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HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameHAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

HAMILL MANUFACTURING COMPANY has sponsored the creation of one or more 401k plans.

Company Name:HAMILL MANUFACTURING COMPANY
Employer identification number (EIN):251057462
NAIC Classification:332300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-04-01CHRIS HUSTON2024-10-11
5012022-04-01CHRIS HUSTON2023-09-28
5012021-04-01CHRIS HUSTON2022-06-17
5012020-04-01CHRIS HUSTON2021-06-25
5012019-04-01CHRIS HUSTON2020-09-28
5012018-04-01CHRIS NEUBAUER2019-10-30
5012017-04-01
5012016-04-01CHRIS NEUBAUER2019-01-10
5012015-04-01
5012014-04-01
5012013-04-01
5012012-04-01PHYLLIS E. MILLER
5012011-04-01PHYLLIS MILLER

Plan Statistics for HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2023: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-04-01109
Total number of active participants reported on line 7a of the Form 55002023-04-01102
Number of retired or separated participants receiving benefits2023-04-010
Number of other retired or separated participants entitled to future benefits2023-04-010
Total of all active and inactive participants2023-04-01102
Number of employers contributing to the scheme2023-04-010
2022: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01109
Total number of active participants reported on line 7a of the Form 55002022-04-01109
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01109
Number of employers contributing to the scheme2022-04-010
2021: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01114
Total number of active participants reported on line 7a of the Form 55002021-04-01109
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01109
Number of employers contributing to the scheme2021-04-010
2020: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01117
Total number of active participants reported on line 7a of the Form 55002020-04-01114
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01114
Number of employers contributing to the scheme2020-04-010
2019: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01119
Total number of active participants reported on line 7a of the Form 55002019-04-01117
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01117
Number of employers contributing to the scheme2019-04-010
2018: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01118
Total number of active participants reported on line 7a of the Form 55002018-04-01119
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01119
Number of employers contributing to the scheme2018-04-010
2017: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01117
Total number of active participants reported on line 7a of the Form 55002017-04-01116
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01116
Number of employers contributing to the scheme2017-04-010
2016: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01100
Total number of active participants reported on line 7a of the Form 55002016-04-01120
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01120
2015: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01101
Total number of active participants reported on line 7a of the Form 55002015-04-0196
Number of retired or separated participants receiving benefits2015-04-011
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-0197
2014: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01112
Total number of active participants reported on line 7a of the Form 55002014-04-0197
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-0197
2013: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01115
Total number of active participants reported on line 7a of the Form 55002013-04-01112
Number of retired or separated participants receiving benefits2013-04-011
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-01113
2012: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01119
Total number of active participants reported on line 7a of the Form 55002012-04-01110
Number of retired or separated participants receiving benefits2012-04-012
Number of other retired or separated participants entitled to future benefits2012-04-012
Total of all active and inactive participants2012-04-01114
2011: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01110
Total number of active participants reported on line 7a of the Form 55002011-04-01111
Number of retired or separated participants receiving benefits2011-04-012
Number of other retired or separated participants entitled to future benefits2011-04-010
Total of all active and inactive participants2011-04-01113

Form 5500 Responses for HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN

2023: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan funding arrangement – General assets of the sponsorYes
2023-04-01Plan benefit arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – General assets of the sponsorYes
2022: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – General assets of the sponsorYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – General assets of the sponsorYes
2021: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – General assets of the sponsorYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – General assets of the sponsorYes
2020: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – General assets of the sponsorYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – General assets of the sponsorYes
2019: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – General assets of the sponsorYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – General assets of the sponsorYes
2018: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – General assets of the sponsorYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – General assets of the sponsorYes
2017: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – General assets of the sponsorYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – General assets of the sponsorYes
2015: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: HAMILL MANUFACTURING CO. HEALTH AND WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01First time form 5500 has been submittedYes
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number397549
Policy instance 4
Insurance contract or identification number397549
Number of Individuals Covered102
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $16,559
Total amount of fees paid to insurance companyUSD $1,987
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $107,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
BACK ON TRACK EMPLOYEE ASSISTANCE PROGRAM (National Association of Insurance Commissioners NAIC id number: 62322 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered102
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE9159146
Policy instance 2
Insurance contract or identification numberE9159146
Number of Individuals Covered8
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $533
Total amount of fees paid to insurance companyUSD $22
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $3,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract numberCOL9159146
Policy instance 1
Insurance contract or identification numberCOL9159146
Number of Individuals Covered1
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract numberCOL9159146
Policy instance 1
Insurance contract or identification numberCOL9159146
Number of Individuals Covered1
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE9159146
Policy instance 2
Insurance contract or identification numberE9159146
Number of Individuals Covered10
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $490
Total amount of fees paid to insurance companyUSD $1
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $4,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $347
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
BACK ON TRACK EMPLOYEE ASSISTANCE PROGRAM (National Association of Insurance Commissioners NAIC id number: 62322 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered108
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number397549
Policy instance 4
Insurance contract or identification number397549
Number of Individuals Covered100
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $17,653
Total amount of fees paid to insurance companyUSD $1,768
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $115,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,853
Amount paid for insurance broker fees1768
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract numberCOL9159146
Policy instance 1
Insurance contract or identification numberCOL9159146
Number of Individuals Covered1
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE9159146
Policy instance 2
Insurance contract or identification numberE9159146
Number of Individuals Covered10
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $1,218
Total amount of fees paid to insurance companyUSD $16
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $823
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
WASHINGTON EAP SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered115
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,277
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number397549
Policy instance 4
Insurance contract or identification number397549
Number of Individuals Covered109
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $16,266
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $105,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,983
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number397549
Policy instance 4
Insurance contract or identification number397549
Number of Individuals Covered114
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $23,312
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $123,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,153
Amount paid for insurance broker fees0
Insurance broker organization code?3
WASHINGTON EAP SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered117
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE9159146
Policy instance 2
Insurance contract or identification numberE9159146
Number of Individuals Covered13
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $428
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $328
Amount paid for insurance broker fees0
Insurance broker organization code?3
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract numberCOL9159146
Policy instance 1
Insurance contract or identification numberCOL9159146
Number of Individuals Covered1
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE9159146
Policy instance 2
Insurance contract or identification numberE9159146
Number of Individuals Covered13
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $282
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $197
Amount paid for insurance broker fees0
Insurance broker organization code?3
WASHINGTON EAP SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered117
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number397549
Policy instance 4
Insurance contract or identification number397549
Number of Individuals Covered117
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $21,711
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $123,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,415
Amount paid for insurance broker fees0
Insurance broker organization code?3
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract numberCOL9159146
Policy instance 1
Insurance contract or identification numberCOL9159146
Number of Individuals Covered2
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $1,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number397549
Policy instance 5
Insurance contract or identification number397549
Number of Individuals Covered119
Insurance policy start date2018-10-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $11,710
Total amount of fees paid to insurance companyUSD $3,631
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $60,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,710
Amount paid for insurance broker fees3631
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
WASHINGTON EAP SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 4
Insurance contract or identification number00
Number of Individuals Covered116
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE9159146
Policy instance 3
Insurance contract or identification numberE9159146
Number of Individuals Covered17
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $339
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $101
Amount paid for insurance broker fees0
Insurance broker organization code?3
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract numberCOL9159146
Policy instance 2
Insurance contract or identification numberCOL9159146
Number of Individuals Covered3
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $1,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number397549
Policy instance 1
Insurance contract or identification number397549
Number of Individuals Covered118
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $18,330
Total amount of fees paid to insurance companyUSD $2,111
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $122,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,298
Amount paid for insurance broker fees2111
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00397549
Policy instance 1
Insurance contract or identification number00397549
Number of Individuals Covered117
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $15,292
Total amount of fees paid to insurance companyUSD $1,578
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $116,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,292
Amount paid for insurance broker fees1578
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameASSUREDPARTNERS
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract numberCOL9159146
Policy instance 2
Insurance contract or identification numberCOL9159146
Number of Individuals Covered116
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CANCER
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE9159146
Policy instance 3
Insurance contract or identification numberE9159146
Number of Individuals Covered20
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $894
Total amount of fees paid to insurance companyUSD $34
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $448
Amount paid for insurance broker fees15
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameTUCKER JOHNSTON SMELZER & OTH AGNTS
WASHINGTON EAP SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 4
Insurance contract or identification number00
Number of Individuals Covered116
Insurance policy start date2017-06-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00397549
Policy instance 3
Insurance contract or identification number00397549
Number of Individuals Covered117
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $16,265
Total amount of fees paid to insurance companyUSD $4,605
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, OPTIONAL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $110,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,265
Amount paid for insurance broker fees4605
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameTUCKER JOHNSTON & SMELZER, INC.
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE9159146
Policy instance 2
Insurance contract or identification numberE9159146
Number of Individuals Covered210
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $908
Total amount of fees paid to insurance companyUSD $318
Other welfare benefits providedVOLUNTARY LIFE, AD&D, STD, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $6,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $450
Amount paid for insurance broker fees286
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameDEEANN GREENE-MARSZALEK
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract numberCOL9159146
Policy instance 1
Insurance contract or identification numberCOL9159146
Number of Individuals Covered3
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number5925990000
Policy instance 1
Insurance contract or identification number5925990000
Number of Individuals Covered217
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $20,949
Total amount of fees paid to insurance companyUSD $2,954
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,047,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,949
Insurance broker organization code?3
Amount paid for insurance broker fees2954
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker nameBENEFITS NETWORK INC.
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number5925990000
Policy instance 1
Insurance contract or identification number5925990000
Number of Individuals Covered246
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $20,516
Total amount of fees paid to insurance companyUSD $5,004
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,025,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,516
Insurance broker organization code?3
Amount paid for insurance broker fees5004
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker nameBENEFITS NETWORK INC.
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number01645600
Policy instance 1
Insurance contract or identification number01645600
Number of Individuals Covered262
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $28,573
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $951,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,573
Insurance broker organization code?3
Insurance broker nameTUCKER, JOHNSTON & SMELZER, INC.
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number01645600
Policy instance 1
Insurance contract or identification number01645600
Number of Individuals Covered255
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $23,743
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $777,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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