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TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 401k Plan overview

Plan NameTRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M.
Plan identification number 504

TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Other welfare benefit cover

401k Sponsoring company profile

BANK HAPOALIM B.M. has sponsored the creation of one or more 401k plans.

Company Name:BANK HAPOALIM B.M.
Employer identification number (EIN):132775750
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042023-04-26
5042022-04-26
5042021-04-26
5042020-04-26
5042019-04-26
5042018-04-26
5042017-04-26CARMEN MILLS
5042016-04-26CARMEN MILLS
5042015-04-26CARMEN MILLS
5042014-04-26CARMEN MILLS
5042013-04-26CARMEN MILLS
5042012-04-26CARMEN MILLS
5042011-04-26CARMEN MILLS
5042010-04-26CARMEN MILLS
5042009-04-26CARMEN MILLS

Plan Statistics for TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M.

401k plan membership statisitcs for TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M.

Measure Date Value
2023: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2023 401k membership
Total participants, beginning-of-year2023-04-2670
Total number of active participants reported on line 7a of the Form 55002023-04-2670
Total of all active and inactive participants2023-04-2670
Total participants2023-04-2670
2022: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2022 401k membership
Total participants, beginning-of-year2022-04-2670
Total number of active participants reported on line 7a of the Form 55002022-04-2670
Total of all active and inactive participants2022-04-2670
Total participants2022-04-2670
2021: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2021 401k membership
Total participants, beginning-of-year2021-04-2670
Total number of active participants reported on line 7a of the Form 55002021-04-2670
Total of all active and inactive participants2021-04-2670
Total participants2021-04-2670
2020: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2020 401k membership
Total participants, beginning-of-year2020-04-2686
Total number of active participants reported on line 7a of the Form 55002020-04-2686
Total of all active and inactive participants2020-04-2686
Total participants2020-04-2686
2019: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2019 401k membership
Total participants, beginning-of-year2019-04-2668
Total number of active participants reported on line 7a of the Form 55002019-04-2686
Total of all active and inactive participants2019-04-2686
Total participants2019-04-2686
2018: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2018 401k membership
Total participants, beginning-of-year2018-04-2673
Total number of active participants reported on line 7a of the Form 55002018-04-2668
Total of all active and inactive participants2018-04-2668
Total participants2018-04-2668
2017: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2017 401k membership
Total participants, beginning-of-year2017-04-26299
Total number of active participants reported on line 7a of the Form 55002017-04-2673
Total of all active and inactive participants2017-04-2673
Total participants2017-04-2673
2016: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2016 401k membership
Total participants, beginning-of-year2016-04-26307
Total number of active participants reported on line 7a of the Form 55002016-04-26299
Total of all active and inactive participants2016-04-26299
Total participants2016-04-26299
2015: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2015 401k membership
Total participants, beginning-of-year2015-04-26298
Total number of active participants reported on line 7a of the Form 55002015-04-26307
Total of all active and inactive participants2015-04-26307
Total participants2015-04-26307
2014: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2014 401k membership
Total participants, beginning-of-year2014-04-26305
Total number of active participants reported on line 7a of the Form 55002014-04-26298
Total of all active and inactive participants2014-04-26298
Total participants2014-04-26298
2013: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2013 401k membership
Total participants, beginning-of-year2013-04-26329
Total number of active participants reported on line 7a of the Form 55002013-04-26305
Total of all active and inactive participants2013-04-26305
Total participants2013-04-26305
2012: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2012 401k membership
Total participants, beginning-of-year2012-04-26330
Total number of active participants reported on line 7a of the Form 55002012-04-26329
Number of retired or separated participants receiving benefits2012-04-260
Number of other retired or separated participants entitled to future benefits2012-04-260
Total of all active and inactive participants2012-04-26329
Total participants2012-04-26329
2011: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2011 401k membership
Total participants, beginning-of-year2011-04-26316
Total number of active participants reported on line 7a of the Form 55002011-04-26330
Total of all active and inactive participants2011-04-26330
Total participants2011-04-26330
2010: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2010 401k membership
Total participants, beginning-of-year2010-04-26311
Total number of active participants reported on line 7a of the Form 55002010-04-26316
Total of all active and inactive participants2010-04-26316
Total participants2010-04-26316
2009: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2009 401k membership
Total participants, beginning-of-year2009-04-26285
Total number of active participants reported on line 7a of the Form 55002009-04-26311
Total of all active and inactive participants2009-04-26311
Total participants2009-04-26311

Form 5500 Responses for TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M.

2023: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2023 form 5500 responses
2023-04-26Type of plan entitySingle employer plan
2023-04-26Submission has been amendedNo
2023-04-26This submission is the final filingNo
2023-04-26This return/report is a short plan year return/report (less than 12 months)No
2023-04-26Plan is a collectively bargained planNo
2023-04-26Plan funding arrangement – InsuranceYes
2023-04-26Plan benefit arrangement – InsuranceYes
2022: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2022 form 5500 responses
2022-04-26Type of plan entitySingle employer plan
2022-04-26Submission has been amendedNo
2022-04-26This submission is the final filingNo
2022-04-26This return/report is a short plan year return/report (less than 12 months)No
2022-04-26Plan is a collectively bargained planNo
2022-04-26Plan funding arrangement – InsuranceYes
2022-04-26Plan benefit arrangement – InsuranceYes
2021: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2021 form 5500 responses
2021-04-26Type of plan entitySingle employer plan
2021-04-26Submission has been amendedNo
2021-04-26This submission is the final filingNo
2021-04-26This return/report is a short plan year return/report (less than 12 months)No
2021-04-26Plan is a collectively bargained planNo
2021-04-26Plan funding arrangement – InsuranceYes
2021-04-26Plan benefit arrangement – InsuranceYes
2020: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2020 form 5500 responses
2020-04-26Type of plan entitySingle employer plan
2020-04-26Submission has been amendedNo
2020-04-26This submission is the final filingNo
2020-04-26This return/report is a short plan year return/report (less than 12 months)No
2020-04-26Plan is a collectively bargained planNo
2020-04-26Plan funding arrangement – InsuranceYes
2020-04-26Plan benefit arrangement – InsuranceYes
2019: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2019 form 5500 responses
2019-04-26Type of plan entitySingle employer plan
2019-04-26Submission has been amendedNo
2019-04-26This submission is the final filingNo
2019-04-26This return/report is a short plan year return/report (less than 12 months)No
2019-04-26Plan is a collectively bargained planNo
2019-04-26Plan funding arrangement – InsuranceYes
2019-04-26Plan benefit arrangement – InsuranceYes
2018: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2018 form 5500 responses
2018-04-26Type of plan entitySingle employer plan
2018-04-26Submission has been amendedNo
2018-04-26This submission is the final filingNo
2018-04-26This return/report is a short plan year return/report (less than 12 months)No
2018-04-26Plan is a collectively bargained planNo
2018-04-26Plan funding arrangement – InsuranceYes
2018-04-26Plan benefit arrangement – InsuranceYes
2017: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2017 form 5500 responses
2017-04-26Type of plan entitySingle employer plan
2017-04-26Submission has been amendedNo
2017-04-26This submission is the final filingNo
2017-04-26This return/report is a short plan year return/report (less than 12 months)No
2017-04-26Plan is a collectively bargained planNo
2017-04-26Plan funding arrangement – InsuranceYes
2017-04-26Plan benefit arrangement – InsuranceYes
2016: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2016 form 5500 responses
2016-04-26Type of plan entitySingle employer plan
2016-04-26Submission has been amendedNo
2016-04-26This submission is the final filingNo
2016-04-26This return/report is a short plan year return/report (less than 12 months)No
2016-04-26Plan is a collectively bargained planNo
2016-04-26Plan funding arrangement – InsuranceYes
2016-04-26Plan benefit arrangement – InsuranceYes
2015: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2015 form 5500 responses
2015-04-26Type of plan entitySingle employer plan
2015-04-26Submission has been amendedNo
2015-04-26This submission is the final filingNo
2015-04-26This return/report is a short plan year return/report (less than 12 months)No
2015-04-26Plan is a collectively bargained planNo
2015-04-26Plan funding arrangement – InsuranceYes
2015-04-26Plan benefit arrangement – InsuranceYes
2014: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2014 form 5500 responses
2014-04-26Type of plan entitySingle employer plan
2014-04-26First time form 5500 has been submittedYes
2014-04-26Submission has been amendedNo
2014-04-26This submission is the final filingNo
2014-04-26This return/report is a short plan year return/report (less than 12 months)No
2014-04-26Plan is a collectively bargained planNo
2014-04-26Plan funding arrangement – InsuranceYes
2014-04-26Plan benefit arrangement – InsuranceYes
2013: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2013 form 5500 responses
2013-04-26Type of plan entitySingle employer plan
2013-04-26First time form 5500 has been submittedYes
2013-04-26Submission has been amendedNo
2013-04-26This submission is the final filingNo
2013-04-26This return/report is a short plan year return/report (less than 12 months)No
2013-04-26Plan is a collectively bargained planNo
2013-04-26Plan funding arrangement – InsuranceYes
2013-04-26Plan benefit arrangement – InsuranceYes
2012: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2012 form 5500 responses
2012-04-26Type of plan entitySingle employer plan
2012-04-26First time form 5500 has been submittedYes
2012-04-26Submission has been amendedNo
2012-04-26This submission is the final filingNo
2012-04-26This return/report is a short plan year return/report (less than 12 months)No
2012-04-26Plan is a collectively bargained planNo
2012-04-26Plan funding arrangement – InsuranceYes
2012-04-26Plan benefit arrangement – InsuranceYes
2011: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2011 form 5500 responses
2011-04-26Type of plan entitySingle employer plan
2011-04-26First time form 5500 has been submittedYes
2011-04-26Submission has been amendedNo
2011-04-26This submission is the final filingNo
2011-04-26This return/report is a short plan year return/report (less than 12 months)No
2011-04-26Plan is a collectively bargained planNo
2011-04-26Plan funding arrangement – InsuranceYes
2011-04-26Plan benefit arrangement – InsuranceYes
2010: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2010 form 5500 responses
2010-04-26Type of plan entitySingle employer plan
2010-04-26First time form 5500 has been submittedYes
2010-04-26Submission has been amendedNo
2010-04-26This submission is the final filingNo
2010-04-26This return/report is a short plan year return/report (less than 12 months)No
2010-04-26Plan is a collectively bargained planNo
2010-04-26Plan funding arrangement – InsuranceYes
2010-04-26Plan benefit arrangement – InsuranceYes
2009: TRAVEL ACCIDENT PLAN FOR THE EMPLOYEES OF BANK HAPOALIM B.M. 2009 form 5500 responses
2009-04-26Type of plan entitySingle employer plan
2009-04-26First time form 5500 has been submittedYes
2009-04-26Submission has been amendedNo
2009-04-26This submission is the final filingNo
2009-04-26This return/report is a short plan year return/report (less than 12 months)No
2009-04-26Plan is a collectively bargained planNo
2009-04-26Plan funding arrangement – InsuranceYes
2009-04-26Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberN10846304
Policy instance 1
Insurance contract or identification numberN10846304
Number of Individuals Covered70
Insurance policy start date2023-04-26
Insurance policy end date2024-04-25
Total amount of commissions paid to insurance brokerUSD $7,913
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberN10846304
Policy instance 1
Insurance contract or identification numberN10846304
Number of Individuals Covered70
Insurance policy start date2022-04-26
Insurance policy end date2023-04-25
Total amount of commissions paid to insurance brokerUSD $7,913
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,913
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberN10846304
Policy instance 1
Insurance contract or identification numberN10846304
Number of Individuals Covered70
Insurance policy start date2021-04-26
Insurance policy end date2022-04-25
Total amount of commissions paid to insurance brokerUSD $7,913
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,913
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberN10846304
Policy instance 1
Insurance contract or identification numberN10846304
Number of Individuals Covered86
Insurance policy start date2020-04-26
Insurance policy end date2021-04-25
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number10846304
Policy instance 1
Insurance contract or identification number10846304
Number of Individuals Covered86
Insurance policy start date2019-04-26
Insurance policy end date2020-04-25
Total amount of commissions paid to insurance brokerUSD $21,826
Total amount of fees paid to insurance companyUSD $72,752
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,826
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberN10846304
Policy instance 1
Insurance contract or identification numberN10846304
Number of Individuals Covered68
Insurance policy start date2018-04-26
Insurance policy end date2019-04-26
Total amount of commissions paid to insurance brokerUSD $7,412
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 CarrierUSD $24,708
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,412
Additional information about fees paid to insurance brokerCOMMISSIONS
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberADDN10846304
Policy instance 1
Insurance contract or identification numberADDN10846304
Number of Individuals Covered73
Insurance policy start date2017-04-26
Insurance policy end date2018-04-25
Total amount of commissions paid to insurance brokerUSD $8,550
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 CarrierUSD $28,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,550
Additional information about fees paid to insurance brokerSERVICES
Insurance broker nameGLOBAL UNDERWRITERS AGANCY
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number000099071655
Policy instance 1
Insurance contract or identification number000099071655
Number of Individuals Covered307
Insurance policy start date2015-04-26
Insurance policy end date2016-04-25
Total amount of commissions paid to insurance brokerUSD $10,800
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 CarrierUSD $36,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,800
Additional information about fees paid to insurance brokerSTRAIGHT COMMISSIONS
Insurance broker nameGLOBAL UNDERWRITERS AGCY INC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number000099071655
Policy instance 1
Insurance contract or identification number000099071655
Number of Individuals Covered298
Insurance policy start date2014-04-26
Insurance policy end date2015-04-25
Total amount of commissions paid to insurance brokerUSD $11,439
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 CarrierUSD $38,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,439
Additional information about fees paid to insurance brokerSTRAIGHT COMMISSIONS
Insurance broker nameGLOBAL UNDERWRITERS AGCY INC.
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number000099071655
Policy instance 1
Insurance contract or identification number000099071655
Number of Individuals Covered305
Insurance policy start date2013-04-26
Insurance policy end date2014-04-25
Total amount of commissions paid to insurance brokerUSD $11,439
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 CarrierUSD $38,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,439
Additional information about fees paid to insurance brokerSTRAIGHT COMMISSIONS
Insurance broker nameGLOBAL UNDERWRITTERS AGENCY INC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number000099071655
Policy instance 1
Insurance contract or identification number000099071655
Number of Individuals Covered330
Insurance policy start date2012-04-26
Insurance policy end date2013-04-25
Total amount of commissions paid to insurance brokerUSD $11,439
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $38,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,439
Additional information about fees paid to insurance brokerSTRAIGHT COMMISSIONS
Insurance broker nameGLOBAL UNDERWRITERS AGENCY, INC.
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract numberGTP0009130511-A
Policy instance 1
Insurance contract or identification numberGTP0009130511-A
Number of Individuals Covered330
Insurance policy start date2011-04-26
Insurance policy end date2012-04-25
Total amount of commissions paid to insurance brokerUSD $7,600
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $38,000
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 numberGTP 0009130511
Policy instance 1
Insurance contract or identification numberGTP 0009130511
Number of Individuals Covered316
Insurance policy start date2010-04-26
Insurance policy end date2011-04-25
Total amount of commissions paid to insurance brokerUSD $786
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $3,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $786
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameTHE TRAYNER GROUP LTD

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