 5500 responses |
|---|
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | Submission has been amended | No |
| 2018-02-01 | This submission is the final filing | No |
| 2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-02-01 | Plan is a collectively bargained plan | No |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2017 form 5500 responses |
|---|
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Submission has been amended | No |
| 2017-02-01 | This submission is the final filing | No |
| 2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-02-01 | Plan is a collectively bargained plan | No |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2016 form 5500 responses |
|---|
| 2016-02-01 | Type of plan entity | Single employer plan |
| 2016-02-01 | Submission has been amended | No |
| 2016-02-01 | This submission is the final filing | No |
| 2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-02-01 | Plan is a collectively bargained plan | No |
| 2016-02-01 | Plan funding arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2015 form 5500 responses |
|---|
| 2015-02-01 | Type of plan entity | Single employer plan |
| 2015-02-01 | Submission has been amended | No |
| 2015-02-01 | This submission is the final filing | No |
| 2015-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-02-01 | Plan is a collectively bargained plan | No |
| 2015-02-01 | Plan funding arrangement – Insurance | Yes |
| 2015-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2014 form 5500 responses |
|---|
| 2014-02-01 | Type of plan entity | Single employer plan |
| 2014-02-01 | Submission has been amended | No |
| 2014-02-01 | This submission is the final filing | No |
| 2014-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-02-01 | Plan is a collectively bargained plan | No |
| 2014-02-01 | Plan funding arrangement – Insurance | Yes |
| 2014-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2013 form 5500 responses |
|---|
| 2013-02-01 | Type of plan entity | Single employer plan |
| 2013-02-01 | Submission has been amended | No |
| 2013-02-01 | This submission is the final filing | No |
| 2013-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-02-01 | Plan is a collectively bargained plan | No |
| 2013-02-01 | Plan funding arrangement – Insurance | Yes |
| 2013-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2012 form 5500 responses |
|---|
| 2012-02-01 | Type of plan entity | Single employer plan |
| 2012-02-01 | Submission has been amended | No |
| 2012-02-01 | This submission is the final filing | No |
| 2012-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-02-01 | Plan is a collectively bargained plan | No |
| 2012-02-01 | Plan funding arrangement – Insurance | Yes |
| 2012-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2011 form 5500 responses |
|---|
| 2011-02-01 | Type of plan entity | Single employer plan |
| 2011-02-01 | Submission has been amended | No |
| 2011-02-01 | This submission is the final filing | No |
| 2011-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-02-01 | Plan is a collectively bargained plan | No |
| 2011-02-01 | Plan funding arrangement – Insurance | Yes |
| 2011-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2010 form 5500 responses |
|---|
| 2010-02-01 | Type of plan entity | Single employer plan |
| 2010-02-01 | Submission has been amended | No |
| 2010-02-01 | This submission is the final filing | No |
| 2010-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-02-01 | Plan is a collectively bargained plan | No |
| 2010-02-01 | Plan funding arrangement – Insurance | Yes |
| 2010-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: TRAVEL & ACCIDENT INSURANCE PLAN OF THE ROCKEFELLER UNIVERSITY 2009 form 5500 responses |
|---|
| 2009-02-01 | Type of plan entity | Single employer plan |
| 2009-02-01 | Submission has been amended | No |
| 2009-02-01 | This submission is the final filing | No |
| 2009-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-02-01 | Plan is a collectively bargained plan | No |
| 2009-02-01 | Plan funding arrangement – Insurance | Yes |
| 2009-02-01 | Plan benefit arrangement – Insurance | Yes |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009129647-A |
| Policy instance | 1 |
| Insurance contract or identification number | GTP0009129647-A | | Number of Individuals Covered | 1469 | | Insurance policy start date | 2023-02-01 | | Insurance policy end date | 2024-01-31 | | Total amount of commissions paid to insurance broker | USD $1,027 | | 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 | 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 $5,133 | | 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 | GTP 0009129647A |
| Policy instance | 1 |
| Insurance contract or identification number | GTP 0009129647A | | Number of Individuals Covered | 1786 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $1,027 | | 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 | 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 $5,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,027 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009129647A |
| Policy instance | 1 |
| Insurance contract or identification number | GTP0009129647A | | Number of Individuals Covered | 1679 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $1,027 | | 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 | 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 $5,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,027 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009129647A |
| Policy instance | 1 |
| Insurance contract or identification number | GTP0009129647A | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $1,027 | | 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 | No | | 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 $5,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,027 | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 0009129647 |
| Policy instance | 1 |
| Insurance contract or identification number | GTP 0009129647 | | Number of Individuals Covered | 1641 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $1,053 | | 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 | 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 $5,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,053 | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009129647A |
| Policy instance | 1 |
| Insurance contract or identification number | GTP0009129647A | | Number of Individuals Covered | 1620 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $1,051 | | 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 | 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 $5,263 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1051 | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 0009129647- |
| Policy instance | 1 |
| Insurance contract or identification number | GTP 0009129647- | | Number of Individuals Covered | 1640 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $1,053 | | 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 | 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 $5,263 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,053 | | Insurance broker organization code? | 3 | | Insurance broker name | WILLIS OF NEW YORK, INC. |
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