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GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 401k Plan overview

Plan NameGROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF
Plan identification number 503

GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover

401k Sponsoring company profile

PROVIDENCE COLLEGE has sponsored the creation of one or more 401k plans.

Company Name:PROVIDENCE COLLEGE
Employer identification number (EIN):050258932
NAIC Classification:611000

Additional information about PROVIDENCE COLLEGE

Jurisdiction of Incorporation: Secretary of State Rhode Island
Incorporation Date:
Company Identification Number: 000028238

More information about PROVIDENCE COLLEGE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-07-01MARGARET CARD2024-01-05
5032021-07-01MARGARET CARD2022-12-15
5032020-07-01KATHLEEN M. ALVINO2022-01-14
5032019-07-01ELIZABETH J. WALSH2020-12-03
5032018-07-01ELIZABETH J. WALSH2019-12-20
5032017-07-01ELIZABETH WALSH2019-03-26
5032016-07-01
5032015-07-01ELIZABETH J. WALSH
5032014-07-01ELIZABETH WALSH KATHLEEN ALVINO2016-04-18
5032013-07-01ELIZABETH WALSH KATHLEEN ALVINO2015-04-14
5032012-07-01ELIZABETH WALSH KATHLEEN ALVINO2014-04-11
5032011-07-01ELIZABETH WALSH KATHLEEN ALVINO2013-03-25
5032010-07-01ELIZABETH WALSH KATHLEEN ALVINO2012-01-31
5032009-07-01ELIZABETH WALSH KATHLEEN ALVINO2011-01-28

Plan Statistics for GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF

401k plan membership statisitcs for GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF

Measure Date Value
2022: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2022 401k membership
Total participants, beginning-of-year2022-07-01813
Total number of active participants reported on line 7a of the Form 55002022-07-01840
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01840
Number of employers contributing to the scheme2022-07-010
2021: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2021 401k membership
Total participants, beginning-of-year2021-07-01796
Total number of active participants reported on line 7a of the Form 55002021-07-01813
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01813
Number of employers contributing to the scheme2021-07-010
2020: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2020 401k membership
Total participants, beginning-of-year2020-07-01820
Total number of active participants reported on line 7a of the Form 55002020-07-01796
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01796
Number of employers contributing to the scheme2020-07-010
2019: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2019 401k membership
Total participants, beginning-of-year2019-07-01799
Total number of active participants reported on line 7a of the Form 55002019-07-01820
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01820
Number of employers contributing to the scheme2019-07-010
2018: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2018 401k membership
Total participants, beginning-of-year2018-07-01792
Total number of active participants reported on line 7a of the Form 55002018-07-01799
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01799
Number of employers contributing to the scheme2018-07-010
2017: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2017 401k membership
Total participants, beginning-of-year2017-07-01789
Total number of active participants reported on line 7a of the Form 55002017-07-01792
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01792
Number of employers contributing to the scheme2017-07-010
2016: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2016 401k membership
Total participants, beginning-of-year2016-07-01781
Total number of active participants reported on line 7a of the Form 55002016-07-01789
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01789
2015: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2015 401k membership
Total participants, beginning-of-year2015-07-01752
Total number of active participants reported on line 7a of the Form 55002015-07-01781
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01781
2014: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2014 401k membership
Total participants, beginning-of-year2014-07-01745
Total number of active participants reported on line 7a of the Form 55002014-07-01748
Number of retired or separated participants receiving benefits2014-07-014
Total of all active and inactive participants2014-07-01752
Total participants2014-07-01752
2013: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2013 401k membership
Total participants, beginning-of-year2013-07-01738
Total number of active participants reported on line 7a of the Form 55002013-07-01741
Number of retired or separated participants receiving benefits2013-07-014
Total of all active and inactive participants2013-07-01745
Total participants2013-07-01745
2012: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2012 401k membership
Total participants, beginning-of-year2012-07-01720
Total number of active participants reported on line 7a of the Form 55002012-07-01738
Number of retired or separated participants receiving benefits2012-07-016
Total of all active and inactive participants2012-07-01744
Total participants2012-07-01744
2011: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2011 401k membership
Total participants, beginning-of-year2011-07-01719
Total number of active participants reported on line 7a of the Form 55002011-07-01720
Number of retired or separated participants receiving benefits2011-07-016
Total of all active and inactive participants2011-07-01726
Total participants2011-07-01726
2010: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2010 401k membership
Total participants, beginning-of-year2010-07-01725
Total number of active participants reported on line 7a of the Form 55002010-07-01711
Number of retired or separated participants receiving benefits2010-07-018
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01719
Total participants2010-07-01719
2009: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2009 401k membership
Total participants, beginning-of-year2009-07-01708
Total number of active participants reported on line 7a of the Form 55002009-07-01719
Number of retired or separated participants receiving benefits2009-07-015
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01724
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-011
Total participants2009-07-01725
Number of participants with account balances2009-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010
Number of employers contributing to the scheme2009-07-010

Form 5500 Responses for GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF

2022: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: GROUP TOTAL DISABILITY PLAN FOR FACULTY, ADMINISTRATIVE, AND SUPPORT STAFF 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGF3810B6360901
Policy instance 1
Insurance contract or identification numberGF3810B6360901
Number of Individuals Covered840
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $16,110
Total amount of fees paid to insurance companyUSD $3,489
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $161,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,055
Amount paid for insurance broker fees3489
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGF3810B360901
Policy instance 1
Insurance contract or identification numberGF3810B360901
Number of Individuals Covered813
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $15,221
Total amount of fees paid to insurance companyUSD $2,740
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $138,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,610
Amount paid for insurance broker fees2740
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3810B360901
Policy instance 1
Insurance contract or identification numberGF3810B360901
Number of Individuals Covered796
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $16,509
Total amount of fees paid to insurance companyUSD $3,311
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $164,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,255
Amount paid for insurance broker fees3311
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3810B360901
Policy instance 1
Insurance contract or identification numberGF3810B360901
Number of Individuals Covered820
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $17,042
Total amount of fees paid to insurance companyUSD $3,762
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $177,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,190
Amount paid for insurance broker fees3762
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3810B360901
Policy instance 1
Insurance contract or identification numberGF3810B360901
Number of Individuals Covered799
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $15,590
Total amount of fees paid to insurance companyUSD $2,057
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $157,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,795
Amount paid for insurance broker fees2057
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3810B360901
Policy instance 1
Insurance contract or identification numberGF3810B360901
Number of Individuals Covered792
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $13,947
Total amount of fees paid to insurance companyUSD $5,027
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $152,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK960460
Policy instance 1
Insurance contract or identification numberLK960460
Number of Individuals Covered781
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $9,482
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 BenefitYes
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 $123,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,482
Insurance broker organization code?3
Insurance broker nameNOMAND SAINT LAURENT
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 960460
Policy instance 1
Insurance contract or identification numberLK 960460
Number of Individuals Covered752
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $4,669
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 BenefitYes
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 $65,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,669
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
Insurance broker nameNORMAND ST. LAURENT
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 960460
Policy instance 1
Insurance contract or identification numberLK 960460
Number of Individuals Covered745
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $3,891
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 BenefitYes
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 $59,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,891
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
Insurance broker nameNORMAND ST. LAURENT
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 960460
Policy instance 1
Insurance contract or identification numberLK 960460
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $4,859
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 BenefitYes
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 $80,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,859
Insurance broker organization code?3
Insurance broker nameNORMAND ST LAURENT
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 960460
Policy instance 1
Insurance contract or identification numberLK 960460
Number of Individuals Covered726
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $4,436
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 960460
Policy instance 1
Insurance contract or identification numberLK 960460
Number of Individuals Covered719
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $5,715
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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