TRUSTEES OF PRINCETON UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 602 | 2023-01-01 | | | | |
| 602 | 2022-01-01 | | | | |
| 602 | 2021-01-01 | | | | |
| 602 | 2020-01-01 | | | | |
| 602 | 2019-01-01 | | | | |
| 602 | 2018-01-01 | | | | |
| 602 | 2017-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | | | |
| 602 | 2016-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | | | |
| 602 | 2016-01-01 | LIANNE SULLIVAN-CROWLEY | 2017-10-08 | | |
| 602 | 2015-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | | | |
| 602 | 2014-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | | | |
| 602 | 2013-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | 2014-10-13 | LIANNE SULLIVAN-CROWLEY,VP HR | 2014-10-13 |
| 602 | 2012-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | 2013-09-05 | LIANNE SULLIVAN-CROWLEY,VP HR | 2013-09-05 |
| 602 | 2011-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | | LIANNE SULLIVAN-CROWLEY,VP HR | 2012-10-12 |
| 602 | 2009-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | 2010-10-19 | LIANNE SULLIVAN-CROWLEY,VP HR | 2010-10-19 |
| 602 | 2009-01-01 | LIANNE SULLIVAN-CROWLEY,VP,HR | 2010-10-15 | LIANNE SULLIVAN-CROWLEY,VP HR | 2010-10-15 |
| Measure | Date | Value |
|---|
| 2023: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 4,886 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 5,263 |
| Total of all active and inactive participants | 2023-01-01 | 5,263 |
| 2022: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 4,709 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 4,886 |
| Total of all active and inactive participants | 2022-01-01 | 4,886 |
| 2021: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 4,649 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 4,709 |
| Total of all active and inactive participants | 2021-01-01 | 4,709 |
| 2020: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 4,449 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 4,649 |
| Total of all active and inactive participants | 2020-01-01 | 4,649 |
| 2019: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 4,377 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 4,449 |
| Total of all active and inactive participants | 2019-01-01 | 4,449 |
| 2018: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 4,799 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 4,377 |
| Total of all active and inactive participants | 2018-01-01 | 4,377 |
| 2017: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 4,776 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 4,799 |
| Total of all active and inactive participants | 2017-01-01 | 4,799 |
| 2016: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 4,724 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 4,776 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 4,776 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| 2015: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 4,724 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 4,665 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 4,665 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| 2014: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 4,411 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 4,724 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 4,724 |
| 2013: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 4,307 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 4,411 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 4,411 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| 2012: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 4,215 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 4,307 |
| Total of all active and inactive participants | 2012-01-01 | 4,307 |
| 2011: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 4,058 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 4,215 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 4,215 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 4,215 |
| 2009: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 2,981 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 2,949 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 2,949 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 2,949 |
| 2023: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | Yes |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP LIFE INSURANCE PROGRAM - SUPPLEMENTAL 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681431G |
| Policy instance | 1 |
| Insurance contract or identification number | 681431G | | Number of Individuals Covered | 5263 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $25,876 | | Total amount of fees paid to insurance company | USD $127,738 | | 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 $2,593,356 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681431G |
| Policy instance | 1 |
| Insurance contract or identification number | 681431G | | Number of Individuals Covered | 4886 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $24,398 | | Total amount of fees paid to insurance company | USD $97,592 | | 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 $2,439,807 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,398 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 97592 | | Additional information about fees paid to insurance broker | FEES |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681431G |
| Policy instance | 1 |
| Insurance contract or identification number | 681431G | | Number of Individuals Covered | 4709 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $23,701 | | Total amount of fees paid to insurance company | USD $94,803 | | 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 $2,370,071 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,701 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 94803 | | Additional information about fees paid to insurance broker | FEES |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681431G |
| Policy instance | 1 |
| Insurance contract or identification number | 681431G | | Number of Individuals Covered | 4649 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $22,966 | | Total amount of fees paid to insurance company | USD $91,866 | | 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 $2,296,650 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,966 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 91866 | | Additional information about fees paid to insurance broker | FEES |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681431G |
| Policy instance | 1 |
| Insurance contract or identification number | 681431G | | Number of Individuals Covered | 4449 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $22,337 | | Total amount of fees paid to insurance company | USD $89,349 | | 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 $2,233,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,337 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 89349 | | Additional information about fees paid to insurance broker | FEES |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 44399-2 |
| Policy instance | 1 |
| Insurance contract or identification number | 44399-2 | | Number of Individuals Covered | 4377 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $89,921 | | Total amount of fees paid to insurance company | USD $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 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 $2,242,993 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $63,552 | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 44399-2 |
| Policy instance | 1 |
| Insurance contract or identification number | 44399-2 | | Number of Individuals Covered | 4799 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $66,279 | | Total amount of fees paid to insurance company | USD $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 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 $2,209,286 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $66,279 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF PA, INC. |
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