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CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 401k Plan overview

Plan NameCANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN
Plan identification number 504

CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 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

THE CANANDAIGUA NATIONAL BANK AND TRUST COMPANY has sponsored the creation of one or more 401k plans.

Company Name:THE CANANDAIGUA NATIONAL BANK AND TRUST COMPANY
Employer identification number (EIN):160373410
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042023-05-01
5042022-05-01
5042021-05-01
5042020-05-01
5042019-05-01
5042018-05-01MICHELLE PEDZICH MICHELLE PEDZICH2019-07-09
5042017-05-15MICHELLE PEDZICH MICHELLE PEDZICH2018-08-07
5042016-05-15MICHELLE PEDZICH MICHELLE PEDZICH2017-11-27
5042015-05-15MICHELLE PEDZICH MICHELLE PEDZICH2016-12-13
5042014-05-15MICHELLE PEDZICH MICHELLE PEDZICH2015-12-08
5042013-05-15MICHELLE PEDZICH
5042012-05-15MICHELLE PEDZICH
5042011-05-15MARY ANN RIDLEY
5042009-05-15MARY ANN RIDLEY

Plan Statistics for CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN

401k plan membership statisitcs for CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN

Measure Date Value
2023: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2023 401k membership
Total participants, beginning-of-year2023-05-01623
Total number of active participants reported on line 7a of the Form 55002023-05-01619
Total of all active and inactive participants2023-05-01619
2022: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01596
Total number of active participants reported on line 7a of the Form 55002022-05-01623
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01623
2021: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01541
Total number of active participants reported on line 7a of the Form 55002021-05-01596
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01596
2020: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01514
Total number of active participants reported on line 7a of the Form 55002020-05-01541
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01541
2019: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01482
Total number of active participants reported on line 7a of the Form 55002019-05-01514
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01514
2018: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01470
Total number of active participants reported on line 7a of the Form 55002018-05-01482
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01482
2017: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-15446
Total number of active participants reported on line 7a of the Form 55002017-05-15470
Number of retired or separated participants receiving benefits2017-05-150
Number of other retired or separated participants entitled to future benefits2017-05-150
Total of all active and inactive participants2017-05-15470
2016: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-15439
Total number of active participants reported on line 7a of the Form 55002016-05-15446
Total of all active and inactive participants2016-05-15446
2015: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-15426
Total number of active participants reported on line 7a of the Form 55002015-05-15439
Number of retired or separated participants receiving benefits2015-05-150
Number of other retired or separated participants entitled to future benefits2015-05-150
Total of all active and inactive participants2015-05-15439
2014: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-15413
Total number of active participants reported on line 7a of the Form 55002014-05-15426
Number of retired or separated participants receiving benefits2014-05-150
Number of other retired or separated participants entitled to future benefits2014-05-150
Total of all active and inactive participants2014-05-15426
2013: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-15405
Total number of active participants reported on line 7a of the Form 55002013-05-15413
Number of retired or separated participants receiving benefits2013-05-150
Number of other retired or separated participants entitled to future benefits2013-05-150
Total of all active and inactive participants2013-05-15413
2012: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-15396
Total number of active participants reported on line 7a of the Form 55002012-05-15405
Number of retired or separated participants receiving benefits2012-05-150
Number of other retired or separated participants entitled to future benefits2012-05-150
Total of all active and inactive participants2012-05-15405
Total participants2012-05-15405
2011: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-15377
Total number of active participants reported on line 7a of the Form 55002011-05-15396
Number of retired or separated participants receiving benefits2011-05-150
Number of other retired or separated participants entitled to future benefits2011-05-150
Total of all active and inactive participants2011-05-15396
Total participants2011-05-15396
2009: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-15323
Total number of active participants reported on line 7a of the Form 55002009-05-15336
Number of retired or separated participants receiving benefits2009-05-150
Number of other retired or separated participants entitled to future benefits2009-05-150
Total of all active and inactive participants2009-05-15336
Total participants2009-05-15336

Form 5500 Responses for CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN

2023: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2023 form 5500 responses
2023-05-01Type of plan entitySingle employer plan
2023-05-01Submission has been amendedNo
2023-05-01This submission is the final filingNo
2023-05-01This return/report is a short plan year return/report (less than 12 months)No
2023-05-01Plan is a collectively bargained planNo
2023-05-01Plan funding arrangement – InsuranceYes
2023-05-01Plan funding arrangement – General assets of the sponsorYes
2023-05-01Plan benefit arrangement – InsuranceYes
2023-05-01Plan benefit arrangement – General assets of the sponsorYes
2022: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – General assets of the sponsorYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – General assets of the sponsorYes
2019: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – General assets of the sponsorYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – General assets of the sponsorYes
2018: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – General assets of the sponsorYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – General assets of the sponsorYes
2017: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2017 form 5500 responses
2017-05-15Type of plan entitySingle employer plan
2017-05-15Submission has been amendedNo
2017-05-15This submission is the final filingNo
2017-05-15This return/report is a short plan year return/report (less than 12 months)Yes
2017-05-15Plan is a collectively bargained planNo
2017-05-15Plan funding arrangement – InsuranceYes
2017-05-15Plan funding arrangement – General assets of the sponsorYes
2017-05-15Plan benefit arrangement – InsuranceYes
2017-05-15Plan benefit arrangement – General assets of the sponsorYes
2016: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2016 form 5500 responses
2016-05-15Type of plan entitySingle employer plan
2016-05-15Submission has been amendedNo
2016-05-15This submission is the final filingNo
2016-05-15This return/report is a short plan year return/report (less than 12 months)No
2016-05-15Plan is a collectively bargained planNo
2016-05-15Plan funding arrangement – InsuranceYes
2016-05-15Plan funding arrangement – General assets of the sponsorYes
2016-05-15Plan benefit arrangement – InsuranceYes
2016-05-15Plan benefit arrangement – General assets of the sponsorYes
2015: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2015 form 5500 responses
2015-05-15Type of plan entitySingle employer plan
2015-05-15Submission has been amendedNo
2015-05-15This submission is the final filingNo
2015-05-15This return/report is a short plan year return/report (less than 12 months)No
2015-05-15Plan is a collectively bargained planNo
2015-05-15Plan funding arrangement – InsuranceYes
2015-05-15Plan funding arrangement – General assets of the sponsorYes
2015-05-15Plan benefit arrangement – InsuranceYes
2015-05-15Plan benefit arrangement – General assets of the sponsorYes
2014: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2014 form 5500 responses
2014-05-15Type of plan entitySingle employer plan
2014-05-15Submission has been amendedNo
2014-05-15This submission is the final filingNo
2014-05-15This return/report is a short plan year return/report (less than 12 months)No
2014-05-15Plan is a collectively bargained planNo
2014-05-15Plan funding arrangement – InsuranceYes
2014-05-15Plan funding arrangement – General assets of the sponsorYes
2014-05-15Plan benefit arrangement – InsuranceYes
2014-05-15Plan benefit arrangement – General assets of the sponsorYes
2013: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2013 form 5500 responses
2013-05-15Type of plan entitySingle employer plan
2013-05-15Submission has been amendedNo
2013-05-15This submission is the final filingNo
2013-05-15This return/report is a short plan year return/report (less than 12 months)No
2013-05-15Plan is a collectively bargained planNo
2013-05-15Plan funding arrangement – InsuranceYes
2013-05-15Plan funding arrangement – General assets of the sponsorYes
2013-05-15Plan benefit arrangement – InsuranceYes
2013-05-15Plan benefit arrangement – General assets of the sponsorYes
2012: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2012 form 5500 responses
2012-05-15Type of plan entitySingle employer plan
2012-05-15Submission has been amendedNo
2012-05-15This submission is the final filingNo
2012-05-15This return/report is a short plan year return/report (less than 12 months)No
2012-05-15Plan is a collectively bargained planNo
2012-05-15Plan funding arrangement – InsuranceYes
2012-05-15Plan funding arrangement – General assets of the sponsorYes
2012-05-15Plan benefit arrangement – InsuranceYes
2012-05-15Plan benefit arrangement – General assets of the sponsorYes
2011: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2011 form 5500 responses
2011-05-15Type of plan entitySingle employer plan
2011-05-15Submission has been amendedNo
2011-05-15This submission is the final filingNo
2011-05-15This return/report is a short plan year return/report (less than 12 months)No
2011-05-15Plan is a collectively bargained planNo
2011-05-15Plan funding arrangement – InsuranceYes
2011-05-15Plan funding arrangement – General assets of the sponsorYes
2011-05-15Plan benefit arrangement – InsuranceYes
2011-05-15Plan benefit arrangement – General assets of the sponsorYes
2009: CANANDAIGUA NATIONAL BANK AND TRUST CO EMPLOYER PAID GROUP LIFE INSURANCE PLAN 2009 form 5500 responses
2009-05-15Type of plan entitySingle employer plan
2009-05-15Submission has been amendedNo
2009-05-15This submission is the final filingNo
2009-05-15This return/report is a short plan year return/report (less than 12 months)No
2009-05-15Plan is a collectively bargained planNo
2009-05-15Plan funding arrangement – InsuranceYes
2009-05-15Plan funding arrangement – General assets of the sponsorYes
2009-05-15Plan benefit arrangement – InsuranceYes
2009-05-15Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered617
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $20,715
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 providedADD, VOL LIFE, VOL DEP LIFE
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 $247,364
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 number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered621
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $19,835
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 providedADD, VOL LIFE, VOL DEP LIFE
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 $231,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,281
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered584
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $18,818
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 providedADD, VOL LIFE, VOL DEP LIFE
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 $215,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,894
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered540
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $17,744
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 providedADD, VOL LIFE, VOL DEP LIFE
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 $204,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,776
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered515
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $17,600
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 providedADD, VOL LIFE, VOL DEP LIFE
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 $180,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,672
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered482
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $15,263
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 providedADD, VOL LIFE, VOL DEP LIFE
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 $172,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,989
Insurance broker organization code?3
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered461
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $15,239
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 providedADD, VOL LIFE, VOL DEP LIFE
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 $144,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,796
Insurance broker organization code?3
Insurance broker nameBOND FINANCIAL NETWORK
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00341271
Policy instance 2
Insurance contract or identification number00341271
Number of Individuals Covered117
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,862
Total amount of fees paid to insurance companyUSD $2,556
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 $37,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,862
Amount paid for insurance broker fees2556
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameBOND FINANCIAL NETWORK INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered444
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $16,164
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 providedADD
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 $111,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,164
Insurance broker organization code?3
Insurance broker nameBOND FINANCIAL NETWORK INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00341271
Policy instance 2
Insurance contract or identification number00341271
Number of Individuals Covered109
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,747
Total amount of fees paid to insurance companyUSD $2,557
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 $36,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,747
Amount paid for insurance broker fees2557
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameBOND FINANCIAL NETWORK INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered431
Insurance policy start date2014-06-01
Insurance policy end date2015-06-01
Total amount of commissions paid to insurance brokerUSD $8,490
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 providedADD
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 $107,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,490
Insurance broker organization code?3
Insurance broker nameBOND FINANCIAL NETWORK INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00341271
Policy instance 2
Insurance contract or identification number00341271
Number of Individuals Covered102
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,797
Total amount of fees paid to insurance companyUSD $2,474
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 $36,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,748
Amount paid for insurance broker fees2474
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameALLIANCE ADVISORY GROUP INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered414
Insurance policy start date2013-06-01
Insurance policy end date2014-06-01
Total amount of commissions paid to insurance brokerUSD $8,199
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 providedADD
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 $101,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,199
Insurance broker organization code?3
Insurance broker nameBOND FINANCIAL NETWORK INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 1
Insurance contract or identification number246686500
Number of Individuals Covered405
Insurance policy start date2012-06-01
Insurance policy end date2013-06-01
Total amount of commissions paid to insurance brokerUSD $8,057
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 providedADD
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 $97,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,057
Insurance broker organization code?3
Insurance broker nameBOND FINANCIAL NETWORK INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00341271
Policy instance 2
Insurance contract or identification number00341271
Number of Individuals Covered94
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,643
Total amount of fees paid to insurance companyUSD $2,421
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 $35,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,595
Amount paid for insurance broker fees2421
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameALLIANCE ADVISORY GROUP INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number246686500
Policy instance 2
Insurance contract or identification number246686500
Number of Individuals Covered391
Insurance policy start date2011-06-01
Insurance policy end date2012-06-01
Total amount of commissions paid to insurance brokerUSD $7,799
Total amount of fees paid to insurance companyUSD $7,048
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 providedADD
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 $91,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00341271
Policy instance 1
Insurance contract or identification number00341271
Number of Individuals Covered93
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,508
Total amount of fees paid to insurance companyUSD $2,214
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 $34,589
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 number246686500
Policy instance 2
Insurance contract or identification number246686500
Number of Individuals Covered374
Insurance policy start date2010-06-01
Insurance policy end date2011-06-01
Total amount of commissions paid to insurance brokerUSD $7,545
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 providedADD
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 $85,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00341271
Policy instance 1
Insurance contract or identification number00341271
Number of Individuals Covered97
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,112
Total amount of fees paid to insurance companyUSD $1,549
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 $31,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number14717
Policy instance 3
Insurance contract or identification number14717
Number of Individuals Covered340
Insurance policy start date2010-01-01
Insurance policy end date2010-05-31
Total amount of commissions paid to insurance brokerUSD $10,337
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 providedADD
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 $39,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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