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FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 401k Plan overview

Plan NameFARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN
Plan identification number 505

FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN Benefits

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

401k Sponsoring company profile

FARMERS AUTOMOBILE INSURANCE ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name:FARMERS AUTOMOBILE INSURANCE ASSOCIATION
Employer identification number (EIN):370268670
NAIC Classification:524150

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-01-01
5052021-01-01
5052020-01-01
5052019-01-01
5052018-01-01KIMBERLY REMMERT DANIEL CONNELL2019-07-02
5052017-01-01KIMBERLY REMMERT DANIEL CONNELL2018-06-18
5052016-01-01KIMBERLY S. REMMERT DANIEL V CONNELL2017-07-18
5052015-01-01DANIEL V CONNELL DANIEL V CONNELL2016-07-21
5052014-01-01DANIEL V CONNELL DANIEL V CONNELL2015-07-09
5052013-01-01DANIEL V CONNELL DANIEL V CONNELL2014-06-26
5052012-01-01DANIEL V CONNELL DANIEL V CONNELL2013-07-25
5052011-01-01DANIEL V CONNELL DANIEL V CONNELL2012-07-19
5052009-01-01DANIEL V CONNELL DANIEL V CONNELL2010-07-12

Plan Statistics for FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN

401k plan membership statisitcs for FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN

Measure Date Value
2022: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01775
Total number of active participants reported on line 7a of the Form 55002022-01-01783
Total of all active and inactive participants2022-01-01783
Total participants2022-01-01783
2021: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01794
Total number of active participants reported on line 7a of the Form 55002021-01-01775
Total of all active and inactive participants2021-01-01775
Total participants2021-01-01775
2020: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01932
Total number of active participants reported on line 7a of the Form 55002020-01-01794
Total of all active and inactive participants2020-01-01794
Total participants2020-01-01794
2019: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01911
Total number of active participants reported on line 7a of the Form 55002019-01-01932
Total of all active and inactive participants2019-01-01932
Total participants2019-01-01932
2018: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01898
Total number of active participants reported on line 7a of the Form 55002018-01-01911
Total of all active and inactive participants2018-01-01911
Total participants2018-01-01911
2017: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01880
Total number of active participants reported on line 7a of the Form 55002017-01-01898
Total of all active and inactive participants2017-01-01898
Total participants2017-01-01898
2016: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01803
Total number of active participants reported on line 7a of the Form 55002016-01-01880
Total of all active and inactive participants2016-01-01880
2015: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01766
Total number of active participants reported on line 7a of the Form 55002015-01-01803
Total of all active and inactive participants2015-01-01803
2014: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01756
Total number of active participants reported on line 7a of the Form 55002014-01-01766
Total of all active and inactive participants2014-01-01766
2013: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01745
Total number of active participants reported on line 7a of the Form 55002013-01-01756
Total of all active and inactive participants2013-01-01756
2012: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01729
Total number of active participants reported on line 7a of the Form 55002012-01-01745
Total of all active and inactive participants2012-01-01745
2011: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01712
Total number of active participants reported on line 7a of the Form 55002011-01-01729
Total of all active and inactive participants2011-01-01729
2009: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01707
Total number of active participants reported on line 7a of the Form 55002009-01-01709
Total of all active and inactive participants2009-01-01709

Form 5500 Responses for FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN

2022: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: FARMERS AUTOMOBILE INSURANCE ASSOCIATION TRAVEL ACCIDENT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99076968
Policy instance 1
Insurance contract or identification number99076968
Number of Individuals Covered783
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT
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 $2,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99076968
Policy instance 1
Insurance contract or identification number99076968
Number of Individuals Covered775
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT
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 $2,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99076968
Policy instance 1
Insurance contract or identification number99076968
Number of Individuals Covered794
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT
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 $2,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99076968
Policy instance 1
Insurance contract or identification number99076968
Number of Individuals Covered932
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT
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 $2,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99076968
Policy instance 1
Insurance contract or identification number99076968
Number of Individuals Covered911
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT
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 $2,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99076968
Policy instance 1
Insurance contract or identification number99076968
Number of Individuals Covered898
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRAVEL ACCIDENT
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 $2,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number99076968
Policy instance 1
Insurance contract or identification number99076968
Number of Individuals Covered803
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $2,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $405
Insurance broker nameTHE LIDDLE AGENCY INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL655952
Policy instance 1
Insurance contract or identification numberABL655952
Number of Individuals Covered766
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $692
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
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $4,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $692
Insurance broker nameTHE LIDDLE AGENCY INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL655952
Policy instance 1
Insurance contract or identification numberABL655952
Number of Individuals Covered756
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $692
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
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $4,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $692
Insurance broker nameTHE LIDDLE AGENCY INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL655952
Policy instance 1
Insurance contract or identification numberABL655952
Number of Individuals Covered745
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $692
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
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $4,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $692
Insurance broker nameTHE LIDDLE AGENCY INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL655952
Policy instance 1
Insurance contract or identification numberABL655952
Number of Individuals Covered729
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $692
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
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $4,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL655952
Policy instance 1
Insurance contract or identification numberABL655952
Number of Individuals Covered712
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $692
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
Other welfare benefits providedTRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $4,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $692
Insurance broker nameILIFF & HAUSER AGENCY

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