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NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 401k Plan overview

Plan NameNEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN
Plan identification number 503

NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

NEIGHBORHOOD SERVICE ORGANIZATION has sponsored the creation of one or more 401k plans.

Company Name:NEIGHBORHOOD SERVICE ORGANIZATION
Employer identification number (EIN):381561624
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about NEIGHBORHOOD SERVICE ORGANIZATION

Jurisdiction of Incorporation: Michigan Secretary of State
Incorporation Date: 0000-00-00
Company Identification Number: 705079
Legal Registered Office Address: 882 OAKMAN BLVD STE C DETROIT


United States of America (USA)
48238

More information about NEIGHBORHOOD SERVICE ORGANIZATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032018-01-01LINDA LITTLE2019-08-23
5032017-01-01SHIELAH CLAY
5032016-01-01SHIELAH CLAY
5032015-01-01SHIELAH CLAY
5032014-01-01SHEILAH CLAY
5032013-01-01SHEILAH CLAY
5032012-01-01SHEILAH CLAY
5032011-01-01SHEILAH CLAY
5032009-01-01SHEILAH CLAY

Plan Statistics for NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN

401k plan membership statisitcs for NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN

Measure Date Value
2018: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01323
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-010
Number of employers contributing to the scheme2018-01-010
2017: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01328
Total number of active participants reported on line 7a of the Form 55002017-01-01323
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01323
2016: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01235
Total number of active participants reported on line 7a of the Form 55002016-01-01328
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01328
2015: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01202
Total number of active participants reported on line 7a of the Form 55002015-01-01235
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01235
2014: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01211
Total number of active participants reported on line 7a of the Form 55002014-01-01202
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01202
2013: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01230
Total number of active participants reported on line 7a of the Form 55002013-01-01211
Total of all active and inactive participants2013-01-01211
2012: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01230
Total number of active participants reported on line 7a of the Form 55002012-01-01230
Total of all active and inactive participants2012-01-01230
2011: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01227
Total number of active participants reported on line 7a of the Form 55002011-01-01230
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01230
2009: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01268
Total number of active participants reported on line 7a of the Form 55002009-01-01225
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01225

Form 5500 Responses for NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN

2018: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE 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: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE 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: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE 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: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE 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: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE 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: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE 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: NEIGHBORHOOD SERVICE ORGANIZATION DISABILITY AND LIFE INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number8114088
Policy instance 2
Insurance contract or identification number8114088
Number of Individuals Covered17
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $75
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150697-0001
Policy instance 1
Insurance contract or identification number150697-0001
Number of Individuals Covered11
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,224
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $6,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,224
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150697
Policy instance 1
Insurance contract or identification number150697
Number of Individuals Covered10
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,123
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,123
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameDALY MERRITT, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5912111
Policy instance 2
Insurance contract or identification number5912111
Number of Individuals Covered62
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,797
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $9,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,797
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0008114088
Policy instance 3
Insurance contract or identification number0008114088
Number of Individuals Covered22
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $82
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $82
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number283724
Policy instance 4
Insurance contract or identification number283724
Number of Individuals Covered229
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $25,859
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $110,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,859
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number283724
Policy instance 5
Insurance contract or identification number283724
Number of Individuals Covered235
Insurance policy start date2015-10-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $41,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0008114088
Policy instance 4
Insurance contract or identification number0008114088
Number of Individuals Covered26
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $101
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $101
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5912111
Policy instance 3
Insurance contract or identification number5912111
Number of Individuals Covered73
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $17,751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010180717
Policy instance 2
Insurance contract or identification number000010180717
Number of Individuals Covered223
Insurance policy start date2015-01-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $3,076
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $20,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,076
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150697
Policy instance 1
Insurance contract or identification number150697
Number of Individuals Covered17
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,246
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,246
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameDALY MERRITT, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5912111
Policy instance 5
Insurance contract or identification number5912111
Number of Individuals Covered84
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,965
Total amount of fees paid to insurance companyUSD $227
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $14,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,965
Amount paid for insurance broker fees227
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010180719
Policy instance 4
Insurance contract or identification number000010180719
Number of Individuals Covered202
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,606
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $70,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,606
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010180718
Policy instance 3
Insurance contract or identification number000010180718
Number of Individuals Covered201
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,463
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,463
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010180717
Policy instance 2
Insurance contract or identification number000010180717
Number of Individuals Covered202
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,735
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $38,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,735
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150697
Policy instance 1
Insurance contract or identification number150697
Number of Individuals Covered17
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,663
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,663
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameDALY MERRITT, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010180718
Policy instance 3
Insurance contract or identification number000010180718
Number of Individuals Covered211
Insurance policy start date2013-10-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,322
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,322
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010180717
Policy instance 2
Insurance contract or identification number000010180717
Number of Individuals Covered211
Insurance policy start date2013-10-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $816
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $5,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $816
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150696
Policy instance 1
Insurance contract or identification number150696
Number of Individuals Covered211
Insurance policy start date2013-01-01
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $15,017
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $92,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,017
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameDALY MERRITT, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5912111
Policy instance 5
Insurance contract or identification number5912111
Number of Individuals Covered162
Insurance policy start date2013-10-01
Insurance policy end date2013-12-31
Total amount of fees paid to insurance companyUSD $23
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $3,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees23
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010180719
Policy instance 4
Insurance contract or identification number000010180719
Number of Individuals Covered211
Insurance policy start date2013-10-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,652
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $11,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,652
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150697
Policy instance 2
Insurance contract or identification number150697
Number of Individuals Covered24
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,763
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,763
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameDALY MERRITT, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150696
Policy instance 1
Insurance contract or identification number150696
Number of Individuals Covered199
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $18,336
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $158,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,336
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameDALY MERRITT, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150696
Policy instance 2
Insurance contract or identification number150696
Number of Individuals Covered207
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $13,718
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $105,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150697
Policy instance 1
Insurance contract or identification number150697
Number of Individuals Covered23
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,780
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $8,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150697
Policy instance 2
Insurance contract or identification number150697
Number of Individuals Covered22
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,161
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $10,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,161
Additional information about fees paid to insurance brokerNA
Insurance broker organization code?3
Insurance broker nameDALY MERRITT, INC.
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberP96466
Policy instance 1
Insurance contract or identification numberP96466
Number of Individuals Covered215
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $797
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $797
Additional information about fees paid to insurance brokerNA
Insurance broker organization code?3
Insurance broker nameDALY-MERRITT, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150696
Policy instance 3
Insurance contract or identification number150696
Number of Individuals Covered204
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $14,536
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $101,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,536
Additional information about fees paid to insurance brokerNA
Insurance broker organization code?3
Insurance broker nameDALY MERRITT, INC.

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