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BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 401k Plan overview

Plan NameBARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES
Plan identification number 502

BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES Benefits

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

401k Sponsoring company profile

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

Company Name:BARNARD COLLEGE
Employer identification number (EIN):131628149
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-01-01
5022017-01-01
5022016-01-01EILEEN DIBENEDETTO
5022015-01-01EILEEN DIBENEDETTO
5022014-01-01EILEEN DIBENEDETTO EILEEN DIBENEDETTO2015-10-12
5022013-01-01EILEEN DIBENEDETTO EILEEN DIBENEDETTO2014-10-09
5022012-01-01EILEEN DIBENEDETTO
5022011-01-01EILEEN DIBENEDETTO
5022009-01-01EILEEN DIBENEDETTO
5022009-01-01 EILEEN DIBENEDETTO2010-07-27

Plan Statistics for BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES

401k plan membership statisitcs for BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES

Measure Date Value
2017: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2017 401k membership
Total participants, beginning-of-year2017-01-01760
Total number of active participants reported on line 7a of the Form 55002017-01-01775
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 participants2017-01-01775
Number of employers contributing to the scheme2017-01-010
2016: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2016 401k membership
Total participants, beginning-of-year2016-01-01778
Total number of active participants reported on line 7a of the Form 55002016-01-01760
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01760
2015: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2015 401k membership
Total participants, beginning-of-year2015-01-01773
Total number of active participants reported on line 7a of the Form 55002015-01-01778
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01778
2014: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2014 401k membership
Total participants, beginning-of-year2014-01-01711
Total number of active participants reported on line 7a of the Form 55002014-01-01755
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01755
2013: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2013 401k membership
Total participants, beginning-of-year2013-01-01709
Total number of active participants reported on line 7a of the Form 55002013-01-01711
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01711
2012: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2012 401k membership
Total participants, beginning-of-year2012-01-01737
Total number of active participants reported on line 7a of the Form 55002012-01-01709
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01709
2011: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2011 401k membership
Total participants, beginning-of-year2011-01-011,281
Total number of active participants reported on line 7a of the Form 55002011-01-011,317
Total of all active and inactive participants2011-01-011,317
Total participants2011-01-011,317
2009: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2009 401k membership
Total participants, beginning-of-year2009-01-01695
Total number of active participants reported on line 7a of the Form 55002009-01-01694
Total of all active and inactive participants2009-01-01694
Total participants2009-01-01694

Form 5500 Responses for BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES

2017: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01This submission is the final filingYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL 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: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL 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: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL 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: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL 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: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL 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: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL 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
2009: BARNARD COLLEGE GROUP INS PLAN AND LIFE INSURANCE FOR ADMINISTRATIVE OPERATIONAL, ACADEMIC AND CONFIDENTIAL EMPLOYEES 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
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

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYOK008371
Policy instance 2
Insurance contract or identification numberYOK008371
Number of Individuals Covered622
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $74
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $17,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees74
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameAON CONSULTING
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY051132
Policy instance 1
Insurance contract or identification numberFLY051132
Number of Individuals Covered775
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $407
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees407
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameAON CONSULTING
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY051132
Policy instance 2
Insurance contract or identification numberFLY051132
Number of Individuals Covered778
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $55,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYOK008371
Policy instance 1
Insurance contract or identification numberYOK008371
Number of Individuals Covered778
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 AND 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 $8,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY051132
Policy instance 1
Insurance contract or identification numberFLY051132
Number of Individuals Covered755
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $70,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYOK008371
Policy instance 2
Insurance contract or identification numberYOK008371
Number of Individuals Covered596
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 AND 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 $8,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYOK008371
Policy instance 2
Insurance contract or identification numberYOK008371
Number of Individuals Covered559
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $83
Total amount of fees paid to insurance companyUSD $-20
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 providedAD&D
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 $8,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTARY COMMISSION & OVERRIDE
Insurance broker nameMERCER HEALTH & BENEFITS
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY051132
Policy instance 1
Insurance contract or identification numberFLY051132
Number of Individuals Covered711
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $656
Total amount of fees paid to insurance companyUSD $-161
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
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 $67,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $332
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTARY COMMISSION & OVERRIDE
Insurance broker nameMERCER HEALTH & BENEFITS
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY051132
Policy instance 2
Insurance contract or identification numberFLY051132
Number of Individuals Covered709
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $485
Total amount of fees paid to insurance companyUSD $161
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
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 $65,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $485
Amount paid for insurance broker fees161
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSION & OVERRIDE
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYOK008371
Policy instance 1
Insurance contract or identification numberYOK008371
Number of Individuals Covered558
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $52
Total amount of fees paid to insurance companyUSD $20
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 providedAD&D
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 $8,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52
Amount paid for insurance broker fees20
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSION & OVERRIDE
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY051132
Policy instance 1
Insurance contract or identification numberFLY051132
Number of Individuals Covered737
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $652
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYOK008371
Policy instance 2
Insurance contract or identification numberYOK008371
Number of Individuals Covered580
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $94
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTIAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYOK008371
Policy instance 1
Insurance contract or identification numberYOK008371
Number of Individuals Covered566
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,424
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,357
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPP. COMMISSION
Insurance broker nameMERCER HEALTH AND BENEDITS
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY051132
Policy instance 2
Insurance contract or identification numberFLY051132
Number of Individuals Covered715
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,218
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,803
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPP. COMMISSION
Insurance broker nameMERCER HEALTH AND BENEFITS

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