LEECH INDUSTRIES INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LEECH INDUSTRIES INC WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2020: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-03-01 | 83 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 74 |
| Total of all active and inactive participants | 2020-03-01 | 74 |
| Total participants | 2020-03-01 | 74 |
| 2019: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-03-01 | 80 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 83 |
| Total of all active and inactive participants | 2019-03-01 | 83 |
| Total participants | 2019-03-01 | 83 |
| 2018: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-03-01 | 77 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 83 |
| Total of all active and inactive participants | 2018-03-01 | 83 |
| Total participants | 2018-03-01 | 83 |
| 2017: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 73 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 72 |
| Total of all active and inactive participants | 2017-03-01 | 72 |
| Total participants | 2017-03-01 | 72 |
| 2016: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 71 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 73 |
| Total of all active and inactive participants | 2016-03-01 | 73 |
| Total participants | 2016-03-01 | 73 |
| 2015: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 80 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 73 |
| Total of all active and inactive participants | 2015-03-01 | 73 |
| Total participants | 2015-03-01 | 73 |
| 2014: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 74 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 78 |
| Total of all active and inactive participants | 2014-03-01 | 78 |
| Total participants | 2014-03-01 | 78 |
| 2013: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 80 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 71 |
| Total of all active and inactive participants | 2013-03-01 | 71 |
| Total participants | 2013-03-01 | 71 |
| 2012: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 79 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 78 |
| Total of all active and inactive participants | 2012-03-01 | 78 |
| Total participants | 2012-03-01 | 78 |
| 2011: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 75 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 74 |
| Total of all active and inactive participants | 2011-03-01 | 74 |
| Total participants | 2011-03-01 | 74 |
| 2010: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 77 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 77 |
| Total of all active and inactive participants | 2010-03-01 | 77 |
| Total participants | 2010-03-01 | 77 |
| 2009: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-03-01 | 55 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 70 |
| Total of all active and inactive participants | 2009-03-01 | 70 |
| Total participants | 2009-03-01 | 70 |
| Measure | Date | Value |
|---|
| 2021 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2021 401k financial data |
|---|
| Total income from all sources | 2021-02-28 | $811,522 |
| Expenses. Total of all expenses incurred | 2021-02-28 | $811,522 |
| Benefits paid (including direct rollovers) | 2021-02-28 | $515,889 |
| Expenses. Other expenses not covered elsewhere | 2021-02-28 | $250,064 |
| Net income (gross income less expenses) | 2021-02-28 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2021-02-28 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2021-02-28 | $811,522 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-02-28 | $45,569 |
| 2020 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2020 401k financial data |
|---|
| Total income from all sources | 2020-02-29 | $672,743 |
| Expenses. Total of all expenses incurred | 2020-02-29 | $672,743 |
| Benefits paid (including direct rollovers) | 2020-02-29 | $436,403 |
| Expenses. Other expenses not covered elsewhere | 2020-02-29 | $194,485 |
| Net income (gross income less expenses) | 2020-02-29 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2020-02-29 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-02-29 | $0 |
| Total contributions received or receivable from employer(s) | 2020-02-29 | $672,743 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-02-29 | $41,855 |
| 2019 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2019 401k financial data |
|---|
| Total income from all sources | 2019-02-28 | $653,435 |
| Expenses. Total of all expenses incurred | 2019-02-28 | $653,435 |
| Benefits paid (including direct rollovers) | 2019-02-28 | $430,380 |
| Expenses. Other expenses not covered elsewhere | 2019-02-28 | $183,549 |
| Net income (gross income less expenses) | 2019-02-28 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2019-02-28 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2019-02-28 | $653,435 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-02-28 | $39,506 |
| 2018 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-02-28 | $607,898 |
| Expenses. Total of all expenses incurred | 2018-02-28 | $607,898 |
| Benefits paid (including direct rollovers) | 2018-02-28 | $404,202 |
| Expenses. Other expenses not covered elsewhere | 2018-02-28 | $158,291 |
| Net income (gross income less expenses) | 2018-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2018-02-28 | $607,898 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-02-28 | $45,405 |
| 2017 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-02-28 | $566,369 |
| Expenses. Total of all expenses incurred | 2017-02-28 | $566,369 |
| Benefits paid (including direct rollovers) | 2017-02-28 | $381,143 |
| Expenses. Other expenses not covered elsewhere | 2017-02-28 | $143,843 |
| Net income (gross income less expenses) | 2017-02-28 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2017-02-28 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2017-02-28 | $566,369 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-02-28 | $41,383 |
| 2016 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-02-29 | $580,799 |
| Expenses. Total of all expenses incurred | 2016-02-29 | $580,799 |
| Benefits paid (including direct rollovers) | 2016-02-29 | $430,764 |
| Expenses. Other expenses not covered elsewhere | 2016-02-29 | $108,975 |
| Net income (gross income less expenses) | 2016-02-29 | $0 |
| Total contributions received or receivable from employer(s) | 2016-02-29 | $580,799 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-02-29 | $41,060 |
| 2015 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-02-28 | $462,064 |
| Expenses. Total of all expenses incurred | 2015-02-28 | $462,064 |
| Benefits paid (including direct rollovers) | 2015-02-28 | $307,434 |
| Expenses. Other expenses not covered elsewhere | 2015-02-28 | $115,562 |
| Net income (gross income less expenses) | 2015-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2015-02-28 | $462,064 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-02-28 | $39,068 |
| 2014 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-02-28 | $426,062 |
| Expenses. Total of all expenses incurred | 2014-02-28 | $426,062 |
| Benefits paid (including direct rollovers) | 2014-02-28 | $280,764 |
| Expenses. Other expenses not covered elsewhere | 2014-02-28 | $106,091 |
| Net income (gross income less expenses) | 2014-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2014-02-28 | $426,062 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-02-28 | $39,207 |
| 2013 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-02-28 | $505,737 |
| Expenses. Total of all expenses incurred | 2013-02-28 | $505,737 |
| Benefits paid (including direct rollovers) | 2013-02-28 | $370,863 |
| Expenses. Other expenses not covered elsewhere | 2013-02-28 | $96,086 |
| Net income (gross income less expenses) | 2013-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2013-02-28 | $505,737 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-02-28 | $38,788 |
| 2012 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-02-29 | $483,102 |
| Expenses. Total of all expenses incurred | 2012-02-29 | $483,102 |
| Benefits paid (including direct rollovers) | 2012-02-29 | $371,300 |
| Expenses. Other expenses not covered elsewhere | 2012-02-29 | $85,027 |
| Net income (gross income less expenses) | 2012-02-29 | $0 |
| Total contributions received or receivable from employer(s) | 2012-02-29 | $483,102 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-02-29 | $26,775 |
| 2011 : LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-02-28 | $318,937 |
| Expenses. Total of all expenses incurred | 2011-02-28 | $318,937 |
| Benefits paid (including direct rollovers) | 2011-02-28 | $212,292 |
| Expenses. Other expenses not covered elsewhere | 2011-02-28 | $81,777 |
| Net income (gross income less expenses) | 2011-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2011-02-28 | $318,937 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-02-28 | $24,868 |
| 2020: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-03-01 | Type of plan entity | Single employer plan |
| 2020-03-01 | Plan funding arrangement – Insurance | Yes |
| 2020-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-03-01 | Type of plan entity | Single employer plan |
| 2019-03-01 | Submission has been amended | No |
| 2019-03-01 | This submission is the final filing | No |
| 2019-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-03-01 | Plan is a collectively bargained plan | No |
| 2019-03-01 | Plan funding arrangement – Insurance | Yes |
| 2019-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-03-01 | Type of plan entity | Single employer plan |
| 2018-03-01 | Submission has been amended | No |
| 2018-03-01 | This submission is the final filing | No |
| 2018-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-03-01 | Plan is a collectively bargained plan | No |
| 2018-03-01 | Plan funding arrangement – Insurance | Yes |
| 2018-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Submission has been amended | No |
| 2017-03-01 | This submission is the final filing | No |
| 2017-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-03-01 | Plan is a collectively bargained plan | No |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | Submission has been amended | No |
| 2016-03-01 | This submission is the final filing | No |
| 2016-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-03-01 | Plan is a collectively bargained plan | No |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | Submission has been amended | No |
| 2015-03-01 | This submission is the final filing | No |
| 2015-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-03-01 | Plan is a collectively bargained plan | No |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Submission has been amended | No |
| 2014-03-01 | This submission is the final filing | No |
| 2014-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-03-01 | Plan is a collectively bargained plan | No |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Submission has been amended | No |
| 2013-03-01 | This submission is the final filing | No |
| 2013-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-03-01 | Plan is a collectively bargained plan | No |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Submission has been amended | No |
| 2012-03-01 | This submission is the final filing | No |
| 2012-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-03-01 | Plan is a collectively bargained plan | No |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Submission has been amended | No |
| 2011-03-01 | This submission is the final filing | No |
| 2011-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-03-01 | Plan is a collectively bargained plan | No |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 2010-03-01 | Submission has been amended | No |
| 2010-03-01 | This submission is the final filing | No |
| 2010-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-03-01 | Plan is a collectively bargained plan | No |
| 2010-03-01 | Plan funding arrangement – Insurance | Yes |
| 2010-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: LEECH INDUSTRIES INC WELFARE BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | Submission has been amended | No |
| 2009-03-01 | This submission is the final filing | No |
| 2009-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-03-01 | Plan is a collectively bargained plan | No |
| 2009-03-01 | Plan funding arrangement – Insurance | Yes |
| 2009-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 ) |
| Policy contract number | 0265 |
| Policy instance | 1 |
| Insurance contract or identification number | 0265 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $35,009 | | Total amount of fees paid to insurance company | USD $1,000 | | Welfare Benefit Premiums Paid to Carrier | USD $250,064 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,008 | | Amount paid for insurance broker fees | 1000 | | Additional information about fees paid to insurance broker | SERVICE |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 111234 |
| Policy instance | 1 |
| Insurance contract or identification number | 111234 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $960 | | 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 | | 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 $8,005 | | Commission paid to Insurance Broker | USD $960 | | Additional information about fees paid to insurance broker | SERVICE | | Insurance broker organization code? | 3 |
|
| AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 ) |
| Policy contract number | 0265 |
| Policy instance | 2 |
| Insurance contract or identification number | 0265 | | Number of Individuals Covered | 83 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-28 | | Total amount of commissions paid to insurance broker | USD $27,227 | | Total amount of fees paid to insurance company | USD $1,000 | | 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 | | 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 $194,485 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,338 | | Additional information about fees paid to insurance broker | SERVICE |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 111234 |
| Policy instance | 1 |
| Insurance contract or identification number | 111234 | | Number of Individuals Covered | 101 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $844 | | 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $844 | | Additional information about fees paid to insurance broker | SERVICE | | Insurance broker organization code? | 3 |
|
| AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 ) |
| Policy contract number | 0265 |
| Policy instance | 2 |
| Insurance contract or identification number | 0265 | | Number of Individuals Covered | 83 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $25,697 | | Total amount of fees paid to insurance company | USD $1,000 | | 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 | | 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 $183,549 | | Commission paid to Insurance Broker | USD $3,671 | | Amount paid for insurance broker fees | 1000 | | Additional information about fees paid to insurance broker | SERVICE |
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| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | 0265 |
| Policy instance | 1 |
| Insurance contract or identification number | 0265 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | 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 | | 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 $-122 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | SERVICE | | Insurance broker name | THE DJB GROUP |
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| AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 ) |
| Policy contract number | 0265 |
| Policy instance | 2 |
| Insurance contract or identification number | 0265 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $22,177 | | Total amount of fees paid to insurance company | USD $1,000 | | 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 | | 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 $158,413 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,168 | | Amount paid for insurance broker fees | 1000 | | Additional information about fees paid to insurance broker | SERVICE | | Insurance broker name | THE DJB GROUP |
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| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 111234 |
| Policy instance | 3 |
| Insurance contract or identification number | 111234 | | Number of Individuals Covered | 95 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $693 | | 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 | | 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 $5,848 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $693 | | Additional information about fees paid to insurance broker | SERVICE | | Insurance broker name | THE DJB GROUP |
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| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 0265 |
| Policy instance | 4 |
| Insurance contract or identification number | 0265 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2017-03-02 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $1,278 | | 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 | | 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 $12,783 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $639 | | Additional information about fees paid to insurance broker | SERVICE | | Insurance broker name | THE DJB GROUP |
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