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HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 401k Plan overview

Plan NameHORMEL FOODS CORPORATION COMPREHENSIVE WELFARE
Plan identification number 503

HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

HORMEL FOODS CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:HORMEL FOODS CORPORATION
Employer identification number (EIN):410319970
NAIC Classification:311610
NAIC Description: Animal Slaughtering and Processing

Additional information about HORMEL FOODS CORPORATION

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 0243112

More information about HORMEL FOODS CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-11-01
5032020-10-26
5032019-10-28
5032018-10-29
5032018-10-29
5032017-10-30
5032016-10-31THOMAS BROWN BRIAN JOHNSON2018-05-30
5032015-10-26THOMAS BROWN BRIAN JOHNSON2017-08-07
5032014-10-27THOMAS BROWN GARY JAMISON2016-08-04
5032013-10-28JAMES DOYLE BRIAN JOHNSON2015-07-22
5032012-10-29JAMES DOYLE BRIAN JOHNSON2014-05-30
5032011-10-31JAMES DOYLE BRIAN JOHNSON2013-05-30
5032009-10-26JAMES DOYLE BRIAN JOHNSON2011-08-08

Plan Statistics for HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE

401k plan membership statisitcs for HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE

Measure Date Value
2021: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2021 401k membership
Total participants, beginning-of-year2021-11-0120,895
Total number of active participants reported on line 7a of the Form 55002021-11-0117,423
Number of retired or separated participants receiving benefits2021-11-013,283
Total of all active and inactive participants2021-11-0120,706
2020: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2020 401k membership
Total participants, beginning-of-year2020-10-2619,453
Total number of active participants reported on line 7a of the Form 55002020-10-2617,612
Number of retired or separated participants receiving benefits2020-10-263,283
Number of other retired or separated participants entitled to future benefits2020-10-260
Total of all active and inactive participants2020-10-2620,895
2019: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2019 401k membership
Total participants, beginning-of-year2019-10-2819,188
Total number of active participants reported on line 7a of the Form 55002019-10-2816,185
Number of retired or separated participants receiving benefits2019-10-283,268
Total of all active and inactive participants2019-10-2819,453
2018: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2018 401k membership
Total participants, beginning-of-year2018-10-2920,296
Total number of active participants reported on line 7a of the Form 55002018-10-2915,897
Number of retired or separated participants receiving benefits2018-10-293,291
Total of all active and inactive participants2018-10-2919,188
2017: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2017 401k membership
Total participants, beginning-of-year2017-10-3020,884
Total number of active participants reported on line 7a of the Form 55002017-10-3017,166
Number of retired or separated participants receiving benefits2017-10-303,130
Total of all active and inactive participants2017-10-3020,296
2016: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2016 401k membership
Total participants, beginning-of-year2016-10-3121,190
Total number of active participants reported on line 7a of the Form 55002016-10-3117,741
Number of retired or separated participants receiving benefits2016-10-313,143
Total of all active and inactive participants2016-10-3120,884
2015: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2015 401k membership
Total participants, beginning-of-year2015-10-2620,812
Total number of active participants reported on line 7a of the Form 55002015-10-2618,100
Number of retired or separated participants receiving benefits2015-10-263,090
Total of all active and inactive participants2015-10-2621,190
2014: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2014 401k membership
Total participants, beginning-of-year2014-10-2712,225
Total number of active participants reported on line 7a of the Form 55002014-10-2717,840
Number of retired or separated participants receiving benefits2014-10-272,972
Total of all active and inactive participants2014-10-2720,812
2013: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2013 401k membership
Total participants, beginning-of-year2013-10-2812,290
Total number of active participants reported on line 7a of the Form 55002013-10-288,404
Number of retired or separated participants receiving benefits2013-10-283,821
Total of all active and inactive participants2013-10-2812,225
2012: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2012 401k membership
Total participants, beginning-of-year2012-10-2912,059
Total number of active participants reported on line 7a of the Form 55002012-10-298,374
Number of retired or separated participants receiving benefits2012-10-293,916
Total of all active and inactive participants2012-10-2912,290
2011: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2011 401k membership
Total participants, beginning-of-year2011-10-3112,132
Total number of active participants reported on line 7a of the Form 55002011-10-318,145
Number of retired or separated participants receiving benefits2011-10-313,914
Total of all active and inactive participants2011-10-3112,059
2009: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2009 401k membership
Total participants, beginning-of-year2009-10-2610,240
Total number of active participants reported on line 7a of the Form 55002009-10-265,922
Number of retired or separated participants receiving benefits2009-10-264,142
Number of other retired or separated participants entitled to future benefits2009-10-260
Total of all active and inactive participants2009-10-2610,064

Form 5500 Responses for HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE

2021: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2021 form 5500 responses
2021-11-01Type of plan entitySingle employer plan
2021-11-01Submission has been amendedNo
2021-11-01This submission is the final filingNo
2021-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-11-01Plan is a collectively bargained planYes
2021-11-01Plan funding arrangement – General assets of the sponsorYes
2021-11-01Plan benefit arrangement – InsuranceYes
2021-11-01Plan benefit arrangement – General assets of the sponsorYes
2020: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2020 form 5500 responses
2020-10-26Type of plan entitySingle employer plan
2020-10-26Submission has been amendedNo
2020-10-26This submission is the final filingNo
2020-10-26This return/report is a short plan year return/report (less than 12 months)No
2020-10-26Plan is a collectively bargained planYes
2020-10-26Plan funding arrangement – General assets of the sponsorYes
2020-10-26Plan benefit arrangement – InsuranceYes
2020-10-26Plan benefit arrangement – General assets of the sponsorYes
2019: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2019 form 5500 responses
2019-10-28Type of plan entitySingle employer plan
2019-10-28Submission has been amendedNo
2019-10-28This submission is the final filingNo
2019-10-28This return/report is a short plan year return/report (less than 12 months)Yes
2019-10-28Plan is a collectively bargained planYes
2019-10-28Plan funding arrangement – General assets of the sponsorYes
2019-10-28Plan benefit arrangement – InsuranceYes
2019-10-28Plan benefit arrangement – General assets of the sponsorYes
2018: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2018 form 5500 responses
2018-10-29Type of plan entitySingle employer plan
2018-10-29Submission has been amendedYes
2018-10-29This submission is the final filingNo
2018-10-29This return/report is a short plan year return/report (less than 12 months)Yes
2018-10-29Plan is a collectively bargained planYes
2018-10-29Plan funding arrangement – General assets of the sponsorYes
2018-10-29Plan benefit arrangement – InsuranceYes
2018-10-29Plan benefit arrangement – General assets of the sponsorYes
2017: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2017 form 5500 responses
2017-10-30Type of plan entitySingle employer plan
2017-10-30Submission has been amendedNo
2017-10-30This submission is the final filingNo
2017-10-30This return/report is a short plan year return/report (less than 12 months)Yes
2017-10-30Plan is a collectively bargained planYes
2017-10-30Plan funding arrangement – General assets of the sponsorYes
2017-10-30Plan benefit arrangement – InsuranceYes
2017-10-30Plan benefit arrangement – General assets of the sponsorYes
2016: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2016 form 5500 responses
2016-10-31Type of plan entitySingle employer plan
2016-10-31Submission has been amendedNo
2016-10-31This submission is the final filingNo
2016-10-31This return/report is a short plan year return/report (less than 12 months)Yes
2016-10-31Plan is a collectively bargained planYes
2016-10-31Plan funding arrangement – General assets of the sponsorYes
2016-10-31Plan benefit arrangement – InsuranceYes
2016-10-31Plan benefit arrangement – General assets of the sponsorYes
2015: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2015 form 5500 responses
2015-10-26Type of plan entitySingle employer plan
2015-10-26Submission has been amendedNo
2015-10-26This submission is the final filingNo
2015-10-26This return/report is a short plan year return/report (less than 12 months)No
2015-10-26Plan is a collectively bargained planYes
2015-10-26Plan funding arrangement – General assets of the sponsorYes
2015-10-26Plan benefit arrangement – InsuranceYes
2015-10-26Plan benefit arrangement – General assets of the sponsorYes
2014: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2014 form 5500 responses
2014-10-27Type of plan entitySingle employer plan
2014-10-27Submission has been amendedNo
2014-10-27This submission is the final filingNo
2014-10-27This return/report is a short plan year return/report (less than 12 months)Yes
2014-10-27Plan is a collectively bargained planYes
2014-10-27Plan funding arrangement – General assets of the sponsorYes
2014-10-27Plan benefit arrangement – InsuranceYes
2014-10-27Plan benefit arrangement – General assets of the sponsorYes
2013: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2013 form 5500 responses
2013-10-28Type of plan entitySingle employer plan
2013-10-28Submission has been amendedNo
2013-10-28This submission is the final filingNo
2013-10-28This return/report is a short plan year return/report (less than 12 months)Yes
2013-10-28Plan is a collectively bargained planYes
2013-10-28Plan funding arrangement – General assets of the sponsorYes
2013-10-28Plan benefit arrangement – InsuranceYes
2013-10-28Plan benefit arrangement – General assets of the sponsorYes
2012: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2012 form 5500 responses
2012-10-29Type of plan entitySingle employer plan
2012-10-29Submission has been amendedNo
2012-10-29This submission is the final filingNo
2012-10-29This return/report is a short plan year return/report (less than 12 months)Yes
2012-10-29Plan is a collectively bargained planYes
2012-10-29Plan funding arrangement – General assets of the sponsorYes
2012-10-29Plan benefit arrangement – InsuranceYes
2012-10-29Plan benefit arrangement – General assets of the sponsorYes
2011: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2011 form 5500 responses
2011-10-31Type of plan entitySingle employer plan
2011-10-31Submission has been amendedNo
2011-10-31This submission is the final filingNo
2011-10-31This return/report is a short plan year return/report (less than 12 months)Yes
2011-10-31Plan is a collectively bargained planYes
2011-10-31Plan funding arrangement – General assets of the sponsorYes
2011-10-31Plan benefit arrangement – InsuranceYes
2011-10-31Plan benefit arrangement – General assets of the sponsorYes
2009: HORMEL FOODS CORPORATION COMPREHENSIVE WELFARE 2009 form 5500 responses
2009-10-26Type of plan entitySingle employer plan
2009-10-26Submission has been amendedNo
2009-10-26This submission is the final filingNo
2009-10-26This return/report is a short plan year return/report (less than 12 months)No
2009-10-26Plan is a collectively bargained planYes
2009-10-26Plan funding arrangement – General assets of the sponsorYes
2009-10-26Plan benefit arrangement – InsuranceYes
2009-10-26Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466792
Policy instance 3
Insurance contract or identification numberGTU 5466792
Number of Individuals Covered2844
Insurance policy start date2021-11-01
Insurance policy end date2022-10-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGTU - BUSINESS TRAVEL, AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $517,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466791
Policy instance 2
Insurance contract or identification numberGTU 5466791
Number of Individuals Covered17326
Insurance policy start date2021-11-01
Insurance policy end date2022-10-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGTU - BUSINESS TRAVEL AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $66,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 )
Policy contract numberCLPEX01136
Policy instance 1
Insurance contract or identification numberCLPEX01136
Number of Individuals Covered20706
Insurance policy start date2021-11-01
Insurance policy end date2022-10-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $6,357,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466792-05
Policy instance 3
Insurance contract or identification numberGTU 5466792-05
Number of Individuals Covered2886
Insurance policy start date2020-10-26
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGTU - BUSINESS TRAVEL AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $459,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 )
Policy contract numberCLPEX01186
Policy instance 2
Insurance contract or identification numberCLPEX01186
Number of Individuals Covered20895
Insurance policy start date2020-10-26
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,285,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466791-04
Policy instance 1
Insurance contract or identification numberGTU 5466791-04
Number of Individuals Covered17493
Insurance policy start date2020-10-26
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGTU - BUSINESS TRAVEL AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $36,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466792-04
Policy instance 3
Insurance contract or identification numberGTU 5466792-04
Number of Individuals Covered2336
Insurance policy start date2019-10-28
Insurance policy end date2020-10-25
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGTU - BUSINESS TRAVEL AD&D
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
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466791-04
Policy instance 2
Insurance contract or identification numberGTU 5466791-04
Number of Individuals Covered15466
Insurance policy start date2019-10-28
Insurance policy end date2020-10-25
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGTU - BUSINESS TRAVEL AD&D
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
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 )
Policy contract numberCLPEX01002
Policy instance 1
Insurance contract or identification numberCLPEX01002
Number of Individuals Covered19453
Insurance policy start date2019-10-28
Insurance policy end date2020-10-25
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,098,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466792
Policy instance 1
Insurance contract or identification numberGTU 5466792
Number of Individuals Covered2145
Insurance policy start date2018-10-29
Insurance policy end date2019-10-27
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $201,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 )
Policy contract numberCLPEX01002
Policy instance 2
Insurance contract or identification numberCLPEX01002
Number of Individuals Covered19188
Insurance policy start date2018-10-29
Insurance policy end date2019-10-27
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,099,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466791
Policy instance 3
Insurance contract or identification numberGTU 5466791
Number of Individuals Covered15973
Insurance policy start date2018-10-29
Insurance policy end date2019-10-27
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $41,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466792
Policy instance 2
Insurance contract or identification numberGTU 5466792
Number of Individuals Covered2145
Insurance policy start date2018-10-29
Insurance policy end date2019-10-27
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $201,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 )
Policy contract numberCLPEX01002
Policy instance 1
Insurance contract or identification numberCLPEX01002
Number of Individuals Covered19188
Insurance policy start date2018-10-29
Insurance policy end date2019-10-27
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,099,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 )
Policy contract numberCLPEX01002
Policy instance 3
Insurance contract or identification numberCLPEX01002
Number of Individuals Covered20296
Insurance policy start date2017-10-31
Insurance policy end date2018-10-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,220,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466791
Policy instance 1
Insurance contract or identification numberGTU 5466791
Number of Individuals Covered17193
Insurance policy start date2017-10-31
Insurance policy end date2018-10-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $23,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU 5466792
Policy instance 2
Insurance contract or identification numberGTU 5466792
Number of Individuals Covered2384
Insurance policy start date2017-10-31
Insurance policy end date2018-10-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $177,118
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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