C-P FLEXIBLE PACKAGING has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN
401k plan membership statisitcs for C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN
Measure | Date | Value |
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2023: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2023 401k membership |
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Total participants, beginning-of-year | 2023-01-01 | 457 |
Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 442 |
Number of retired or separated participants receiving benefits | 2023-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
Total of all active and inactive participants | 2023-01-01 | 443 |
2022: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 454 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 454 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 457 |
2021: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 407 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 405 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 5 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 410 |
2020: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 289 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 403 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 407 |
2019: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 299 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 280 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 9 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
Total of all active and inactive participants | 2019-01-01 | 289 |
2018: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 273 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 290 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 9 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 299 |
2017: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 368 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 269 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
Total of all active and inactive participants | 2017-01-01 | 273 |
2016: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 211 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 368 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 368 |
2015: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 214 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 211 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 211 |
2014: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 205 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 213 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 214 |
2013: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 217 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 202 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 205 |
2012: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 197 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 217 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 217 |
2011: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-08-01 | 179 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-08-01 | 194 |
Number of retired or separated participants receiving benefits | 2011-08-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2011-08-01 | 0 |
Total of all active and inactive participants | 2011-08-01 | 197 |
2009: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-08-01 | 176 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-08-01 | 188 |
Number of retired or separated participants receiving benefits | 2009-08-01 | 5 |
Number of other retired or separated participants entitled to future benefits | 2009-08-01 | 0 |
Total of all active and inactive participants | 2009-08-01 | 193 |
Measure | Date | Value |
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2016 : C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2016 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2016-12-31 | $0 |
Total transfer of assets from this plan | 2016-12-31 | $138,731 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $153,428 |
Total income from all sources (including contributions) | 2016-12-31 | $0 |
Total loss/gain on sale of assets | 2016-12-31 | $0 |
Total of all expenses incurred | 2016-12-31 | $0 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $0 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $0 |
Value of total assets at end of year | 2016-12-31 | $0 |
Value of total assets at beginning of year | 2016-12-31 | $292,159 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $0 |
Total interest from all sources | 2016-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
Value of fidelity bond cover | 2016-12-31 | $1,000,000 |
If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $1,518 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Value of net income/loss | 2016-12-31 | $0 |
Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $0 |
Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $138,731 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $290,641 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $290,641 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
Assets. Invements in employer securities at end of year | 2016-12-31 | $0 |
Assets. Invements in employer securities at beginning of year | 2016-12-31 | $0 |
Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $0 |
Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $153,428 |
Did the plan have assets held for investment | 2016-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | Yes |
2015 : C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2015 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2015-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $153,428 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $129,805 |
Total income from all sources (including contributions) | 2015-12-31 | $2,222,149 |
Total loss/gain on sale of assets | 2015-12-31 | $0 |
Total of all expenses incurred | 2015-12-31 | $2,349,795 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $2,132,392 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $2,222,077 |
Value of total assets at end of year | 2015-12-31 | $292,159 |
Value of total assets at beginning of year | 2015-12-31 | $396,182 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $217,403 |
Total interest from all sources | 2015-12-31 | $72 |
Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
Value of fidelity bond cover | 2015-12-31 | $1,000,000 |
If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
Contributions received from participants | 2015-12-31 | $400,881 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $1,518 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $92,251 |
Administrative expenses (other) incurred | 2015-12-31 | $217,403 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Value of net income/loss | 2015-12-31 | $-127,646 |
Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $138,731 |
Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $266,377 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $290,641 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $303,931 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $303,931 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $72 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $501,485 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
Assets. Invements in employer securities at end of year | 2015-12-31 | $0 |
Assets. Invements in employer securities at beginning of year | 2015-12-31 | $0 |
Contributions received in cash from employer | 2015-12-31 | $1,821,196 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $1,630,907 |
Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $153,428 |
Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $129,805 |
Did the plan have assets held for investment | 2015-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Disclaimer |
Accountancy firm name | 2015-12-31 | REINSEL KUNTZ LESHER, LLP |
Accountancy firm EIN | 2015-12-31 | 232108173 |
2014 : C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2014 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2014-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $129,805 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $149,514 |
Total income from all sources (including contributions) | 2014-12-31 | $1,945,792 |
Total loss/gain on sale of assets | 2014-12-31 | $0 |
Total of all expenses incurred | 2014-12-31 | $2,040,149 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $1,837,835 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $1,945,737 |
Value of total assets at end of year | 2014-12-31 | $396,182 |
Value of total assets at beginning of year | 2014-12-31 | $510,248 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $202,314 |
Total interest from all sources | 2014-12-31 | $55 |
Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
Value of fidelity bond cover | 2014-12-31 | $1,000,000 |
If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
Contributions received from participants | 2014-12-31 | $334,452 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $92,251 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $12,054 |
Administrative expenses (other) incurred | 2014-12-31 | $202,314 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Value of net income/loss | 2014-12-31 | $-94,357 |
Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $266,377 |
Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $360,734 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $303,931 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $498,194 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $498,194 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $55 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $502,842 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
Assets. Invements in employer securities at end of year | 2014-12-31 | $0 |
Assets. Invements in employer securities at beginning of year | 2014-12-31 | $0 |
Contributions received in cash from employer | 2014-12-31 | $1,611,285 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $1,334,993 |
Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $129,805 |
Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $149,514 |
Did the plan have assets held for investment | 2014-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Disclaimer |
Accountancy firm name | 2014-12-31 | REINSEL KUNTZ LESHER, LLP |
Accountancy firm EIN | 2014-12-31 | 232108173 |
2013 : C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2013 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2013-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $149,514 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $196,744 |
Total income from all sources (including contributions) | 2013-12-31 | $2,407,329 |
Total loss/gain on sale of assets | 2013-12-31 | $0 |
Total of all expenses incurred | 2013-12-31 | $2,120,665 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $1,888,682 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $2,407,243 |
Value of total assets at end of year | 2013-12-31 | $510,248 |
Value of total assets at beginning of year | 2013-12-31 | $270,814 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $231,983 |
Total interest from all sources | 2013-12-31 | $86 |
Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
Value of fidelity bond cover | 2013-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
Contributions received from participants | 2013-12-31 | $313,692 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $12,054 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $0 |
Administrative expenses (other) incurred | 2013-12-31 | $231,983 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Value of net income/loss | 2013-12-31 | $286,664 |
Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $360,734 |
Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $74,070 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $498,194 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $270,814 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $270,814 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $86 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $533,053 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
Contributions received in cash from employer | 2013-12-31 | $2,093,551 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $1,355,629 |
Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $149,514 |
Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $196,744 |
Did the plan have assets held for investment | 2013-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
Accountancy firm name | 2013-12-31 | REINSEL KUNTZ LESHER, LLP |
Accountancy firm EIN | 2013-12-31 | 232108173 |
2012 : C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2012 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2012-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $196,744 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $172,893 |
Total income from all sources (including contributions) | 2012-12-31 | $2,943,387 |
Total loss/gain on sale of assets | 2012-12-31 | $0 |
Total of all expenses incurred | 2012-12-31 | $2,848,085 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $2,630,579 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $2,412,178 |
Value of total assets at end of year | 2012-12-31 | $270,814 |
Value of total assets at beginning of year | 2012-12-31 | $151,661 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $217,506 |
Total interest from all sources | 2012-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $120 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $120 |
Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
Value of fidelity bond cover | 2012-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
Contributions received from participants | 2012-12-31 | $322,438 |
Other income not declared elsewhere | 2012-12-31 | $531,089 |
Administrative expenses (other) incurred | 2012-12-31 | $217,506 |
Total non interest bearing cash at end of year | 2012-12-31 | $0 |
Total non interest bearing cash at beginning of year | 2012-12-31 | $0 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Value of net income/loss | 2012-12-31 | $95,302 |
Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $74,070 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $-21,232 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $270,814 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $151,661 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $463,804 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
Contributions received in cash from employer | 2012-12-31 | $2,089,740 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $2,166,775 |
Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $196,744 |
Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $172,893 |
Did the plan have assets held for investment | 2012-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
Accountancy firm name | 2012-12-31 | REINSEL KUNTZ LESHER, LLP |
Accountancy firm EIN | 2012-12-31 | 232108173 |
2011 : C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2011 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2011-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $172,893 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $190,431 |
Total income from all sources (including contributions) | 2011-12-31 | $990,911 |
Total loss/gain on sale of assets | 2011-12-31 | $0 |
Total of all expenses incurred | 2011-12-31 | $863,723 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $783,197 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $990,897 |
Value of total assets at end of year | 2011-12-31 | $151,661 |
Value of total assets at beginning of year | 2011-12-31 | $42,011 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $80,526 |
Total interest from all sources | 2011-12-31 | $14 |
Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
Value of fidelity bond cover | 2011-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
Contributions received from participants | 2011-12-31 | $104,651 |
Administrative expenses (other) incurred | 2011-12-31 | $80,526 |
Total non interest bearing cash at end of year | 2011-12-31 | $0 |
Total non interest bearing cash at beginning of year | 2011-12-31 | $19,049 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Value of net income/loss | 2011-12-31 | $127,188 |
Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $-21,232 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $-148,420 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $151,661 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $22,962 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $14 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $155,241 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
Contributions received in cash from employer | 2011-12-31 | $886,246 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $627,956 |
Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $172,893 |
Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $190,431 |
Did the plan have assets held for investment | 2011-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
Total unrealized appreciation/depreciation of assets | 2011-07-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-07-31 | $190,431 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-07-31 | $0 |
Total income from all sources (including contributions) | 2011-07-31 | $2,161,755 |
Total loss/gain on sale of assets | 2011-07-31 | $0 |
Total of all expenses incurred | 2011-07-31 | $2,310,175 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-07-31 | $2,124,005 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-07-31 | $2,161,696 |
Value of total assets at end of year | 2011-07-31 | $42,011 |
Value of total assets at beginning of year | 2011-07-31 | $0 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-07-31 | $186,170 |
Total interest from all sources | 2011-07-31 | $59 |
Total dividends received (eg from common stock, registered investment company shares) | 2011-07-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-07-31 | No |
Was this plan covered by a fidelity bond | 2011-07-31 | Yes |
Value of fidelity bond cover | 2011-07-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2011-07-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2011-07-31 | No |
Contributions received from participants | 2011-07-31 | $233,468 |
Administrative expenses (other) incurred | 2011-07-31 | $186,170 |
Total non interest bearing cash at end of year | 2011-07-31 | $19,049 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-07-31 | No |
Value of net income/loss | 2011-07-31 | $-148,420 |
Value of net assets at end of year (total assets less liabilities) | 2011-07-31 | $-148,420 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-07-31 | $0 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-07-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-07-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-07-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-07-31 | $22,962 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-07-31 | $59 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2011-07-31 | $326,896 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-07-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2011-07-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-07-31 | No |
Contributions received in cash from employer | 2011-07-31 | $1,928,228 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-07-31 | $1,797,109 |
Liabilities. Value of benefit claims payable at end of year | 2011-07-31 | $190,431 |
Did the plan have assets held for investment | 2011-07-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-07-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-07-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-07-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2011-07-31 | Disclaimer |
Accountancy firm name | 2011-07-31 | REINSEL KUNTZ LESHER LLP |
Accountancy firm EIN | 2011-07-31 | 232108173 |
2023: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2023 form 5500 responses |
---|
2023-01-01 | Type of plan entity | Single employer plan |
2023-01-01 | Submission has been amended | No |
2023-01-01 | This submission is the final filing | No |
2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2023-01-01 | Plan is a collectively bargained plan | No |
2023-01-01 | Plan funding arrangement – Insurance | Yes |
2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2023-01-01 | Plan benefit arrangement – Insurance | Yes |
2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2022: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2022 form 5500 responses |
---|
2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Submission has been amended | No |
2022-01-01 | This submission is the final filing | No |
2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-01-01 | Plan is a collectively bargained plan | No |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses |
---|
2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Submission has been amended | No |
2021-01-01 | This submission is the final filing | No |
2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-01-01 | Plan is a collectively bargained plan | No |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses |
---|
2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | No |
2020-01-01 | This submission is the final filing | No |
2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-01-01 | Plan is a collectively bargained plan | No |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses |
---|
2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Submission has been amended | No |
2019-01-01 | This submission is the final filing | No |
2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-01-01 | Plan is a collectively bargained plan | No |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2018 form 5500 responses |
---|
2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Submission has been amended | No |
2018-01-01 | This submission is the final filing | No |
2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-01-01 | Plan is a collectively bargained plan | No |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2017 form 5500 responses |
---|
2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Submission has been amended | No |
2017-01-01 | This submission is the final filing | No |
2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-01-01 | Plan is a collectively bargained plan | No |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2016 form 5500 responses |
---|
2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2015 form 5500 responses |
---|
2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – Trust | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement - Trust | Yes |
2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2014 form 5500 responses |
---|
2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – Trust | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement - Trust | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2013 form 5500 responses |
---|
2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – Trust | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement - Trust | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2012 form 5500 responses |
---|
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – Trust | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement - Trust | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2011 form 5500 responses |
---|
2011-08-01 | Type of plan entity | Single employer plan |
2011-08-01 | Submission has been amended | No |
2011-08-01 | This submission is the final filing | No |
2011-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2011-08-01 | Plan is a collectively bargained plan | No |
2011-08-01 | Plan funding arrangement – Insurance | Yes |
2011-08-01 | Plan funding arrangement – Trust | Yes |
2011-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-08-01 | Plan benefit arrangement – Insurance | Yes |
2011-08-01 | Plan benefit arrangement - Trust | Yes |
2011-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: C P CONVERTERS, INC. EMPLOYEE BENEFIT PLAN 2009 form 5500 responses |
---|
2009-08-01 | Type of plan entity | Single employer plan |
2009-08-01 | Submission has been amended | No |
2009-08-01 | This submission is the final filing | No |
2009-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-08-01 | Plan is a collectively bargained plan | No |
2009-08-01 | Plan funding arrangement – Insurance | Yes |
2009-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-08-01 | Plan benefit arrangement – Insurance | Yes |
2009-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000403007629 |
Policy instance | 5 |
Insurance contract or identification number | 000403007629 | Number of Individuals Covered | 64 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $480 | Total amount of fees paid to insurance company | USD $152 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY LIFE & AD&D, VOLUNTARY SPOUSE LIFE & AD&D, VOLUNTARY CHILD 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 Carrier | USD $3,042 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259287 |
Policy instance | 4 |
Insurance contract or identification number | 000010259287 | Number of Individuals Covered | 55 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $5,650 | Total amount of fees paid to insurance company | USD $1,914 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $38,177 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259516 |
Policy instance | 3 |
Insurance contract or identification number | 000010259516 | Number of Individuals Covered | 115 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $6,790 | Total amount of fees paid to insurance company | USD $2,272 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $45,428 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259286 |
Policy instance | 2 |
Insurance contract or identification number | 000010259286 | Number of Individuals Covered | 442 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $11,446 | Total amount of fees paid to insurance company | USD $5,729 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $114,251 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 1 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 340 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $46,099 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000400001000 25 |
Policy instance | 6 |
Insurance contract or identification number | 000400001000 25 | Number of Individuals Covered | 129 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $8,253 | Total amount of fees paid to insurance company | USD $2,750 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY LIFE & AD&D, VOLUNTARY SPOUSE LIFE & AD&D, VOLUNTARY CHILD 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 Carrier | USD $54,861 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259516 |
Policy instance | 3 |
Insurance contract or identification number | 000010259516 | Number of Individuals Covered | 60 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,544 | Total amount of fees paid to insurance company | USD $1,868 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $37,243 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,544 | Amount paid for insurance broker fees | 1868 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259286 |
Policy instance | 2 |
Insurance contract or identification number | 000010259286 | Number of Individuals Covered | 465 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $11,521 | Total amount of fees paid to insurance company | USD $5,887 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $115,922 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,521 | Amount paid for insurance broker fees | 5887 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 1 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 457 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $56,805 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 1 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 660 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $32,430 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 403007629 |
Policy instance | 4 |
Insurance contract or identification number | 403007629 | Number of Individuals Covered | 60 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $506 | Total amount of fees paid to insurance company | USD $25 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY AD&D, VOLUNTARY SPOUSE & CHILD AD&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 Carrier | USD $3,398 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $434 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259286 |
Policy instance | 2 |
Insurance contract or identification number | 000010259286 | Number of Individuals Covered | 405 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $8,582 | Total amount of fees paid to insurance company | USD $728 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $85,825 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,127 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259516 |
Policy instance | 3 |
Insurance contract or identification number | 000010259516 | Number of Individuals Covered | 48 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,442 | Total amount of fees paid to insurance company | USD $281 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $29,611 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,598 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 400001000 25923 |
Policy instance | 5 |
Insurance contract or identification number | 400001000 25923 | Number of Individuals Covered | 108 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $6,992 | Total amount of fees paid to insurance company | USD $364 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY LIFE, VOLUNTARY SPOUSE & CHILD 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 Carrier | USD $46,620 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,900 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259516 |
Policy instance | 3 |
Insurance contract or identification number | 000010259516 | Number of Individuals Covered | 140 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,648 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $35,445 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,648 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 000010259286 |
Policy instance | 2 |
Insurance contract or identification number | 000010259286 | Number of Individuals Covered | 403 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $2,225 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $72,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,225 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 1 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 667 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $27,017 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 909943 |
Policy instance | 2 |
Insurance contract or identification number | 909943 | Number of Individuals Covered | 327 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $11,946 | Total amount of fees paid to insurance company | USD $789 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $99,219 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,946 | Amount paid for insurance broker fees | 789 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 1 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 278 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $23,923 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 909944 |
Policy instance | 3 |
Insurance contract or identification number | 909944 | Number of Individuals Covered | 148 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $3,661 | Total amount of fees paid to insurance company | USD $249 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SELECT LTD | 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 Carrier | USD $35,216 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,661 | Amount paid for insurance broker fees | 249 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 1 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 547 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $22,139 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 909943 |
Policy instance | 2 |
Insurance contract or identification number | 909943 | Number of Individuals Covered | 180 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $6,700 | Total amount of fees paid to insurance company | USD $441 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $58,780 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,700 | Amount paid for insurance broker fees | 441 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 909944 |
Policy instance | 3 |
Insurance contract or identification number | 909944 | Number of Individuals Covered | 51 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $3,241 | Total amount of fees paid to insurance company | USD $162 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LIFESTYLE LIFE, LIFESTYLE AD&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 Carrier | USD $21,608 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,241 | Amount paid for insurance broker fees | 162 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 909944 |
Policy instance | 4 |
Insurance contract or identification number | 909944 | Number of Individuals Covered | 74 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $4,473 | Total amount of fees paid to insurance company | USD $596 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LIFESTYLE LIFE, LIFESTYLE AD&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 Carrier | USD $29,818 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,473 | Amount paid for insurance broker fees | 596 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | MCCONKEY BENEFITS & FINANCIAL SERV |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 909943 |
Policy instance | 3 |
Insurance contract or identification number | 909943 | Number of Individuals Covered | 230 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $9,214 | Total amount of fees paid to insurance company | USD $1,619 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $80,956 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,214 | Amount paid for insurance broker fees | 1619 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | MCCONKEY BENEFITS & FINANCIAL SERV |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 910013 |
Policy instance | 2 |
Insurance contract or identification number | 910013 | Number of Individuals Covered | 151 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,992 | Total amount of fees paid to insurance company | USD $797 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $39,841 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,992 | Amount paid for insurance broker fees | 797 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | MCCONKEY BENEFITS & FINANCIAL SERV |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 1 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 544 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $25,627 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 2 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 372 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $15,440 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | KBP |
Policy instance | 3 |
Insurance contract or identification number | KBP | Number of Individuals Covered | 200 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $410,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H59221 |
Policy instance | 1 |
Insurance contract or identification number | H59221 | Number of Individuals Covered | 211 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $4,695 | Total amount of fees paid to insurance company | USD $751 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $52,998 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,695 | Amount paid for insurance broker fees | 751 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | MCCONKEY BENEFITS & FINANCIAL SERV |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H59221 |
Policy instance | 1 |
Insurance contract or identification number | H59221 | Number of Individuals Covered | 213 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $4,388 | Total amount of fees paid to insurance company | USD $1,388 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $50,042 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,388 | Amount paid for insurance broker fees | 1388 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | MCCONKEY BENEFITS & FINANCIAL SVCS. |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 2 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 199 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $17,606 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | KBP |
Policy instance | 3 |
Insurance contract or identification number | KBP | Number of Individuals Covered | 214 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-03-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $102,517 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | KBP |
Policy instance | 4 |
Insurance contract or identification number | KBP | Number of Individuals Covered | 214 | Insurance policy start date | 2014-04-01 | Insurance policy end date | 2014-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $298,846 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | KBP |
Policy instance | 3 |
Insurance contract or identification number | KBP | Number of Individuals Covered | 205 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $434,716 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H59221 |
Policy instance | 1 |
Insurance contract or identification number | H59221 | Number of Individuals Covered | 214 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,467 | Total amount of fees paid to insurance company | USD $830 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $50,033 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,467 | Amount paid for insurance broker fees | 830 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | MCCONKEY BENEFITS & FINANCIAL SVCS. |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 2 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 205 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $20,734 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 2 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 214 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $20,451 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H59221 |
Policy instance | 1 |
Insurance contract or identification number | H59221 | Number of Individuals Covered | 217 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,220 | Total amount of fees paid to insurance company | USD $1,048 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $34,545 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,220 | Amount paid for insurance broker fees | 1048 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | MCCONKEY BENEFITS & FINANCIAL SVCS. |
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EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | KBP |
Policy instance | 3 |
Insurance contract or identification number | KBP | Number of Individuals Covered | 215 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $367,689 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 2 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 438 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2011-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $7,793 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | KBP |
Policy instance | 3 |
Insurance contract or identification number | KBP | Number of Individuals Covered | 194 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2011-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $119,534 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H59221 |
Policy instance | 1 |
Insurance contract or identification number | H59221 | Number of Individuals Covered | 205 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,446 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $12,757 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | KBP |
Policy instance | 3 |
Insurance contract or identification number | KBP | Number of Individuals Covered | 177 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $243,391 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 126374 |
Policy instance | 2 |
Insurance contract or identification number | 126374 | Number of Individuals Covered | 398 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $18,009 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H59221 |
Policy instance | 1 |
Insurance contract or identification number | H59221 | Number of Individuals Covered | 193 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $3,563 | Total amount of fees paid to insurance company | USD $1,076 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $35,352 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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