MASTERGRAPHICS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC.
401k plan membership statisitcs for HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC.
| Measure | Date | Value |
|---|
| 2019: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 41 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 22 |
| Total of all active and inactive participants | 2019-01-01 | 22 |
| 2018: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-03-01 | 70 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 41 |
| Total of all active and inactive participants | 2018-03-01 | 41 |
| 2017: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 72 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 70 |
| Number of retired or separated participants receiving benefits | 2017-03-01 | 2 |
| Total of all active and inactive participants | 2017-03-01 | 72 |
| 2016: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 80 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 72 |
| Total of all active and inactive participants | 2016-03-01 | 72 |
| 2015: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 78 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 80 |
| Total of all active and inactive participants | 2015-03-01 | 80 |
| 2014: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 80 |
| 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 |
| 2013: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 81 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 79 |
| Number of retired or separated participants receiving benefits | 2013-03-01 | 1 |
| Total of all active and inactive participants | 2013-03-01 | 80 |
| 2012: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 75 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 79 |
| Number of retired or separated participants receiving benefits | 2012-03-01 | 2 |
| Total of all active and inactive participants | 2012-03-01 | 81 |
| 2011: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 76 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 75 |
| Number of retired or separated participants receiving benefits | 2011-03-01 | 0 |
| Total of all active and inactive participants | 2011-03-01 | 75 |
| 2010: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 76 |
| Number of retired or separated participants receiving benefits | 2010-03-01 | 0 |
| Total of all active and inactive participants | 2010-03-01 | 76 |
| 2009: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-03-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 84 |
| Number of retired or separated participants receiving benefits | 2009-03-01 | 2 |
| Total of all active and inactive participants | 2009-03-01 | 86 |
| Measure | Date | Value |
|---|
| 2019 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-31 | $16,842 |
| Total plan liabilities at beginning of year | 2019-12-31 | $13,982 |
| Total income from all sources | 2019-12-31 | $277,912 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $291,430 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $255,014 |
| Total plan assets at end of year | 2019-12-31 | $20,563 |
| Total plan assets at beginning of year | 2019-12-31 | $31,221 |
| Value of fidelity bond covering the plan | 2019-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $104,891 |
| Net income (gross income less expenses) | 2019-12-31 | $-13,518 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $3,721 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $17,239 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $173,021 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $36,416 |
| 2018 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-12-31 | $13,982 |
| Total plan liabilities at beginning of year | 2018-12-31 | $13,302 |
| Total income from all sources | 2018-12-31 | $335,277 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $310,960 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $284,340 |
| Total plan assets at end of year | 2018-12-31 | $31,221 |
| Total plan assets at beginning of year | 2018-12-31 | $6,224 |
| Value of fidelity bond covering the plan | 2018-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $117,230 |
| Net income (gross income less expenses) | 2018-12-31 | $24,317 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $17,239 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $-7,078 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $218,047 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $26,620 |
| Total plan liabilities at end of year | 2018-02-28 | $13,302 |
| Total plan liabilities at beginning of year | 2018-02-28 | $73,053 |
| Total income from all sources | 2018-02-28 | $703,695 |
| Expenses. Total of all expenses incurred | 2018-02-28 | $842,468 |
| Benefits paid (including direct rollovers) | 2018-02-28 | $805,697 |
| Total plan assets at end of year | 2018-02-28 | $6,224 |
| Total plan assets at beginning of year | 2018-02-28 | $204,748 |
| Value of fidelity bond covering the plan | 2018-02-28 | $500,000 |
| Total contributions received or receivable from participants | 2018-02-28 | $214,430 |
| Net income (gross income less expenses) | 2018-02-28 | $-138,773 |
| Net plan assets at end of year (total assets less liabilities) | 2018-02-28 | $-7,078 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-02-28 | $131,695 |
| Total contributions received or receivable from employer(s) | 2018-02-28 | $489,265 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-02-28 | $36,771 |
| 2017 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-02-28 | $73,053 |
| Total plan liabilities at beginning of year | 2017-02-28 | $76,965 |
| Total income from all sources | 2017-02-28 | $829,250 |
| Expenses. Total of all expenses incurred | 2017-02-28 | $755,543 |
| Benefits paid (including direct rollovers) | 2017-02-28 | $732,227 |
| Total plan assets at end of year | 2017-02-28 | $204,748 |
| Total plan assets at beginning of year | 2017-02-28 | $134,953 |
| Value of fidelity bond covering the plan | 2017-02-28 | $500,000 |
| Total contributions received or receivable from participants | 2017-02-28 | $288,616 |
| Net income (gross income less expenses) | 2017-02-28 | $73,707 |
| Net plan assets at end of year (total assets less liabilities) | 2017-02-28 | $131,695 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-02-28 | $57,988 |
| Total contributions received or receivable from employer(s) | 2017-02-28 | $540,634 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-02-28 | $23,316 |
| 2016 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-02-29 | $76,965 |
| Total plan liabilities at beginning of year | 2016-02-29 | $85,074 |
| Total income from all sources | 2016-02-29 | $685,794 |
| Expenses. Total of all expenses incurred | 2016-02-29 | $543,231 |
| Benefits paid (including direct rollovers) | 2016-02-29 | $515,700 |
| Total plan assets at end of year | 2016-02-29 | $134,954 |
| Total plan assets at beginning of year | 2016-02-29 | $500 |
| Value of fidelity bond covering the plan | 2016-02-29 | $500,000 |
| Total contributions received or receivable from participants | 2016-02-29 | $274,317 |
| Net income (gross income less expenses) | 2016-02-29 | $142,563 |
| Net plan assets at end of year (total assets less liabilities) | 2016-02-29 | $57,989 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-02-29 | $-84,574 |
| Total contributions received or receivable from employer(s) | 2016-02-29 | $411,477 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-02-29 | $27,531 |
| 2015 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-02-28 | $85,074 |
| Total plan liabilities at beginning of year | 2015-02-28 | $30,196 |
| Total income from all sources | 2015-02-28 | $812,376 |
| Expenses. Total of all expenses incurred | 2015-02-28 | $876,266 |
| Benefits paid (including direct rollovers) | 2015-02-28 | $856,004 |
| Total plan assets at end of year | 2015-02-28 | $500 |
| Total plan assets at beginning of year | 2015-02-28 | $9,512 |
| Value of fidelity bond covering the plan | 2015-02-28 | $500,000 |
| Total contributions received or receivable from participants | 2015-02-28 | $297,792 |
| Net income (gross income less expenses) | 2015-02-28 | $-63,890 |
| Net plan assets at end of year (total assets less liabilities) | 2015-02-28 | $-84,574 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-02-28 | $-20,684 |
| Total contributions received or receivable from employer(s) | 2015-02-28 | $514,584 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-02-28 | $20,262 |
| 2014 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2014 401k financial data |
|---|
| Total plan liabilities at end of year | 2014-02-28 | $30,196 |
| Total plan liabilities at beginning of year | 2014-02-28 | $72,927 |
| Total income from all sources | 2014-02-28 | $754,571 |
| Expenses. Total of all expenses incurred | 2014-02-28 | $782,541 |
| Benefits paid (including direct rollovers) | 2014-02-28 | $756,178 |
| Total plan assets at end of year | 2014-02-28 | $9,512 |
| Total plan assets at beginning of year | 2014-02-28 | $80,213 |
| Value of fidelity bond covering the plan | 2014-02-28 | $500,000 |
| Total contributions received or receivable from participants | 2014-02-28 | $292,127 |
| Other income received | 2014-02-28 | $5 |
| Net income (gross income less expenses) | 2014-02-28 | $-27,970 |
| Net plan assets at end of year (total assets less liabilities) | 2014-02-28 | $-20,684 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-02-28 | $7,286 |
| Total contributions received or receivable from employer(s) | 2014-02-28 | $462,439 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-02-28 | $26,363 |
| 2013 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2013 401k financial data |
|---|
| Total plan liabilities at end of year | 2013-02-28 | $72,927 |
| Total plan liabilities at beginning of year | 2013-02-28 | $26,542 |
| Total income from all sources | 2013-02-28 | $670,705 |
| Expenses. Total of all expenses incurred | 2013-02-28 | $740,802 |
| Benefits paid (including direct rollovers) | 2013-02-28 | $725,961 |
| Total plan assets at end of year | 2013-02-28 | $80,213 |
| Total plan assets at beginning of year | 2013-02-28 | $103,925 |
| Value of fidelity bond covering the plan | 2013-02-28 | $500,000 |
| Total contributions received or receivable from participants | 2013-02-28 | $268,278 |
| Other income received | 2013-02-28 | $7 |
| Net income (gross income less expenses) | 2013-02-28 | $-70,097 |
| Net plan assets at end of year (total assets less liabilities) | 2013-02-28 | $7,286 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-02-28 | $77,383 |
| Total contributions received or receivable from employer(s) | 2013-02-28 | $402,420 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-02-28 | $14,841 |
| 2012 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2012 401k financial data |
|---|
| Total plan liabilities at end of year | 2012-02-29 | $26,542 |
| Total plan liabilities at beginning of year | 2012-02-29 | $67,110 |
| Total income from all sources | 2012-02-29 | $628,092 |
| Expenses. Total of all expenses incurred | 2012-02-29 | $541,999 |
| Benefits paid (including direct rollovers) | 2012-02-29 | $530,127 |
| Total plan assets at end of year | 2012-02-29 | $103,925 |
| Total plan assets at beginning of year | 2012-02-29 | $58,400 |
| Value of fidelity bond covering the plan | 2012-02-29 | $500,000 |
| Total contributions received or receivable from participants | 2012-02-29 | $251,231 |
| Other income received | 2012-02-29 | $12 |
| Net income (gross income less expenses) | 2012-02-29 | $86,093 |
| Net plan assets at end of year (total assets less liabilities) | 2012-02-29 | $77,383 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-02-29 | $-8,710 |
| Total contributions received or receivable from employer(s) | 2012-02-29 | $376,849 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-02-29 | $11,872 |
| 2011 : HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2011 401k financial data |
|---|
| Total plan liabilities at end of year | 2011-02-28 | $67,110 |
| Total plan liabilities at beginning of year | 2011-02-28 | $26,028 |
| Total income from all sources | 2011-02-28 | $637,375 |
| Expenses. Total of all expenses incurred | 2011-02-28 | $764,771 |
| Benefits paid (including direct rollovers) | 2011-02-28 | $754,737 |
| Total plan assets at end of year | 2011-02-28 | $58,400 |
| Total plan assets at beginning of year | 2011-02-28 | $144,714 |
| Value of fidelity bond covering the plan | 2011-02-28 | $500,000 |
| Total contributions received or receivable from participants | 2011-02-28 | $382,418 |
| Other income received | 2011-02-28 | $12 |
| Net income (gross income less expenses) | 2011-02-28 | $-127,396 |
| Net plan assets at end of year (total assets less liabilities) | 2011-02-28 | $-8,710 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-02-28 | $118,686 |
| Total contributions received or receivable from employer(s) | 2011-02-28 | $254,945 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-02-28 | $10,034 |
| 2019: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2018 form 5500 responses |
|---|
| 2018-03-01 | Type of plan entity | Single employer plan |
| 2018-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2017 form 5500 responses |
|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2016 form 5500 responses |
|---|
| 2016-03-01 | Type of plan entity | Single employer plan |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2015 form 5500 responses |
|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 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: HEALTH PROTECTION PLAN FOR MASTER GRAPHICS, INC. 2009 form 5500 responses |
|---|
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | This submission is the final filing | 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 |
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 08947 |
| Policy instance | 4 |
| Insurance contract or identification number | 08947 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $182,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 206189 |
| Policy instance | 3 |
| Insurance contract or identification number | 206189 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $24 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $161 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 125012 |
| Policy instance | 2 |
| Insurance contract or identification number | 125012 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $604 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,029 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $604 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 152450 |
| Policy instance | 1 |
| Insurance contract or identification number | 152450 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $394 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $3,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $394 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 43008 |
| Policy instance | 4 |
| Insurance contract or identification number | 43008 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $21,771 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $145,144 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,514 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 206189 |
| Policy instance | 3 |
| Insurance contract or identification number | 206189 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $43 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $289 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 125012 |
| Policy instance | 2 |
| Insurance contract or identification number | 125012 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $890 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,934 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $890 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 152450 |
| Policy instance | 1 |
| Insurance contract or identification number | 152450 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $604 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $5,493 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $604 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 43008 |
| Policy instance | 4 |
| Insurance contract or identification number | 43008 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $32,732 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $218,216 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,821 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | LEFT LANE INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 206189 |
| Policy instance | 3 |
| Insurance contract or identification number | 206189 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $75 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $501 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $75 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | THE ZIMDARS COMPANY INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 125012 |
| Policy instance | 2 |
| Insurance contract or identification number | 125012 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $1,355 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,036 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,355 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | THE ZIMDARS COMPANY INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 152450 |
| Policy instance | 1 |
| Insurance contract or identification number | 152450 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $868 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $8,320 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $868 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | THE ZIMDARS COMPANY INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 125012 |
| Policy instance | 1 |
| Insurance contract or identification number | 125012 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $2,092 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,946 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,092 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 152450 |
| Policy instance | 2 |
| Insurance contract or identification number | 152450 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $1,402 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,643 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,402 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 206189 |
| Policy instance | 3 |
| Insurance contract or identification number | 206189 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $123 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $822 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $123 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 42902 |
| Policy instance | 4 |
| Insurance contract or identification number | 42902 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $37,185 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $247,903 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,790 | | Insurance broker organization code? | 3 | | Insurance broker name | EBSO |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 125012 |
| Policy instance | 1 |
| Insurance contract or identification number | 125012 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $2,102 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,011 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,102 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 152450 |
| Policy instance | 2 |
| Insurance contract or identification number | 152450 | | Number of Individuals Covered | 76 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $1,493 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,041 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,493 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 206189 |
| Policy instance | 3 |
| Insurance contract or identification number | 206189 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $138 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $917 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $138 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 42848 |
| Policy instance | 4 |
| Insurance contract or identification number | 42848 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $38,994 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $259,956 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,996 | | Insurance broker organization code? | 3 | | Insurance broker name | EMPLOYEE BENEFIT CONSULTANTS |
|
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 42792 |
| Policy instance | 4 |
| Insurance contract or identification number | 42792 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $40,653 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $271,020 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,102 | | Insurance broker organization code? | 3 | | Insurance broker name | EMPLOYEE BENEFIT CONSULTANTS |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400047501 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400047501 | | Number of Individuals Covered | 35 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $1,823 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,155 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,823 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010100338 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010100338 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $554 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,118 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $554 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010047457 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010047457 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $2,293 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,430 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,293 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010100338 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010100338 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $557 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,140 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $557 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010047457 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010047457 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $2,332 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,819 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,332 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400047501 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400047501 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $1,592 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,615 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,592 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-012118-000 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-012118-000 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $31,378 | | Total amount of fees paid to insurance company | USD $2,588 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $209,188 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,919 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2588 | | Insurance broker name | WISCONSIN PENSION & GROUP SERVICES |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | 50109002104 |
| Policy instance | 4 |
| Insurance contract or identification number | 50109002104 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $30,606 | | Total amount of fees paid to insurance company | USD $4,081 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $204,038 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400047501 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400047501 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $1,531 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,203 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010100338 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010100338 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $505 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,787 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010047457 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010047457 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $1,999 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010047457 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010047457 | | Number of Individuals Covered | 76 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $2,367 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,779 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,367 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010100338 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010100338 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $565 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,130 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $565 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | 50109002104 |
| Policy instance | 4 |
| Insurance contract or identification number | 50109002104 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $24,405 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $162,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,270 | | Insurance broker organization code? | 3 | | Insurance broker name | WISCONSIN PENSION & GROUP SERVICES |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400047501 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400047501 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $1,326 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,326 | | Insurance broker organization code? | 3 | | Insurance broker name | ZIMDARS COMPANY INC. |
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