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EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 401k Plan overview

Plan NameEMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS
Plan identification number 501

EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS Benefits

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

401k Sponsoring company profile

HILLSIDE FAMILY OF AGENCIES has sponsored the creation of one or more 401k plans.

Company Name:HILLSIDE FAMILY OF AGENCIES
Employer identification number (EIN):161493407
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about HILLSIDE FAMILY OF AGENCIES

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1995-06-29
Company Identification Number: 1935346
Legal Registered Office Address: HILLSIDE FAMILY OF AGENCIES
1183 MONROE AVENUE
ROCHESTER
United States of America (USA)
14620

More information about HILLSIDE FAMILY OF AGENCIES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-01-01
5012018-01-01
5012017-01-01PAUL PERROTTO
5012016-01-01PAUL PERROTTO
5012015-01-01PAUL PERROTTO
5012015-01-01PAUL PERROTTO
5012014-01-01PAUL PERROTTO
5012013-01-01PAUL PERROTTO
5012012-01-01PAUL PERROTTO
5012011-01-01PAUL PERROTTO
5012009-01-01PAUL PERROTTO

Plan Statistics for EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS

Measure Date Value
2019: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2019 401k membership
Total participants, beginning-of-year2019-01-011,878
Total number of active participants reported on line 7a of the Form 55002019-01-011,659
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0120
Total of all active and inactive participants2019-01-011,679
2018: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2018 401k membership
Total participants, beginning-of-year2018-01-012,022
Total number of active participants reported on line 7a of the Form 55002018-01-011,857
Number of retired or separated participants receiving benefits2018-01-0121
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-011,878
2017: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2017 401k membership
Total participants, beginning-of-year2017-01-012,006
Total number of active participants reported on line 7a of the Form 55002017-01-012,022
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 participants2017-01-012,022
Total participants2017-01-012,022
2016: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2016 401k membership
Total participants, beginning-of-year2016-01-011,973
Total number of active participants reported on line 7a of the Form 55002016-01-011,980
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 participants2016-01-011,980
Total participants2016-01-011,980
2015: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2015 401k membership
Total participants, beginning-of-year2015-01-011,953
Total number of active participants reported on line 7a of the Form 55002015-01-011,969
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 participants2015-01-011,969
Total participants2015-01-011,969
2014: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2014 401k membership
Total participants, beginning-of-year2014-01-011,939
Total number of active participants reported on line 7a of the Form 55002014-01-011,919
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 participants2014-01-011,919
Total participants2014-01-011,919
2013: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2013 401k membership
Total participants, beginning-of-year2013-01-011,909
Total number of active participants reported on line 7a of the Form 55002013-01-011,939
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 participants2013-01-011,939
Total participants2013-01-011,939
2012: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2012 401k membership
Total participants, beginning-of-year2012-01-011,995
Total number of active participants reported on line 7a of the Form 55002012-01-011,909
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 participants2012-01-011,909
Total participants2012-01-011,909
2011: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2011 401k membership
Total participants, beginning-of-year2011-01-012,059
Total number of active participants reported on line 7a of the Form 55002011-01-011,995
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-011,995
2009: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2009 401k membership
Total participants, beginning-of-year2009-01-011,865
Total number of active participants reported on line 7a of the Form 55002009-01-011,978
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,978

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS

2019: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 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: EMPLOYEE BENEFIT PLAN OF HILLSIDE FAMILY OF AGENCIES LTD, LIFE, AD&D PLANS 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
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 numberYOK960363
Policy instance 3
Insurance contract or identification numberYOK960363
Number of Individuals Covered1878
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,550
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,550
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960236
Policy instance 2
Insurance contract or identification numberNYK960236
Number of Individuals Covered1878
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,135
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $213,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,135
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY960357
Policy instance 1
Insurance contract or identification numberFLY960357
Number of Individuals Covered1878
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,129
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $326,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,129
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYOK960363
Policy instance 3
Insurance contract or identification numberYOK960363
Number of Individuals Covered1857
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,397
Total amount of fees paid to insurance companyUSD $253
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $18,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,397
Amount paid for insurance broker fees253
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960236
Policy instance 2
Insurance contract or identification numberNYK960236
Number of Individuals Covered1857
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,610
Total amount of fees paid to insurance companyUSD $3,461
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $260,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,610
Amount paid for insurance broker fees3461
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY960357
Policy instance 1
Insurance contract or identification numberFLY960357
Number of Individuals Covered1857
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,121
Total amount of fees paid to insurance companyUSD $4,254
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $324,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,121
Amount paid for insurance broker fees4254
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYDK960363
Policy instance 3
Insurance contract or identification numberYDK960363
Number of Individuals Covered2022
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,668
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $21,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,668
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF NEW YORK
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960236
Policy instance 2
Insurance contract or identification numberNYK960236
Number of Individuals Covered2022
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,969
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $296,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,969
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF NEW YORK
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY960357
Policy instance 1
Insurance contract or identification numberFLY960357
Number of Individuals Covered2022
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,320
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $363,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,320
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF NEW YORK
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0143841
Policy instance 4
Insurance contract or identification number0143841
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,751
Total amount of fees paid to insurance companyUSD $1,812
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $63
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1797
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,751
Insurance broker nameBROWN & BROWN OF NEW YORK INC
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberYDK960363
Policy instance 3
Insurance contract or identification numberYDK960363
Number of Individuals Covered1969
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,151
Total amount of fees paid to insurance companyUSD $353
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $16,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,151
Amount paid for insurance broker fees353
Additional information about fees paid to insurance brokerSALES & SERVICE OVERRIDE
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF NEW YORK
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYK960236
Policy instance 2
Insurance contract or identification numberNYK960236
Number of Individuals Covered1969
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,316
Total amount of fees paid to insurance companyUSD $4,932
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $231,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,316
Amount paid for insurance broker fees4932
Additional information about fees paid to insurance brokerSALES & SERVICE OVERRIDE
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF NEW YORK
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberFLY960357
Policy instance 1
Insurance contract or identification numberFLY960357
Number of Individuals Covered1969
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,812
Total amount of fees paid to insurance companyUSD $5,691
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $262,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,812
Amount paid for insurance broker fees5691
Additional information about fees paid to insurance brokerSALES & SERVICE OVERRIDE
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF NEW YORK
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0143841
Policy instance 1
Insurance contract or identification number0143841
Number of Individuals Covered2491
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $18,327
Total amount of fees paid to insurance companyUSD $10,506
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $603,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,327
Amount paid for insurance broker fees10506
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF NEW YORK INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0143841
Policy instance 1
Insurance contract or identification number0143841
Number of Individuals Covered2494
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $18,950
Total amount of fees paid to insurance companyUSD $9,751
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $646,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,950
Insurance broker organization code?3
Amount paid for insurance broker fees6752
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameBROWN & BROWN OF NEW YORK INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0143841
Policy instance 1
Insurance contract or identification number0143841
Number of Individuals Covered2426
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $15,138
Total amount of fees paid to insurance companyUSD $2,218
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $421,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,138
Insurance broker organization code?3
Amount paid for insurance broker fees2218
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker nameBROWN & BROWN OF NEW YORK INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0143841
Policy instance 1
Insurance contract or identification number0143841
Number of Individuals Covered2579
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $14,850
Total amount of fees paid to insurance companyUSD $6,711
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 BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $402,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0143841
Policy instance 1
Insurance contract or identification number0143841
Number of Individuals Covered2659
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $13,199
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 BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $374,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,199
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF NEW YORK INC

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