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DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 401k Plan overview

Plan NameDENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC
Plan identification number 505

DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY
Employer identification number (EIN):150398170
NAIC Classification:524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052023-01-01
5052022-01-01
5052021-01-01
5052020-01-01
5052019-06-01
5052018-06-01
5052017-06-01DOUGLAS FRANKLIN DOUGLAS FRANKLIN2018-11-29
5052016-06-01DOUGLAS FRANKLIN DOUGLAS FRANKLIN2017-12-21
5052015-06-01DOUGLAS FRANKLIN DOUGLAS FRANKLIN2016-12-07
5052014-06-01DOUGLAS FRANKLIN DOUGLAS FRANKLIN2015-12-21
5052013-06-01DOUGLAS FRANKLIN DOUGLAS FRANKLIN2014-12-24
5052012-06-01DOUGLAS FRANKLIN DOUGLAS FRANKLIN2013-12-30
5052011-06-01DOUGLAS FRANKLIN
5052009-06-01DOUGLAS FRANKLIN

Plan Statistics for DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC

401k plan membership statisitcs for DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC

Measure Date Value
2023: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2023 401k membership
Total participants, beginning-of-year2023-01-01652
Total number of active participants reported on line 7a of the Form 55002023-01-01670
Total of all active and inactive participants2023-01-01670
Total participants2023-01-01670
2022: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2022 401k membership
Total participants, beginning-of-year2022-01-01616
Total number of active participants reported on line 7a of the Form 55002022-01-01652
Total of all active and inactive participants2022-01-01652
Total participants2022-01-01652
2021: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2021 401k membership
Total participants, beginning-of-year2021-01-01589
Total number of active participants reported on line 7a of the Form 55002021-01-01616
Total of all active and inactive participants2021-01-01616
Total participants2021-01-01616
2020: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2020 401k membership
Total participants, beginning-of-year2020-01-01585
Total number of active participants reported on line 7a of the Form 55002020-01-01589
Total of all active and inactive participants2020-01-01589
Total participants2020-01-01589
2019: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2019 401k membership
Total participants, beginning-of-year2019-06-01585
Total number of active participants reported on line 7a of the Form 55002019-06-01585
Total of all active and inactive participants2019-06-01585
Total participants2019-06-01585
2018: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2018 401k membership
Total participants, beginning-of-year2018-06-01569
Total number of active participants reported on line 7a of the Form 55002018-06-01585
Total of all active and inactive participants2018-06-01585
Total participants2018-06-01585
2017: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2017 401k membership
Total participants, beginning-of-year2017-06-01580
Total number of active participants reported on line 7a of the Form 55002017-06-01569
Total of all active and inactive participants2017-06-01569
Total participants2017-06-01569
2016: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2016 401k membership
Total participants, beginning-of-year2016-06-01566
Total number of active participants reported on line 7a of the Form 55002016-06-01580
Total of all active and inactive participants2016-06-01580
Total participants2016-06-01580
2015: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2015 401k membership
Total participants, beginning-of-year2015-06-01566
Total number of active participants reported on line 7a of the Form 55002015-06-01566
Total of all active and inactive participants2015-06-01566
Total participants2015-06-01566
2014: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2014 401k membership
Total participants, beginning-of-year2014-06-01584
Total number of active participants reported on line 7a of the Form 55002014-06-01566
Total of all active and inactive participants2014-06-01566
Total participants2014-06-01566
2013: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2013 401k membership
Total participants, beginning-of-year2013-06-01599
Total number of active participants reported on line 7a of the Form 55002013-06-01584
Total of all active and inactive participants2013-06-01584
Total participants2013-06-01584
2012: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2012 401k membership
Total participants, beginning-of-year2012-06-01642
Total number of active participants reported on line 7a of the Form 55002012-06-01599
Total of all active and inactive participants2012-06-01599
Total participants2012-06-01599
2011: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2011 401k membership
Total participants, beginning-of-year2011-06-01636
Total number of active participants reported on line 7a of the Form 55002011-06-01642
Total of all active and inactive participants2011-06-01642
Total participants2011-06-01642
2009: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2009 401k membership
Total participants, beginning-of-year2009-06-01648
Total number of active participants reported on line 7a of the Form 55002009-06-01629
Total of all active and inactive participants2009-06-01629
Total participants2009-06-01629

Form 5500 Responses for DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC

2023: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Submission has been amendedNo
2019-06-01This submission is the final filingNo
2019-06-01This return/report is a short plan year return/report (less than 12 months)No
2019-06-01Plan is a collectively bargained planNo
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Submission has been amendedNo
2018-06-01This submission is the final filingNo
2018-06-01This return/report is a short plan year return/report (less than 12 months)No
2018-06-01Plan is a collectively bargained planNo
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Submission has been amendedNo
2017-06-01This submission is the final filingNo
2017-06-01This return/report is a short plan year return/report (less than 12 months)No
2017-06-01Plan is a collectively bargained planNo
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Submission has been amendedNo
2016-06-01This submission is the final filingNo
2016-06-01This return/report is a short plan year return/report (less than 12 months)No
2016-06-01Plan is a collectively bargained planNo
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Submission has been amendedNo
2015-06-01This submission is the final filingNo
2015-06-01This return/report is a short plan year return/report (less than 12 months)No
2015-06-01Plan is a collectively bargained planNo
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingNo
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Submission has been amendedNo
2012-06-01This submission is the final filingNo
2012-06-01This return/report is a short plan year return/report (less than 12 months)No
2012-06-01Plan is a collectively bargained planNo
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes
2011: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Submission has been amendedNo
2011-06-01This submission is the final filingNo
2011-06-01This return/report is a short plan year return/report (less than 12 months)No
2011-06-01Plan is a collectively bargained planNo
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – InsuranceYes
2009: DENTAL INSURANCE PLAN FOR THE EMPLOYEES OF NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY & ALBERT F STAGER INC 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Submission has been amendedNo
2009-06-01This submission is the final filingNo
2009-06-01This return/report is a short plan year return/report (less than 12 months)No
2009-06-01Plan is a collectively bargained planNo
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered670
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $8,865
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $457,697
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered652
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,635
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $430,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,635
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered616
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,516
Total amount of fees paid to insurance companyUSD $14,373
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $443,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees14373
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered589
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $10,034
Total amount of fees paid to insurance companyUSD $9,668
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $410,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9668
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $10,034
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered585
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $8,572
Total amount of fees paid to insurance companyUSD $9,668
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $426,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9668
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $8,572
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered585
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $9,509
Total amount of fees paid to insurance companyUSD $13,377
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $431,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees13377
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $9,509
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered569
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $8,353
Total amount of fees paid to insurance companyUSD $12,911
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $424,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,353
Insurance broker organization code?3
Amount paid for insurance broker fees12911
Insurance broker nameBURNHAM FINANCIAL SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered566
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $10,910
Total amount of fees paid to insurance companyUSD $12,952
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $470,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees12952
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $10,910
Insurance broker nameJEFFREY P BURNHAM
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered566
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $6,056
Total amount of fees paid to insurance companyUSD $9,402
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $395,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9402
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $6,056
Insurance broker nameJEFFERY BURNHAM
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered584
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $8,806
Total amount of fees paid to insurance companyUSD $13,866
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $453,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees13866
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $8,806
Insurance broker nameJEFFERY P. BURNHAM
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered599
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $8,867
Total amount of fees paid to insurance companyUSD $13,979
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $458,955
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,867
Insurance broker organization code?3
Amount paid for insurance broker fees13979
Insurance broker nameBURNHAM FINANCIAL SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered642
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $11,628
Total amount of fees paid to insurance companyUSD $14,061
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $515,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00339442
Policy instance 1
Insurance contract or identification number00339442
Number of Individuals Covered636
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $8,853
Total amount of fees paid to insurance companyUSD $13,668
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $456,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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