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STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan NameSTEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN
Plan identification number 501

STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

STEWART GLAPAT CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:STEWART GLAPAT CORPORATION
Employer identification number (EIN):314371751
NAIC Classification:333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01
5012021-07-01
5012020-07-01
5012020-07-01
5012019-07-01
5012018-07-01
5012018-07-01
5012017-07-01CHARLES T STEWART, JR
5012016-07-01CHARLES T STEWART, JR
5012015-07-01CHARLES T STEWART, JR
5012014-07-01CHARLES T STEWART, JR
5012013-07-01CHARLES T STEWART, JR
5012012-08-01CHARLES T STEWART, JR

Plan Statistics for STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN

401k plan membership statisitcs for STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2022: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-0176
Total number of active participants reported on line 7a of the Form 55002022-07-0188
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-0188
Total participants2022-07-0188
2021: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-0154
Total number of active participants reported on line 7a of the Form 55002021-07-0175
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-0175
Total participants2021-07-0175
2020: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-0139
Total number of active participants reported on line 7a of the Form 55002020-07-0154
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-0154
Total participants2020-07-0154
2019: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-0141
Total number of active participants reported on line 7a of the Form 55002019-07-0130
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-0130
Total participants2019-07-0130
2018: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-0139
Total number of active participants reported on line 7a of the Form 55002018-07-0141
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-0141
Total participants2018-07-0141
2017: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-0135
Total number of active participants reported on line 7a of the Form 55002017-07-0137
Number of retired or separated participants receiving benefits2017-07-012
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-0139
2016: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-0127
Total number of active participants reported on line 7a of the Form 55002016-07-0134
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-0134
2015: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0126
Total number of active participants reported on line 7a of the Form 55002015-07-0125
Number of retired or separated participants receiving benefits2015-07-012
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-0127
2014: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0123
Total number of active participants reported on line 7a of the Form 55002014-07-0128
Number of retired or separated participants receiving benefits2014-07-011
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-0129
2013: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-0120
Total number of active participants reported on line 7a of the Form 55002013-07-0124
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-0124
2012: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-0117
Total number of active participants reported on line 7a of the Form 55002012-08-0120
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-010
Total of all active and inactive participants2012-08-0120

Financial Data on STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2023 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2023 401k financial data
Total income from all sources2023-06-30$1,696,724
Expenses. Total of all expenses incurred2023-06-30$1,596,096
Benefits paid (including direct rollovers)2023-06-30$516,883
Total plan assets at end of year2023-06-30$883,534
Total plan assets at beginning of year2023-06-30$782,906
Expenses. Other expenses not covered elsewhere2023-06-30$1,023,029
Contributions received from other sources (not participants or employers)2023-06-30$11,902
Net income (gross income less expenses)2023-06-30$100,628
Net plan assets at end of year (total assets less liabilities)2023-06-30$883,534
Net plan assets at beginning of year (total assets less liabilities)2023-06-30$782,906
Total contributions received or receivable from employer(s)2023-06-30$1,684,822
Expenses. Administrative service providers (salaries,fees and commissions)2023-06-30$56,184
2022 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 401k financial data
Total income from all sources2022-06-30$1,466,210
Expenses. Total of all expenses incurred2022-06-30$1,297,535
Benefits paid (including direct rollovers)2022-06-30$317,552
Total plan assets at end of year2022-06-30$782,906
Total plan assets at beginning of year2022-06-30$614,231
Total contributions received or receivable from participants2022-06-30$0
Expenses. Other expenses not covered elsewhere2022-06-30$935,208
Other income received2022-06-30$4,779
Net income (gross income less expenses)2022-06-30$168,675
Net plan assets at end of year (total assets less liabilities)2022-06-30$782,906
Net plan assets at beginning of year (total assets less liabilities)2022-06-30$614,231
Total contributions received or receivable from employer(s)2022-06-30$1,461,431
Expenses. Administrative service providers (salaries,fees and commissions)2022-06-30$44,775
2021 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 401k financial data
Total income from all sources2021-06-30$872,969
Expenses. Total of all expenses incurred2021-06-30$749,880
Benefits paid (including direct rollovers)2021-06-30$140,715
Total plan assets at end of year2021-06-30$614,231
Total plan assets at beginning of year2021-06-30$491,142
Total contributions received or receivable from participants2021-06-30$0
Expenses. Other expenses not covered elsewhere2021-06-30$581,986
Other income received2021-06-30$4,042
Net income (gross income less expenses)2021-06-30$123,089
Net plan assets at end of year (total assets less liabilities)2021-06-30$614,231
Net plan assets at beginning of year (total assets less liabilities)2021-06-30$491,142
Total contributions received or receivable from employer(s)2021-06-30$868,927
Expenses. Administrative service providers (salaries,fees and commissions)2021-06-30$27,179
2020 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 401k financial data
Total income from all sources2020-06-30$673,602
Expenses. Total of all expenses incurred2020-06-30$639,082
Benefits paid (including direct rollovers)2020-06-30$188,611
Total plan assets at end of year2020-06-30$491,143
Total plan assets at beginning of year2020-06-30$456,623
Value of fidelity bond covering the plan2020-06-30$500,000
Total contributions received or receivable from participants2020-06-30$0
Expenses. Other expenses not covered elsewhere2020-06-30$430,315
Other income received2020-06-30$15,210
Net income (gross income less expenses)2020-06-30$34,520
Net plan assets at end of year (total assets less liabilities)2020-06-30$491,143
Net plan assets at beginning of year (total assets less liabilities)2020-06-30$456,623
Total contributions received or receivable from employer(s)2020-06-30$658,392
Expenses. Administrative service providers (salaries,fees and commissions)2020-06-30$20,156
2019 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k financial data
Transfers to/from the plan2019-06-30$-406,630
Total income from all sources2019-06-30$1,182,194
Expenses. Total of all expenses incurred2019-06-30$733,376
Benefits paid (including direct rollovers)2019-06-30$193,036
Total plan assets at end of year2019-06-30$456,623
Total plan assets at beginning of year2019-06-30$414,435
Value of fidelity bond covering the plan2019-06-30$500,000
Total contributions received or receivable from participants2019-06-30$0
Expenses. Other expenses not covered elsewhere2019-06-30$512,737
Other income received2019-06-30$1,701
Net income (gross income less expenses)2019-06-30$448,818
Net plan assets at end of year (total assets less liabilities)2019-06-30$456,623
Net plan assets at beginning of year (total assets less liabilities)2019-06-30$414,435
Total contributions received or receivable from employer(s)2019-06-30$1,180,493
Expenses. Administrative service providers (salaries,fees and commissions)2019-06-30$27,603
2018 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 401k financial data
Total plan liabilities at end of year2018-06-30$171
Total income from all sources2018-06-30$263,071
Expenses. Total of all expenses incurred2018-06-30$142,403
Benefits paid (including direct rollovers)2018-06-30$115,280
Total plan assets at end of year2018-06-30$414,606
Total plan assets at beginning of year2018-06-30$293,767
Value of fidelity bond covering the plan2018-06-30$500,000
Other income received2018-06-30$4,502
Net income (gross income less expenses)2018-06-30$120,668
Net plan assets at end of year (total assets less liabilities)2018-06-30$414,435
Net plan assets at beginning of year (total assets less liabilities)2018-06-30$293,767
Total contributions received or receivable from employer(s)2018-06-30$258,569
Expenses. Administrative service providers (salaries,fees and commissions)2018-06-30$27,123
2017 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 401k financial data
Total income from all sources2017-06-30$292,036
Expenses. Total of all expenses incurred2017-06-30$223,086
Benefits paid (including direct rollovers)2017-06-30$206,666
Total plan assets at end of year2017-06-30$293,767
Total plan assets at beginning of year2017-06-30$224,817
Value of fidelity bond covering the plan2017-06-30$500,000
Other income received2017-06-30$1,227
Net income (gross income less expenses)2017-06-30$68,950
Net plan assets at end of year (total assets less liabilities)2017-06-30$293,767
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$224,817
Total contributions received or receivable from employer(s)2017-06-30$290,809
Expenses. Administrative service providers (salaries,fees and commissions)2017-06-30$16,420
2016 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k financial data
Total income from all sources2016-06-30$180,559
Expenses. Total of all expenses incurred2016-06-30$80,735
Benefits paid (including direct rollovers)2016-06-30$64,227
Total plan assets at end of year2016-06-30$224,817
Total plan assets at beginning of year2016-06-30$124,993
Value of fidelity bond covering the plan2016-06-30$500,000
Other income received2016-06-30$252
Net income (gross income less expenses)2016-06-30$99,824
Net plan assets at end of year (total assets less liabilities)2016-06-30$224,817
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$124,993
Total contributions received or receivable from employer(s)2016-06-30$180,307
Expenses. Administrative service providers (salaries,fees and commissions)2016-06-30$16,508
2015 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k financial data
Total plan liabilities at beginning of year2015-06-30$220
Total income from all sources2015-06-30$268,234
Expenses. Total of all expenses incurred2015-06-30$256,577
Benefits paid (including direct rollovers)2015-06-30$234,768
Total plan assets at end of year2015-06-30$124,993
Total plan assets at beginning of year2015-06-30$113,556
Value of fidelity bond covering the plan2015-06-30$500,000
Other income received2015-06-30$76
Net income (gross income less expenses)2015-06-30$11,657
Net plan assets at end of year (total assets less liabilities)2015-06-30$124,993
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$113,336
Total contributions received or receivable from employer(s)2015-06-30$268,158
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$21,809
2014 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k financial data
Total plan liabilities at end of year2014-06-30$220
Total plan liabilities at beginning of year2014-06-30$284
Total income from all sources2014-06-30$152,873
Expenses. Total of all expenses incurred2014-06-30$91,300
Benefits paid (including direct rollovers)2014-06-30$74,590
Total plan assets at end of year2014-06-30$113,556
Total plan assets at beginning of year2014-06-30$52,047
Value of fidelity bond covering the plan2014-06-30$500,000
Other income received2014-06-30$41
Net income (gross income less expenses)2014-06-30$61,573
Net plan assets at end of year (total assets less liabilities)2014-06-30$113,336
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$51,763
Total contributions received or receivable from employer(s)2014-06-30$152,832
Expenses. Administrative service providers (salaries,fees and commissions)2014-06-30$16,710
2013 : STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2013 401k financial data
Total plan liabilities at end of year2013-06-30$284
Total income from all sources2013-06-30$120,534
Expenses. Total of all expenses incurred2013-06-30$68,771
Benefits paid (including direct rollovers)2013-06-30$56,797
Total plan assets at end of year2013-06-30$52,047
Total plan assets at beginning of year2013-06-30$0
Value of fidelity bond covering the plan2013-06-30$500,000
Other income received2013-06-30$19
Net income (gross income less expenses)2013-06-30$51,763
Net plan assets at end of year (total assets less liabilities)2013-06-30$51,763
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$0
Total contributions received or receivable from employer(s)2013-06-30$120,515
Expenses. Administrative service providers (salaries,fees and commissions)2013-06-30$11,974

Form 5500 Responses for STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN

2022: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedYes
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement - TrustYes
2016: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement - TrustYes
2015: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement - TrustYes
2014: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement - TrustYes
2013: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement - TrustYes
2012: STEWART GLAPAT CORPORATION SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01First time form 5500 has been submittedYes
2012-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-08-01Plan funding arrangement – TrustYes
2012-08-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10513
Policy instance 1
Insurance contract or identification number10513
Number of Individuals Covered88
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $65,229
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $436,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,731
Insurance broker organization code?5
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10513
Policy instance 1
Insurance contract or identification number10513
Number of Individuals Covered75
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $63,814
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $425,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,271
Insurance broker organization code?5
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10513
Policy instance 1
Insurance contract or identification number10513
Number of Individuals Covered54
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $38,263
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $255,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,753
Insurance broker organization code?5
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10513
Policy instance 1
Insurance contract or identification number10513
Number of Individuals Covered30
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $27,805
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $185,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,269
Insurance broker organization code?5
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10513
Policy instance 1
Insurance contract or identification number10513
Number of Individuals Covered41
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $36,246
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $241,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,082
Insurance broker organization code?5

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