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ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 401k Plan overview

Plan NameANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN
Plan identification number 503

ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

ANCHIN BLOCK & ANCHIN LLP has sponsored the creation of one or more 401k plans.

Company Name:ANCHIN BLOCK & ANCHIN LLP
Employer identification number (EIN):130436940
NAIC Classification:541211
NAIC Description:Offices of Certified Public Accountants

Additional information about ANCHIN BLOCK & ANCHIN LLP

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1995-04-28
Company Identification Number: 1917427
Legal Registered Office Address: 80 STATE STREET

ALBANY
United States of America (USA)
122072543

More information about ANCHIN BLOCK & ANCHIN LLP

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-09-01
5032020-09-01
5032019-09-01
5032018-09-01
5032017-09-01CLARENCE KEHOE
5032016-09-01CLARENCE G KEHOE
5032015-09-01CLARENCE G KEHOE
5032014-09-01CLARENCE G KEHOE
5032013-09-01CLARENCE G KEHOE
5032012-09-01CLARENCE G KEHOE
5032011-09-01CLARENCE G KEHOE CLARENCE G KEHOE2013-01-08
5032010-09-01CLARENCE G KEHOE CLARENCE G KEHOE2011-11-23
5032009-09-01CLARENCE KEHOE CLARENCE KEHOE2011-02-18

Plan Statistics for ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN

401k plan membership statisitcs for ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN

Measure Date Value
2021: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01379
Total number of active participants reported on line 7a of the Form 55002021-09-01388
Total of all active and inactive participants2021-09-01388
2020: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01380
Total number of active participants reported on line 7a of the Form 55002020-09-01379
Total of all active and inactive participants2020-09-01379
2019: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01359
Total number of active participants reported on line 7a of the Form 55002019-09-01380
Total of all active and inactive participants2019-09-01380
2018: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01387
Total number of active participants reported on line 7a of the Form 55002018-09-01359
Total of all active and inactive participants2018-09-01359
2017: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01368
Total number of active participants reported on line 7a of the Form 55002017-09-01387
Total of all active and inactive participants2017-09-01387
2016: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01356
Total number of active participants reported on line 7a of the Form 55002016-09-01368
Total of all active and inactive participants2016-09-01368
Total participants2016-09-01368
2015: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01338
Total number of active participants reported on line 7a of the Form 55002015-09-01356
Total of all active and inactive participants2015-09-01356
Total participants2015-09-01356
2014: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01314
Total number of active participants reported on line 7a of the Form 55002014-09-01338
Total of all active and inactive participants2014-09-01338
Total participants2014-09-01338
2013: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01312
Total number of active participants reported on line 7a of the Form 55002013-09-01314
Total of all active and inactive participants2013-09-01314
Total participants2013-09-01314
2012: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01312
Total number of active participants reported on line 7a of the Form 55002012-09-01312
Total of all active and inactive participants2012-09-01312
Total participants2012-09-01312
2011: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01322
Total number of active participants reported on line 7a of the Form 55002011-09-01312
Total of all active and inactive participants2011-09-01312
Total participants2011-09-01312
2010: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2010 401k membership
Total participants, beginning-of-year2010-09-01321
Total number of active participants reported on line 7a of the Form 55002010-09-01322
Total of all active and inactive participants2010-09-01322
Total participants2010-09-01322
2009: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-01359
Total number of active participants reported on line 7a of the Form 55002009-09-01321
Total of all active and inactive participants2009-09-01321
Total participants2009-09-01321

Form 5500 Responses for ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN

2021: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2010: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Plan funding arrangement – InsuranceYes
2010-09-01Plan benefit arrangement – InsuranceYes
2009: ANCHIN BLOCK & ANCHIN LLP - LIFE, A D & D, AND LTD PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00936877
Policy instance 2
Insurance contract or identification number00936877
Number of Individuals Covered333
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $7,801
Total amount of fees paid to insurance companyUSD $5,007
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $148,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,801
Amount paid for insurance broker fees5007
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818126
Policy instance 1
Insurance contract or identification number818126
Number of Individuals Covered388
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $35,504
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA,D & D
Welfare Benefit Premiums Paid to CarrierUSD $236,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,504
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818126
Policy instance 1
Insurance contract or identification number818126
Number of Individuals Covered379
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $38,640
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA,D & D
Welfare Benefit Premiums Paid to CarrierUSD $221,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,640
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00936877
Policy instance 2
Insurance contract or identification number00936877
Number of Individuals Covered337
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $6,693
Total amount of fees paid to insurance companyUSD $3,901
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,693
Amount paid for insurance broker fees3901
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00936877
Policy instance 2
Insurance contract or identification number00936877
Number of Individuals Covered313
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $4,635
Total amount of fees paid to insurance companyUSD $2,424
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,635
Amount paid for insurance broker fees2424
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818126
Policy instance 1
Insurance contract or identification number818126
Number of Individuals Covered380
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $25,952
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA,D & D
Welfare Benefit Premiums Paid to CarrierUSD $209,118
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,952
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00936877
Policy instance 3
Insurance contract or identification number00936877
Number of Individuals Covered344
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $3,222
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,222
Insurance broker organization code?3
WESCO INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 25011 )
Policy contract numberWDL10269067,001
Policy instance 2
Insurance contract or identification numberWDL10269067,001
Number of Individuals Covered336
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $4,026
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,026
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818126
Policy instance 1
Insurance contract or identification number818126
Number of Individuals Covered359
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $29,994
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA,D & D
Welfare Benefit Premiums Paid to CarrierUSD $199,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,994
Insurance broker organization code?3
WESCO INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 25011 )
Policy contract numberWDL10269067,001
Policy instance 2
Insurance contract or identification numberWDL10269067,001
Number of Individuals Covered328
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $3,370
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818126
Policy instance 1
Insurance contract or identification number818126
Number of Individuals Covered387
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $30,019
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA,D & D
Welfare Benefit Premiums Paid to CarrierUSD $200,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818127
Policy instance 2
Insurance contract or identification number818127
Number of Individuals Covered332
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $1,228
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,228
Insurance broker organization code?3
Insurance broker nameGARY WOOD ASSOCIATES
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818126
Policy instance 1
Insurance contract or identification number818126
Number of Individuals Covered356
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $25,550
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA, D & D
Welfare Benefit Premiums Paid to CarrierUSD $171,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,550
Insurance broker organization code?3
Insurance broker nameGARY WOOD ASSOCIATES INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818127
Policy instance 2
Insurance contract or identification number818127
Number of Individuals Covered300
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $1,165
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,194
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,165
Insurance broker organization code?3
Insurance broker nameGARY WOOD ASSOCIATES
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818126
Policy instance 1
Insurance contract or identification number818126
Number of Individuals Covered338
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $22,747
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA, D & D
Welfare Benefit Premiums Paid to CarrierUSD $144,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,747
Insurance broker organization code?3
Insurance broker nameGARY WOOD ASSOCIATES INC
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number811792
Policy instance 1
Insurance contract or identification number811792
Number of Individuals Covered314
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $14,460
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA, D & D
Welfare Benefit Premiums Paid to CarrierUSD $107,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,460
Insurance broker organization code?3
Insurance broker nameGARY WOOD ASSOCIATES INC
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number811793
Policy instance 2
Insurance contract or identification number811793
Number of Individuals Covered303
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $728
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $728
Insurance broker organization code?3
Insurance broker nameGARY WOOD ASSOCIATES
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number222288
Policy instance 1
Insurance contract or identification number222288
Number of Individuals Covered312
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $3,776
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $34,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,776
Insurance broker organization code?3
Insurance broker nameGARY WOOD ASSOCIATES
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number869927G
Policy instance 2
Insurance contract or identification number869927G
Number of Individuals Covered311
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $14,754
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,754
Insurance broker organization code?3
Insurance broker nameGARY WOOD ASSOCIATES
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number222288
Policy instance 1
Insurance contract or identification number222288
Number of Individuals Covered312
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $6,014
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $51,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number869927G
Policy instance 2
Insurance contract or identification number869927G
Number of Individuals Covered310
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $14,354
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number869927G
Policy instance 2
Insurance contract or identification number869927G
Number of Individuals Covered310
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $12,684
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number222288
Policy instance 1
Insurance contract or identification number222288
Number of Individuals Covered322
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $13,684
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $112,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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