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STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 401k Plan overview

Plan NameSTANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE
Plan identification number 652

STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE Benefits

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

401k Sponsoring company profile

STANADYNE LLC has sponsored the creation of one or more 401k plans.

Company Name:STANADYNE LLC
Employer identification number (EIN):222940378
NAIC Classification:333610

Additional information about STANADYNE LLC

Jurisdiction of Incorporation: Connecticut Secretary of State
Incorporation Date:
Company Identification Number: 1209535

More information about STANADYNE LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
6522022-01-01GREGORY SILLS2023-07-22
6522021-01-01GREGORY SILLS2022-09-23
6522020-01-01GREGORY SILLS2021-07-18
6522019-01-01
6522018-01-01STEPHEN LANGIN
6522017-01-01STEPHEN LANGIN
6522016-01-01STEPHEN LANGIN
6522015-01-01STEPHEN LANGIN
6522014-01-01STEPHEN LANGIN
6522013-01-01STEPHEN RODGERS
6522012-01-01STEPHEN RODGERS
6522011-01-01STEPHEN RODGERS
6522009-01-01STEPHEN RODGERS

Plan Statistics for STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE

401k plan membership statisitcs for STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE

Measure Date Value
2022: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2022 401k membership
Total participants, beginning-of-year2022-01-011,257
Total number of active participants reported on line 7a of the Form 55002022-01-011,257
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-011,257
2021: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-01-011,276
Total number of active participants reported on line 7a of the Form 55002021-01-011,257
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011,257
2020: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-01-011,352
Total number of active participants reported on line 7a of the Form 55002020-01-01183
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01183
2019: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-01-011,086
Total number of active participants reported on line 7a of the Form 55002019-01-011,352
Total of all active and inactive participants2019-01-011,352
Total participants2019-01-011,352
2018: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-01-011,170
Total number of active participants reported on line 7a of the Form 55002018-01-011,086
Total of all active and inactive participants2018-01-011,086
Total participants2018-01-011,086
2017: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-01-011,159
Total number of active participants reported on line 7a of the Form 55002017-01-011,170
Total of all active and inactive participants2017-01-011,170
Total participants2017-01-011,170
2016: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-011,171
Total number of active participants reported on line 7a of the Form 55002016-01-011,159
Total of all active and inactive participants2016-01-011,159
Total participants2016-01-011,159
2015: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-011,203
Total number of active participants reported on line 7a of the Form 55002015-01-011,171
Total of all active and inactive participants2015-01-011,171
Total participants2015-01-011,171
2014: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-011,474
Total number of active participants reported on line 7a of the Form 55002014-01-011,203
Total of all active and inactive participants2014-01-011,203
Total participants2014-01-011,203
2013: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-011,517
Total number of active participants reported on line 7a of the Form 55002013-01-011,474
Total of all active and inactive participants2013-01-011,474
Total participants2013-01-011,474
2012: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-011,562
Total number of active participants reported on line 7a of the Form 55002012-01-011,517
Total of all active and inactive participants2012-01-011,517
Total participants2012-01-011,517
2011: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-01798
Total number of active participants reported on line 7a of the Form 55002011-01-011,562
Total of all active and inactive participants2011-01-011,562
Total participants2011-01-011,562
2009: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-011,170
Total number of active participants reported on line 7a of the Form 55002009-01-01848
Total of all active and inactive participants2009-01-01848
Total participants2009-01-01848

Form 5500 Responses for STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE

2022: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 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: STANADYNE LLC GROUP TRAVEL ACCIDENT INSURANCE 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

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064047216
Policy instance 1
Insurance contract or identification number000064047216
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $1,003
Total amount of fees paid to insurance companyUSD $243
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,003
Amount paid for insurance broker fees243
Additional information about fees paid to insurance broker3
Insurance broker organization code?3
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064047216
Policy instance 1
Insurance contract or identification number000064047216
Insurance policy start date2020-06-01
Insurance policy end date2021-06-01
Total amount of commissions paid to insurance brokerUSD $1,354
Total amount of fees paid to insurance companyUSD $440
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT INSURANCE
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 $9,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,354
Amount paid for insurance broker fees440
Additional information about fees paid to insurance broker3
Insurance broker organization code?3
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064047216
Policy instance 1
Insurance contract or identification number000064047216
Number of Individuals Covered1276
Insurance policy start date2019-06-01
Insurance policy end date2020-06-01
Total amount of commissions paid to insurance brokerUSD $1,250
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $8,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,250
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064047216
Policy instance 1
Insurance contract or identification number000064047216
Number of Individuals Covered1352
Insurance policy start date2018-06-01
Insurance policy end date2019-06-01
Total amount of commissions paid to insurance brokerUSD $1,291
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $8,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,291
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064047216
Policy instance 1
Insurance contract or identification number000064047216
Number of Individuals Covered1086
Insurance policy start date2018-06-01
Insurance policy end date2019-06-01
Total amount of commissions paid to insurance brokerUSD $1,193
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT INSURANCE
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 $7,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,193
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064047216
Policy instance 1
Insurance contract or identification number000064047216
Number of Individuals Covered1170
Insurance policy start date2017-06-01
Insurance policy end date2018-06-01
Total amount of commissions paid to insurance brokerUSD $1,193
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT INSURANCE
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 $7,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,193
Insurance broker nameRSC INSURANCE BROKERAGE, INC.
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064047216
Policy instance 1
Insurance contract or identification number000064047216
Number of Individuals Covered1171
Insurance policy start date2015-04-01
Insurance policy end date2016-04-01
Total amount of commissions paid to insurance brokerUSD $1,988
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT INSURANCE
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 $7,953
Commission paid to Insurance BrokerUSD $1,988
Insurance broker nameRSC INSURANCE BROKERAGE, INC/
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064047216
Policy instance 1
Insurance contract or identification number000064047216
Number of Individuals Covered1203
Insurance policy start date2014-04-01
Insurance policy end date2015-04-01
Total amount of commissions paid to insurance brokerUSD $1,988
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT INSURANCE
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 $7,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,988
Insurance broker nameMERCER HEALTH AND BENEFIT LLC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number64047216
Policy instance 1
Insurance contract or identification number64047216
Number of Individuals Covered1474
Insurance policy start date2013-04-01
Insurance policy end date2014-04-01
Total amount of commissions paid to insurance brokerUSD $1,814
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT INSURANCE
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 $7,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameMERCER HEALTH AND BENEFIT LLC
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number64047216
Policy instance 1
Insurance contract or identification number64047216
Number of Individuals Covered1517
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,391
Other welfare benefits providedTRAVEL INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $6,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered1562
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,391
Welfare Benefit Premiums Paid to CarrierUSD $6,953
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number
Policy instance 1
Number of Individuals Covered798
Insurance policy start date2010-04-01
Insurance policy end date2011-04-01
Total amount of commissions paid to insurance brokerUSD $1,391
Welfare Benefit Premiums Paid to CarrierUSD $7,514

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