CLEVELAND BROTHERS EQUIPMENT CO INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 505 | 2023-01-01 | JOSEPH A BURGESS | 2024-07-19 | | |
| 505 | 2022-01-01 | JOSEPH J LUNDY | 2023-07-12 | | |
| 505 | 2021-01-01 | JOSEPH J. LUNDY | 2022-06-27 | | |
| 505 | 2020-01-01 | JOSEPH LUNDY | 2021-07-01 | | |
| 505 | 2019-01-01 | | | | |
| 505 | 2018-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2019-03-18 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2019-03-18 |
| 505 | 2017-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2018-03-08 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2018-03-08 |
| 505 | 2016-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2017-04-20 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2017-04-20 |
| 505 | 2015-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2016-04-21 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2016-04-21 |
| 505 | 2014-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2015-05-21 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2015-05-21 |
| 505 | 2014-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2015-05-21 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2015-05-21 |
| 505 | 2013-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2014-05-22 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2014-05-22 |
| 505 | 2012-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2013-04-25 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2013-04-25 |
| 505 | 2011-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2012-05-18 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2012-05-18 |
| 505 | 2010-01-01 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2011-05-20 | JOSEPH J.LUNDY, SR VICE PRES.CFO | 2011-05-20 |
| 505 | 2009-01-01 | JOSEPH J. LUNDY, SR. VP.FINANCECFO | 2010-06-15 | JOSEPH J. LUNDY, SR. VP.FINANCECFO | 2010-06-15 |
401k plan membership statisitcs for CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN
| Measure | Date | Value |
|---|
| 2023: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 1,372 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 1,379 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 1,379 |
| Number of employers contributing to the scheme | 2023-01-01 | 0 |
| 2022: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 1,372 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 1,372 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 1,372 |
| 2021: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 1,372 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 1,372 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 1,372 |
| 2020: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 1,335 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 1,372 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 1,372 |
| 2019: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 1,290 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 1,335 |
| Total of all active and inactive participants | 2019-01-01 | 1,335 |
| Total participants | 2019-01-01 | 1,335 |
| 2018: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 1,241 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 1,290 |
| Total of all active and inactive participants | 2018-01-01 | 1,290 |
| Total participants | 2018-01-01 | 1,290 |
| 2017: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 1,241 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 1,241 |
| Total of all active and inactive participants | 2017-01-01 | 1,241 |
| Total participants | 2017-01-01 | 1,241 |
| 2016: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 1,340 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1,340 |
| Total of all active and inactive participants | 2016-01-01 | 1,340 |
| Total participants | 2016-01-01 | 1,340 |
| 2015: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 1,340 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,340 |
| Total of all active and inactive participants | 2015-01-01 | 1,340 |
| Total participants | 2015-01-01 | 1,340 |
| 2014: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 1,240 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 1,340 |
| Total of all active and inactive participants | 2014-01-01 | 1,340 |
| Total participants | 2014-01-01 | 1,340 |
| 2013: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 1,322 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 1,240 |
| Total of all active and inactive participants | 2013-01-01 | 1,240 |
| Total participants | 2013-01-01 | 1,240 |
| 2012: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 1,104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 1,322 |
| Total of all active and inactive participants | 2012-01-01 | 1,322 |
| Total participants | 2012-01-01 | 1,322 |
| 2011: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 1,145 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 1,104 |
| Total of all active and inactive participants | 2011-01-01 | 1,104 |
| Total participants | 2011-01-01 | 1,104 |
| 2010: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 1,156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 1,145 |
| Total of all active and inactive participants | 2010-01-01 | 1,145 |
| Total participants | 2010-01-01 | 1,145 |
| 2009: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 1,366 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,156 |
| 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 | 1,156 |
| Total participants | 2009-01-01 | 1,156 |
| 2023: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan is a collectively bargained plan | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 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 | Yes |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 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 | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 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 | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: CLEVELAND BROTHERS TRAVEL ACCIDENTAL DEATH & DISMEMBERMENT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU2092701 |
| Policy instance | 1 |
| Insurance contract or identification number | GTU2092701 | | Number of Individuals Covered | 1379 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,528 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $10,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU2092701 |
| Policy instance | 1 |
| Insurance contract or identification number | GTU2092701 | | Number of Individuals Covered | 1372 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,462 | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS 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 Carrier | USD $9,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,462 | | Insurance broker organization code? | 3 |
|
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU2092701 |
| Policy instance | 1 |
| Insurance contract or identification number | GTU2092701 | | Number of Individuals Covered | 1372 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,462 | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS 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 Carrier | USD $9,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,462 | | Insurance broker organization code? | 3 |
|
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU2092701 |
| Policy instance | 1 |
| Insurance contract or identification number | GTU2092701 | | Number of Individuals Covered | 1372 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,462 | | 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS 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 Carrier | USD $9,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,462 | | Insurance broker organization code? | 3 |
|
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU2092701 |
| Policy instance | 1 |
| Insurance contract or identification number | GTU2092701 | | Number of Individuals Covered | 1335 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,462 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $9,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,462 | | Insurance broker organization code? | 3 |
|
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU2092701 |
| Policy instance | 1 |
| Insurance contract or identification number | GTU2092701 | | Number of Individuals Covered | 1290 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,462 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $9,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,462 | | Insurance broker organization code? | 3 |
|
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU2092701 |
| Policy instance | 1 |
| Insurance contract or identification number | GTU2092701 | | Number of Individuals Covered | 1241 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,462 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $9,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,462 | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH & BENEFITS |
|
