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CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 401k Plan overview

Plan NameCUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES
Plan identification number 529

CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CMFG LIFE INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:CMFG LIFE INSURANCE COMPANY
Employer identification number (EIN):390230590
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Additional information about CMFG LIFE INSURANCE COMPANY

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 2007-05-03
Company Identification Number: 345374
Legal Registered Office Address: 400 E COURT AVE

DES MOINES
United States of America (USA)
50309

More information about CMFG LIFE INSURANCE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5292017-01-01BRIAN BORAKOVE BRAD PRICER2018-07-24
5292016-01-01BRIAN BORAKOVE BRAD PRICER2017-07-18
5292015-01-01BRIAN J BORAKOVE BRADLEY J PRICER2016-07-13
5292014-01-01THOMAS J. MERFELD TERI L. EDMAN2015-07-14
5292013-01-01THOMAS J. MERFELD TERI L. EDMAN2014-07-15
5292012-01-01THOMAS J. MERFELD TERI L. EDMAN2013-06-05
5292011-01-01THOMAS MERFELD TERI EDMAN2012-07-27
5292010-01-01THOMAS MERFELD TERI EDMAN2011-07-20
5292009-01-01THOMAS MERFELD TERI EDMAN2010-07-27

Plan Statistics for CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES

401k plan membership statisitcs for CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES

Measure Date Value
2017: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2017 401k membership
Total participants, beginning-of-year2017-01-011,099
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2016 401k membership
Total participants, beginning-of-year2016-01-011,102
Total number of active participants reported on line 7a of the Form 55002016-01-011,069
Number of retired or separated participants receiving benefits2016-01-0130
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-011,099
2015: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2015 401k membership
Total participants, beginning-of-year2015-01-011,119
Total number of active participants reported on line 7a of the Form 55002015-01-011,097
Number of retired or separated participants receiving benefits2015-01-015
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-011,102
2014: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2014 401k membership
Total participants, beginning-of-year2014-01-01998
Total number of active participants reported on line 7a of the Form 55002014-01-011,003
Number of retired or separated participants receiving benefits2014-01-016
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-011,009
2013: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2013 401k membership
Total participants, beginning-of-year2013-01-01922
Total number of active participants reported on line 7a of the Form 55002013-01-01954
Number of retired or separated participants receiving benefits2013-01-019
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01963
2012: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2012 401k membership
Total participants, beginning-of-year2012-01-01844
Total number of active participants reported on line 7a of the Form 55002012-01-01870
Number of retired or separated participants receiving benefits2012-01-018
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01878
2011: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2011 401k membership
Total participants, beginning-of-year2011-01-01836
Total number of active participants reported on line 7a of the Form 55002011-01-01817
Number of retired or separated participants receiving benefits2011-01-019
Total of all active and inactive participants2011-01-01826
2010: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2010 401k membership
Total participants, beginning-of-year2010-01-01942
Total number of active participants reported on line 7a of the Form 55002010-01-01840
Number of retired or separated participants receiving benefits2010-01-0113
Total of all active and inactive participants2010-01-01853
2009: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2009 401k membership
Total participants, beginning-of-year2009-01-011,086
Total number of active participants reported on line 7a of the Form 55002009-01-01876
Number of retired or separated participants receiving benefits2009-01-0129
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01905

Form 5500 Responses for CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES

2017: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: CUNA MUTUAL GROUP VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR NON-REPRESENTED EMPLOYEES 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADD-S05306
Policy instance 1
Insurance contract or identification numberADD-S05306
Number of Individuals Covered1061
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $34,754
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
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $115,846
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,754
Insurance broker organization code?3
Insurance broker nameHAYS COMPANIES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADD-S05306
Policy instance 1
Insurance contract or identification numberADD-S05306
Number of Individuals Covered1108
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $16,532
Total amount of fees paid to insurance companyUSD $16,532
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $110,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees16532
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $16,532
Insurance broker nameAON CONSULTING
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADD-S05306
Policy instance 1
Insurance contract or identification numberADD-S05306
Number of Individuals Covered1005
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $14,929
Total amount of fees paid to insurance companyUSD $14,929
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $99,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14929
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $14,929
Insurance broker nameAON CONSULTING
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADD-S05306
Policy instance 1
Insurance contract or identification numberADD-S05306
Number of Individuals Covered963
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $14,464
Total amount of fees paid to insurance companyUSD $14,464
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $96,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14464
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $14,464
Insurance broker nameAON CONSULTING
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADD-S05306
Policy instance 1
Insurance contract or identification numberADD-S05306
Number of Individuals Covered878
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $12,534
Total amount of fees paid to insurance companyUSD $14,206
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $83,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14206
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $12,534
Insurance broker nameAON CONSULTING
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract numberGTP 0009115305
Policy instance 1
Insurance contract or identification numberGTP 0009115305
Number of Individuals Covered826
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,213
Total amount of fees paid to insurance companyUSD $4,213
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $28,083
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 0009115305
Policy instance 1
Insurance contract or identification numberGTP 0009115305
Number of Individuals Covered853
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?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 providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameRUEBEN WARNER ASSOCIATES

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