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THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 401k Plan overview

Plan NameTHE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC.
Plan identification number 502

THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 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)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

PUIG NORTH AMERICA, INC. has sponsored the creation of one or more 401k plans.

Company Name:PUIG NORTH AMERICA, INC.
Employer identification number (EIN):131978157
NAIC Classification:424990
NAIC Description:Other Miscellaneous Nondurable Goods Merchant Wholesalers

Additional information about PUIG NORTH AMERICA, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1962-12-03
Company Identification Number: 152473
Legal Registered Office Address: 80 STATE STREET
New York
ALBANY
United States of America (USA)
12207

More information about PUIG NORTH AMERICA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022019-11-01KEVIN SCULLY2021-05-25
5022018-11-01KEVIN SCULLY2020-06-15
5022017-11-01
5022016-11-01GIUSEPPE CELIO GIUSEPPE CELIO2018-05-30
5022015-11-01GIUSEPPE CELIO GIUSEPPE CELIO2017-02-16
5022014-11-01GIUSEPPE CELIO GIUSEPPE CELIO2016-05-18
5022014-09-01GIUSEPPE CELIO GIUSEPPE CELIO2016-06-16
5022013-09-01GIUSEPPE CELIO GIUSEPPE CELIO2016-06-16
5022012-09-01GIUSEPPE CELIO GIUSEPPE CELIO2016-02-19

Plan Statistics for THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC.

401k plan membership statisitcs for THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC.

Measure Date Value
2019: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2019 401k membership
Total participants, beginning-of-year2019-11-01145
Total number of active participants reported on line 7a of the Form 55002019-11-01159
Total of all active and inactive participants2019-11-01159
2018: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2018 401k membership
Total participants, beginning-of-year2018-11-01152
Total number of active participants reported on line 7a of the Form 55002018-11-01145
Number of retired or separated participants receiving benefits2018-11-010
Number of other retired or separated participants entitled to future benefits2018-11-010
Total of all active and inactive participants2018-11-01145
Number of employers contributing to the scheme2018-11-010
2017: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2017 401k membership
Total participants, beginning-of-year2017-11-01131
Total number of active participants reported on line 7a of the Form 55002017-11-01152
Total of all active and inactive participants2017-11-01152
2016: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2016 401k membership
Total participants, beginning-of-year2016-11-01133
Total number of active participants reported on line 7a of the Form 55002016-11-01131
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-01131
2015: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2015 401k membership
Total participants, beginning-of-year2015-11-01128
Total number of active participants reported on line 7a of the Form 55002015-11-01133
Total of all active and inactive participants2015-11-01133
2014: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2014 401k membership
Total participants, beginning-of-year2014-11-01137
Total number of active participants reported on line 7a of the Form 55002014-11-01128
Total of all active and inactive participants2014-11-01128
Total participants, beginning-of-year2014-09-01135
Total number of active participants reported on line 7a of the Form 55002014-09-01137
Total of all active and inactive participants2014-09-01137
2013: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2013 401k membership
Total participants, beginning-of-year2013-09-01141
Total number of active participants reported on line 7a of the Form 55002013-09-01135
Total of all active and inactive participants2013-09-01135
2012: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2012 401k membership
Total participants, beginning-of-year2012-09-01127
Total number of active participants reported on line 7a of the Form 55002012-09-01134
Number of retired or separated participants receiving benefits2012-09-017
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-01141

Form 5500 Responses for THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC.

2019: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Submission has been amendedNo
2019-11-01This submission is the final filingNo
2019-11-01This return/report is a short plan year return/report (less than 12 months)No
2019-11-01Plan is a collectively bargained planNo
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – InsuranceYes
2018: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – InsuranceYes
2017: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Submission has been amendedNo
2017-11-01This submission is the final filingNo
2017-11-01This return/report is a short plan year return/report (less than 12 months)No
2017-11-01Plan is a collectively bargained planNo
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – InsuranceYes
2016: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – InsuranceYes
2015: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)No
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – InsuranceYes
2014: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – InsuranceYes
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: THE GROUP AD&D, LIFE, LONG TERM DISABILITY, OPTIONAL LIFE AND SHORT TERM DISABILITY FOR THE EMPLOYEES OF PUIG NORTH AMERICA, INC. 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedYes
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan 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 number00505364
Policy instance 1
Insurance contract or identification number00505364
Number of Individuals Covered159
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $18,459
Total amount of fees paid to insurance companyUSD $3,872
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $148,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,288
Amount paid for insurance broker fees3872
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number505364
Policy instance 1
Insurance contract or identification number505364
Number of Individuals Covered145
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $15,894
Total amount of fees paid to insurance companyUSD $2,976
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $123,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,894
Amount paid for insurance broker fees2976
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00505364
Policy instance 1
Insurance contract or identification number00505364
Number of Individuals Covered152
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $14,779
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $142,587
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00505364
Policy instance 1
Insurance contract or identification number00505364
Number of Individuals Covered133
Insurance policy start date2015-11-01
Insurance policy end date2016-10-31
Total amount of commissions paid to insurance brokerUSD $8,745
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $99,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,745
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameLADMAR ASSOCIATES LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00505364
Policy instance 1
Insurance contract or identification number00505364
Number of Individuals Covered128
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $8,732
Total amount of fees paid to insurance companyUSD $1,115
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $97,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,229
Amount paid for insurance broker fees1115
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameLADMAR ASSOCIATES LLC
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberG156404
Policy instance 3
Insurance contract or identification numberG156404
Number of Individuals Covered116
Insurance policy start date2014-09-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $595
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $595
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberLTD 111365
Policy instance 4
Insurance contract or identification numberLTD 111365
Number of Individuals Covered58
Insurance policy start date2014-09-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $740
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $740
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberDBL251123
Policy instance 2
Insurance contract or identification numberDBL251123
Number of Individuals Covered134
Insurance policy start date2014-09-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $456
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $456
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberGL137556
Policy instance 1
Insurance contract or identification numberGL137556
Number of Individuals Covered137
Insurance policy start date2014-09-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $1,240
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $12,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,240
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberG156404
Policy instance 3
Insurance contract or identification numberG156404
Number of Individuals Covered135
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $3,292
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,292
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberGL137556
Policy instance 1
Insurance contract or identification numberGL137556
Number of Individuals Covered135
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $3,204
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $65,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,204
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberDBL251123
Policy instance 2
Insurance contract or identification numberDBL251123
Number of Individuals Covered131
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $1,780
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,780
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberG156404
Policy instance 3
Insurance contract or identification numberG156404
Number of Individuals Covered134
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $3,176
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,176
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberDBL251123
Policy instance 2
Insurance contract or identification numberDBL251123
Number of Individuals Covered128
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $1,766
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,766
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberGL137556
Policy instance 1
Insurance contract or identification numberGL137556
Number of Individuals Covered134
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $3,191
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $64,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,191
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES USA

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