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VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 401k Plan overview

Plan NameVON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY
Plan identification number 505

VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY Benefits

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

401k Sponsoring company profile

VON BRIESEN & ROPER, S.C. has sponsored the creation of one or more 401k plans.

Company Name:VON BRIESEN & ROPER, S.C.
Employer identification number (EIN):391576289
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-04-01SUSAN L. BACH2023-10-31
5052021-04-01SUSAN L. BACH2022-10-27
5052020-04-01SUSAN L. BACH2021-10-22
5052019-04-01SUSAN BACH2020-10-06
5052018-04-01SUSAN L. BACH2019-10-11
5052017-04-01
5052016-04-01SUSAN BACH
5052015-04-01SUSAN BACH
5052014-04-01SUSAN BACH
5052013-04-01SUSAN BACH
5052012-04-01PAMELA ZACHARIAS
5052011-04-01KIM BALDWIN
5052010-04-01KIM BALDWIN SUSAN BACH2011-10-17
5052009-04-01KIM BALDWIN

Plan Statistics for VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY

401k plan membership statisitcs for VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY

Measure Date Value
2022: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2022 401k membership
Total participants, beginning-of-year2022-04-01268
Total number of active participants reported on line 7a of the Form 55002022-04-01262
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01262
Number of employers contributing to the scheme2022-04-010
2021: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2021 401k membership
Total participants, beginning-of-year2021-04-01288
Total number of active participants reported on line 7a of the Form 55002021-04-01268
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01268
Number of employers contributing to the scheme2021-04-010
2020: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2020 401k membership
Total participants, beginning-of-year2020-04-01335
Total number of active participants reported on line 7a of the Form 55002020-04-01288
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01288
Number of employers contributing to the scheme2020-04-010
2019: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2019 401k membership
Total participants, beginning-of-year2019-04-01324
Total number of active participants reported on line 7a of the Form 55002019-04-01326
Number of retired or separated participants receiving benefits2019-04-019
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01335
Number of employers contributing to the scheme2019-04-010
2018: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2018 401k membership
Total participants, beginning-of-year2018-04-01338
Total number of active participants reported on line 7a of the Form 55002018-04-01324
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01324
Number of employers contributing to the scheme2018-04-010
2017: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2017 401k membership
Total participants, beginning-of-year2017-04-01238
Total number of active participants reported on line 7a of the Form 55002017-04-01338
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01338
2016: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2016 401k membership
Total participants, beginning-of-year2016-04-01193
Total number of active participants reported on line 7a of the Form 55002016-04-01238
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01238
2015: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year2015-04-01169
Total number of active participants reported on line 7a of the Form 55002015-04-01193
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01193
2014: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year2014-04-01173
Total number of active participants reported on line 7a of the Form 55002014-04-01169
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01169
2013: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year2013-04-01174
Total number of active participants reported on line 7a of the Form 55002013-04-01173
Number of retired or separated participants receiving benefits2013-04-010
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-01173
2012: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year2012-04-01165
Total number of active participants reported on line 7a of the Form 55002012-04-01174
Total of all active and inactive participants2012-04-01174
2011: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year2011-04-01181
Total number of active participants reported on line 7a of the Form 55002011-04-01176
Total of all active and inactive participants2011-04-01176
2010: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2010 401k membership
Total participants, beginning-of-year2010-04-01163
Total number of active participants reported on line 7a of the Form 55002010-04-01178
Number of retired or separated participants receiving benefits2010-04-010
Number of other retired or separated participants entitled to future benefits2010-04-010
Total of all active and inactive participants2010-04-01178
2009: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year2009-04-01157
Total number of active participants reported on line 7a of the Form 55002009-04-01163
Number of retired or separated participants receiving benefits2009-04-010
Number of other retired or separated participants entitled to future benefits2009-04-010
Total of all active and inactive participants2009-04-01163

Form 5500 Responses for VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY

2022: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes
2010: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2010 form 5500 responses
2010-04-01Type of plan entitySingle employer plan
2010-04-01Submission has been amendedNo
2010-04-01This submission is the final filingNo
2010-04-01This return/report is a short plan year return/report (less than 12 months)No
2010-04-01Plan is a collectively bargained planNo
2010-04-01Plan funding arrangement – InsuranceYes
2010-04-01Plan benefit arrangement – InsuranceYes
2009: VON BRIESEN & ROPER, S.C. GROUP LIFE INSURANCE AND LONG TERM DISABILITY 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedNo
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number912572
Policy instance 1
Insurance contract or identification number912572
Number of Individuals Covered262
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $27,290
Total amount of fees paid to insurance companyUSD $5,458
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $272,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,290
Amount paid for insurance broker fees5458
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number912572
Policy instance 1
Insurance contract or identification number912572
Number of Individuals Covered268
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $28,783
Total amount of fees paid to insurance companyUSD $5,220
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $287,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,783
Amount paid for insurance broker fees5220
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number912572
Policy instance 1
Insurance contract or identification number912572
Number of Individuals Covered288
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $29,855
Total amount of fees paid to insurance companyUSD $1,212
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $275,023
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,855
Amount paid for insurance broker fees1212
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number912573
Policy instance 2
Insurance contract or identification number912573
Number of Individuals Covered85
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $3,051
Total amount of fees paid to insurance companyUSD $117
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $28,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,051
Amount paid for insurance broker fees117
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number912573
Policy instance 2
Insurance contract or identification number912573
Number of Individuals Covered94
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,868
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $18,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,868
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 number912572
Policy instance 1
Insurance contract or identification number912572
Number of Individuals Covered326
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $19,205
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $192,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,205
Amount paid for insurance broker fees0
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 1
Insurance contract or identification number645150
Number of Individuals Covered324
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $31,294
Total amount of fees paid to insurance companyUSD $4,077
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,294
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 1
Insurance contract or identification number645150
Number of Individuals Covered338
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $30,098
Total amount of fees paid to insurance companyUSD $3,197
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,965
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker nameWILLIS OF WISCONSIN, INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 1
Insurance contract or identification number645150
Number of Individuals Covered193
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $4,823
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,823
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 2
Insurance contract or identification number645150
Number of Individuals Covered193
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $13,194
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,194
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 2
Insurance contract or identification number645150
Number of Individuals Covered169
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $12,973
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,021
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 1
Insurance contract or identification number645150
Number of Individuals Covered169
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $4,745
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,930
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 2
Insurance contract or identification number645150
Number of Individuals Covered173
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $13,816
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,816
Insurance broker organization code?3
Insurance broker nameWILLIS OF WISCONSIN, INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 1
Insurance contract or identification number645150
Number of Individuals Covered173
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $5,109
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,109
Insurance broker organization code?3
Insurance broker nameWILLIS OF WISCONSIN, INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 1
Insurance contract or identification number645150
Number of Individuals Covered174
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $5,074
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
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,074
Insurance broker organization code?3
Insurance broker nameWILLIS OF WISCONSIN, INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 2
Insurance contract or identification number645150
Number of Individuals Covered174
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $13,626
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
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,626
Insurance broker organization code?3
Insurance broker nameWILLIS OF WISCONSIN, INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 2
Insurance contract or identification number645150
Number of Individuals Covered176
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $13,798
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
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 1
Insurance contract or identification number645150
Number of Individuals Covered176
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $5,171
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
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 2
Insurance contract or identification number645150
Number of Individuals Covered178
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $12,904
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number645150
Policy instance 1
Insurance contract or identification number645150
Number of Individuals Covered178
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $4,132
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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