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STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 401k Plan overview

Plan NameSTANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE
Plan identification number 502

STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

STANDARD FUSEE CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:STANDARD FUSEE CORPORATION
Employer identification number (EIN):061240151
NAIC Classification:339900

Additional information about STANDARD FUSEE CORPORATION

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2153737

More information about STANDARD FUSEE CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-06-07
5022021-06-07
5022020-06-07
5022019-06-07
5022018-06-07
5022017-06-07HEATHER GUY HEATHER GUY2018-07-30
5022016-06-07HEATHER GUY HEATHER GUY2017-11-16
5022015-06-07ALISON BALL ALISON BALL2016-07-25
5022014-06-07ALISON BALL ALISON BALL2015-07-17
5022013-06-07ALISON BALL ALISON BALL2014-06-25
5022012-06-07ALISON BALL ALISON BALL2013-08-27
5022011-06-07ALISON BALL ALISON BALL2012-06-28
5022009-06-07ALISON BALL ALISON BALL2010-12-14

Plan Statistics for STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE

401k plan membership statisitcs for STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE

Measure Date Value
2022: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2022 401k membership
Total participants, beginning-of-year2022-06-07114
Total number of active participants reported on line 7a of the Form 55002022-06-07106
Number of retired or separated participants receiving benefits2022-06-070
Number of other retired or separated participants entitled to future benefits2022-06-070
Total of all active and inactive participants2022-06-07106
2021: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-06-07113
Total number of active participants reported on line 7a of the Form 55002021-06-07114
Number of retired or separated participants receiving benefits2021-06-070
Number of other retired or separated participants entitled to future benefits2021-06-070
Total of all active and inactive participants2021-06-07114
2020: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-06-07121
Total number of active participants reported on line 7a of the Form 55002020-06-07107
Total of all active and inactive participants2020-06-07107
2019: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-06-07123
Total number of active participants reported on line 7a of the Form 55002019-06-07116
Number of retired or separated participants receiving benefits2019-06-070
Number of other retired or separated participants entitled to future benefits2019-06-070
Total of all active and inactive participants2019-06-07116
2018: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-06-07377
Total number of active participants reported on line 7a of the Form 55002018-06-07381
Total of all active and inactive participants2018-06-07381
2017: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-06-07119
Total number of active participants reported on line 7a of the Form 55002017-06-07377
Total of all active and inactive participants2017-06-07377
2016: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-06-07126
Total number of active participants reported on line 7a of the Form 55002016-06-07119
Total of all active and inactive participants2016-06-07119
2015: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-06-07121
Total number of active participants reported on line 7a of the Form 55002015-06-07127
Number of retired or separated participants receiving benefits2015-06-070
Number of other retired or separated participants entitled to future benefits2015-06-070
Total of all active and inactive participants2015-06-07127
2014: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-06-07113
Total number of active participants reported on line 7a of the Form 55002014-06-07121
Number of retired or separated participants receiving benefits2014-06-070
Number of other retired or separated participants entitled to future benefits2014-06-070
Total of all active and inactive participants2014-06-07121
2013: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-06-07114
Total number of active participants reported on line 7a of the Form 55002013-06-07113
Number of retired or separated participants receiving benefits2013-06-070
Number of other retired or separated participants entitled to future benefits2013-06-070
Total of all active and inactive participants2013-06-07113
2012: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-06-07118
Total number of active participants reported on line 7a of the Form 55002012-06-07114
Number of retired or separated participants receiving benefits2012-06-070
Number of other retired or separated participants entitled to future benefits2012-06-070
Total of all active and inactive participants2012-06-07114
2011: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-06-07111
Total number of active participants reported on line 7a of the Form 55002011-06-07118
Number of retired or separated participants receiving benefits2011-06-070
Number of other retired or separated participants entitled to future benefits2011-06-070
Total of all active and inactive participants2011-06-07118
2009: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-06-07115
Total number of active participants reported on line 7a of the Form 55002009-06-07111
Number of retired or separated participants receiving benefits2009-06-070
Number of other retired or separated participants entitled to future benefits2009-06-070
Total of all active and inactive participants2009-06-07111

Form 5500 Responses for STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE

2022: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2022 form 5500 responses
2022-06-07Type of plan entitySingle employer plan
2022-06-07Submission has been amendedNo
2022-06-07This submission is the final filingNo
2022-06-07This return/report is a short plan year return/report (less than 12 months)No
2022-06-07Plan is a collectively bargained planNo
2022-06-07Plan funding arrangement – InsuranceYes
2022-06-07Plan benefit arrangement – InsuranceYes
2021: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2021 form 5500 responses
2021-06-07Type of plan entitySingle employer plan
2021-06-07Submission has been amendedNo
2021-06-07This submission is the final filingNo
2021-06-07This return/report is a short plan year return/report (less than 12 months)No
2021-06-07Plan is a collectively bargained planNo
2021-06-07Plan funding arrangement – InsuranceYes
2021-06-07Plan benefit arrangement – InsuranceYes
2020: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2020 form 5500 responses
2020-06-07Type of plan entitySingle employer plan
2020-06-07Submission has been amendedNo
2020-06-07This submission is the final filingNo
2020-06-07This return/report is a short plan year return/report (less than 12 months)No
2020-06-07Plan is a collectively bargained planNo
2020-06-07Plan funding arrangement – InsuranceYes
2020-06-07Plan benefit arrangement – InsuranceYes
2019: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2019 form 5500 responses
2019-06-07Type of plan entitySingle employer plan
2019-06-07Submission has been amendedNo
2019-06-07This submission is the final filingNo
2019-06-07This return/report is a short plan year return/report (less than 12 months)No
2019-06-07Plan is a collectively bargained planNo
2019-06-07Plan funding arrangement – InsuranceYes
2019-06-07Plan benefit arrangement – InsuranceYes
2018: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2018 form 5500 responses
2018-06-07Type of plan entitySingle employer plan
2018-06-07Submission has been amendedNo
2018-06-07This submission is the final filingNo
2018-06-07This return/report is a short plan year return/report (less than 12 months)No
2018-06-07Plan is a collectively bargained planNo
2018-06-07Plan funding arrangement – InsuranceYes
2018-06-07Plan benefit arrangement – InsuranceYes
2017: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2017 form 5500 responses
2017-06-07Type of plan entitySingle employer plan
2017-06-07Submission has been amendedNo
2017-06-07This submission is the final filingNo
2017-06-07This return/report is a short plan year return/report (less than 12 months)No
2017-06-07Plan is a collectively bargained planNo
2017-06-07Plan funding arrangement – InsuranceYes
2017-06-07Plan benefit arrangement – InsuranceYes
2016: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2016 form 5500 responses
2016-06-07Type of plan entitySingle employer plan
2016-06-07Submission has been amendedNo
2016-06-07This submission is the final filingNo
2016-06-07This return/report is a short plan year return/report (less than 12 months)No
2016-06-07Plan is a collectively bargained planNo
2016-06-07Plan funding arrangement – InsuranceYes
2016-06-07Plan benefit arrangement – InsuranceYes
2015: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2015 form 5500 responses
2015-06-07Type of plan entitySingle employer plan
2015-06-07Submission has been amendedNo
2015-06-07This submission is the final filingNo
2015-06-07This return/report is a short plan year return/report (less than 12 months)No
2015-06-07Plan is a collectively bargained planNo
2015-06-07Plan funding arrangement – InsuranceYes
2015-06-07Plan benefit arrangement – InsuranceYes
2014: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2014 form 5500 responses
2014-06-07Type of plan entitySingle employer plan
2014-06-07Submission has been amendedNo
2014-06-07This submission is the final filingNo
2014-06-07This return/report is a short plan year return/report (less than 12 months)No
2014-06-07Plan is a collectively bargained planNo
2014-06-07Plan funding arrangement – InsuranceYes
2014-06-07Plan benefit arrangement – InsuranceYes
2013: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2013 form 5500 responses
2013-06-07Type of plan entitySingle employer plan
2013-06-07Submission has been amendedNo
2013-06-07This submission is the final filingNo
2013-06-07This return/report is a short plan year return/report (less than 12 months)No
2013-06-07Plan is a collectively bargained planNo
2013-06-07Plan funding arrangement – InsuranceYes
2013-06-07Plan benefit arrangement – InsuranceYes
2012: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2012 form 5500 responses
2012-06-07Type of plan entitySingle employer plan
2012-06-07Submission has been amendedNo
2012-06-07This submission is the final filingNo
2012-06-07This return/report is a short plan year return/report (less than 12 months)No
2012-06-07Plan is a collectively bargained planNo
2012-06-07Plan funding arrangement – InsuranceYes
2012-06-07Plan benefit arrangement – InsuranceYes
2011: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2011 form 5500 responses
2011-06-07Type of plan entitySingle employer plan
2011-06-07Submission has been amendedNo
2011-06-07This submission is the final filingNo
2011-06-07This return/report is a short plan year return/report (less than 12 months)No
2011-06-07Plan is a collectively bargained planNo
2011-06-07Plan funding arrangement – InsuranceYes
2011-06-07Plan benefit arrangement – InsuranceYes
2009: STANDARD FUSEE CORP. GROUP BUSINESS TRAVEL ACCIDENT INSURANCE 2009 form 5500 responses
2009-06-07Type of plan entitySingle employer plan
2009-06-07Submission has been amendedNo
2009-06-07This submission is the final filingNo
2009-06-07This return/report is a short plan year return/report (less than 12 months)No
2009-06-07Plan is a collectively bargained planNo
2009-06-07Plan funding arrangement – InsuranceYes
2009-06-07Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5555311
Policy instance 1
Insurance contract or identification number5555311
Number of Individuals Covered271
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $2,530
Total amount of fees paid to insurance companyUSD $14
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 BenefitYes
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 $30,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,530
Amount paid for insurance broker fees14
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5555311
Policy instance 1
Insurance contract or identification number5555311
Number of Individuals Covered342
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $2,135
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 BenefitYes
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 $30,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,135
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5555311
Policy instance 1
Insurance contract or identification number5555311
Number of Individuals Covered359
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $2,198
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 BenefitYes
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 $31,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,198
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5555311
Policy instance 1
Insurance contract or identification number5555311
Number of Individuals Covered354
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $2,312
Total amount of fees paid to insurance companyUSD $109
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 BenefitYes
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 $28,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,312
Amount paid for insurance broker fees109
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5555311
Policy instance 1
Insurance contract or identification number5555311
Number of Individuals Covered381
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $2,198
Total amount of fees paid to insurance companyUSD $103
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 BenefitYes
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 $29,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,198
Amount paid for insurance broker fees103
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5555311
Policy instance 1
Insurance contract or identification number5555311
Number of Individuals Covered377
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Total amount of commissions paid to insurance brokerUSD $2,226
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 BenefitYes
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 $27,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,226
Insurance broker organization code?3
Insurance broker nameFRED C. CHURCH, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05555311
Policy instance 1
Insurance contract or identification numberTM05555311
Number of Individuals Covered416
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $2,090
Total amount of fees paid to insurance companyUSD $238
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 BenefitYes
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 $27,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,090
Amount paid for insurance broker fees238
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameFRED C. CHURCH, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05555311
Policy instance 1
Insurance contract or identification numberTM05555311
Number of Individuals Covered396
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $2,049
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 BenefitYes
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 $26,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,049
Insurance broker organization code?3
Insurance broker nameFRED C. CHURCH, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05555311
Policy instance 1
Insurance contract or identification numberTM05555311
Number of Individuals Covered393
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $2,091
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 BenefitYes
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 $26,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,091
Insurance broker organization code?3
Insurance broker nameFRED C. CHURCH, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05555311
Policy instance 1
Insurance contract or identification numberTM05555311
Number of Individuals Covered417
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $2,112
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 BenefitYes
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 $29,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,112
Insurance broker organization code?3
Insurance broker nameFRED C. CHURCH, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05555311
Policy instance 1
Insurance contract or identification numberTM05555311
Number of Individuals Covered408
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $1,951
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 BenefitYes
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 $22,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05555311
Policy instance 1
Insurance contract or identification numberTM05555311
Number of Individuals Covered396
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $1,761
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 BenefitYes
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 $22,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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