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LAKELAND ENGINEERING EMPLOYEE LTD PLAN 401k Plan overview

Plan NameLAKELAND ENGINEERING EMPLOYEE LTD PLAN
Plan identification number 504

LAKELAND ENGINEERING EMPLOYEE LTD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

LAKELAND MANAGEMENT SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:LAKELAND MANAGEMENT SERVICES, INC.
Employer identification number (EIN):410716524
NAIC Classification:561900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKELAND ENGINEERING EMPLOYEE LTD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042015-08-01JAY JOHNSON
5042014-08-01JAY JOHNSON
5042013-08-01JAY JOHNSON
5042012-08-01JAY JOHNSON
5042011-08-01JAY JOHNSON
5042010-08-01JAY JOHNSON
5042009-08-01JAY JOHNSON
5042009-07-01JAY JOHNSON
5042008-07-01JAY JOHNSON
5042007-07-01JAY JOHNSON
5042006-07-01JAY JOHNSON
5042005-07-01JAY JOHNSON
5042005-03-01JAY JOHNSON
5042004-03-01JAY JOHNSON
5042003-03-01JAY JOHNSON
5042002-03-01JAY JOHNSON
5042001-03-01JAY JOHNSON
5042000-03-01JAY JOHNSON
5042000-03-01JAY JOHNSON
5041999-07-01JAY JOHNSON
5041999-07-01JAY JOHNSON
5041998-07-01JAY JOHNSON
5041997-07-01JAY JOHNSON
5041996-07-01JAY JOHNSON
5041995-07-01JAY JOHNSON
5041994-07-01JAY JOHNSON
5041993-07-01JAY JOHNSON
5041992-07-01JAY JOHNSON
5041991-07-01JAY JOHNSON
5041990-07-01JAY JOHNSON
5041990-07-01JAY JOHNSON
5041989-07-01JAY JOHNSON
5041989-07-01JAY JOHNSON
5041988-07-01JAY JOHNSON

Plan Statistics for LAKELAND ENGINEERING EMPLOYEE LTD PLAN

401k plan membership statisitcs for LAKELAND ENGINEERING EMPLOYEE LTD PLAN

Measure Date Value
2015: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01318
Total number of active participants reported on line 7a of the Form 55002015-08-01321
Number of retired or separated participants receiving benefits2015-08-010
Number of other retired or separated participants entitled to future benefits2015-08-010
Total of all active and inactive participants2015-08-01321
2014: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01295
Total number of active participants reported on line 7a of the Form 55002014-08-01318
Number of retired or separated participants receiving benefits2014-08-010
Number of other retired or separated participants entitled to future benefits2014-08-010
Total of all active and inactive participants2014-08-01318
2013: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01295
Total number of active participants reported on line 7a of the Form 55002013-08-01295
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-010
Total of all active and inactive participants2013-08-01295
2012: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01303
Total number of active participants reported on line 7a of the Form 55002012-08-01295
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-010
Total of all active and inactive participants2012-08-01295
2011: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01266
Total number of active participants reported on line 7a of the Form 55002011-08-01303
Number of retired or separated participants receiving benefits2011-08-010
Number of other retired or separated participants entitled to future benefits2011-08-010
Total of all active and inactive participants2011-08-01303
2010: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01243
Total number of active participants reported on line 7a of the Form 55002010-08-01266
Number of retired or separated participants receiving benefits2010-08-010
Number of other retired or separated participants entitled to future benefits2010-08-010
Total of all active and inactive participants2010-08-01266
2009: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01294
Total number of active participants reported on line 7a of the Form 55002009-08-01243
Number of retired or separated participants receiving benefits2009-08-010
Number of other retired or separated participants entitled to future benefits2009-08-010
Total of all active and inactive participants2009-08-01243
Total participants, beginning-of-year2009-07-01307
Total number of active participants reported on line 7a of the Form 55002009-07-01294
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01294
2008: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2008 401k membership
Total participants, beginning-of-year2008-07-01353
Total number of active participants reported on line 7a of the Form 55002008-07-01307
Number of retired or separated participants receiving benefits2008-07-010
Number of other retired or separated participants entitled to future benefits2008-07-010
Total of all active and inactive participants2008-07-01307
2007: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2007 401k membership
Total participants, beginning-of-year2007-07-01294
Total number of active participants reported on line 7a of the Form 55002007-07-01353
Number of retired or separated participants receiving benefits2007-07-010
Number of other retired or separated participants entitled to future benefits2007-07-010
Total of all active and inactive participants2007-07-01353
2006: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2006 401k membership
Total participants, beginning-of-year2006-07-01259
Total number of active participants reported on line 7a of the Form 55002006-07-01294
Number of retired or separated participants receiving benefits2006-07-010
Number of other retired or separated participants entitled to future benefits2006-07-010
Total of all active and inactive participants2006-07-01294
2005: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2005 401k membership
Total participants, beginning-of-year2005-07-01252
Total number of active participants reported on line 7a of the Form 55002005-07-01259
Number of retired or separated participants receiving benefits2005-07-010
Number of other retired or separated participants entitled to future benefits2005-07-010
Total of all active and inactive participants2005-07-01259
Total participants, beginning-of-year2005-03-01250
Total number of active participants reported on line 7a of the Form 55002005-03-01252
Number of retired or separated participants receiving benefits2005-03-010
Number of other retired or separated participants entitled to future benefits2005-03-010
Total of all active and inactive participants2005-03-01252
2004: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2004 401k membership
Total participants, beginning-of-year2004-03-01233
Total number of active participants reported on line 7a of the Form 55002004-03-01250
Number of retired or separated participants receiving benefits2004-03-010
Number of other retired or separated participants entitled to future benefits2004-03-010
Total of all active and inactive participants2004-03-01250
2003: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2003 401k membership
Total participants, beginning-of-year2003-03-01244
Total number of active participants reported on line 7a of the Form 55002003-03-01233
Number of retired or separated participants receiving benefits2003-03-010
Number of other retired or separated participants entitled to future benefits2003-03-010
Total of all active and inactive participants2003-03-01233
2002: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2002 401k membership
Total participants, beginning-of-year2002-03-01260
Total number of active participants reported on line 7a of the Form 55002002-03-01244
Number of retired or separated participants receiving benefits2002-03-010
Number of other retired or separated participants entitled to future benefits2002-03-010
Total of all active and inactive participants2002-03-01244
2001: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2001 401k membership
Total participants, beginning-of-year2001-03-01254
Total number of active participants reported on line 7a of the Form 55002001-03-01260
Number of retired or separated participants receiving benefits2001-03-010
Number of other retired or separated participants entitled to future benefits2001-03-010
Total of all active and inactive participants2001-03-01260
2000: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2000 401k membership
Total participants, beginning-of-year2000-03-01254
Total number of active participants reported on line 7a of the Form 55002000-03-01254
Number of retired or separated participants receiving benefits2000-03-010
Number of other retired or separated participants entitled to future benefits2000-03-010
Total of all active and inactive participants2000-03-01254
1999: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1999 401k membership
Total participants, beginning-of-year1999-07-01249
Total number of active participants reported on line 7a of the Form 55001999-07-01254
Number of retired or separated participants receiving benefits1999-07-010
Number of other retired or separated participants entitled to future benefits1999-07-010
Total of all active and inactive participants1999-07-01254
1998: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1998 401k membership
Total participants, beginning-of-year1998-07-01241
Total number of active participants reported on line 7a of the Form 55001998-07-01249
Number of retired or separated participants receiving benefits1998-07-010
Number of other retired or separated participants entitled to future benefits1998-07-010
Total of all active and inactive participants1998-07-01249
1997: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1997 401k membership
Total participants, beginning-of-year1997-07-01233
Total number of active participants reported on line 7a of the Form 55001997-07-01241
Number of retired or separated participants receiving benefits1997-07-010
Number of other retired or separated participants entitled to future benefits1997-07-010
Total of all active and inactive participants1997-07-01241
1996: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1996 401k membership
Total participants, beginning-of-year1996-07-01225
Total number of active participants reported on line 7a of the Form 55001996-07-01233
Number of retired or separated participants receiving benefits1996-07-010
Number of other retired or separated participants entitled to future benefits1996-07-010
Total of all active and inactive participants1996-07-01233
1995: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1995 401k membership
Total participants, beginning-of-year1995-07-01218
Total number of active participants reported on line 7a of the Form 55001995-07-01225
Number of retired or separated participants receiving benefits1995-07-010
Number of other retired or separated participants entitled to future benefits1995-07-010
Total of all active and inactive participants1995-07-01225
1994: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1994 401k membership
Total participants, beginning-of-year1994-07-01210
Total number of active participants reported on line 7a of the Form 55001994-07-01218
Number of retired or separated participants receiving benefits1994-07-010
Number of other retired or separated participants entitled to future benefits1994-07-010
Total of all active and inactive participants1994-07-01218
1993: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1993 401k membership
Total participants, beginning-of-year1993-07-01202
Total number of active participants reported on line 7a of the Form 55001993-07-01210
Number of retired or separated participants receiving benefits1993-07-010
Number of other retired or separated participants entitled to future benefits1993-07-010
Total of all active and inactive participants1993-07-01210
1992: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1992 401k membership
Total participants, beginning-of-year1992-07-01195
Total number of active participants reported on line 7a of the Form 55001992-07-01202
Number of retired or separated participants receiving benefits1992-07-010
Number of other retired or separated participants entitled to future benefits1992-07-010
Total of all active and inactive participants1992-07-01202
1991: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1991 401k membership
Total participants, beginning-of-year1991-07-01187
Total number of active participants reported on line 7a of the Form 55001991-07-01195
Number of retired or separated participants receiving benefits1991-07-010
Number of other retired or separated participants entitled to future benefits1991-07-010
Total of all active and inactive participants1991-07-01195
1990: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1990 401k membership
Total participants, beginning-of-year1990-07-01179
Total number of active participants reported on line 7a of the Form 55001990-07-01187
Number of retired or separated participants receiving benefits1990-07-010
Number of other retired or separated participants entitled to future benefits1990-07-010
Total of all active and inactive participants1990-07-01187
1989: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1989 401k membership
Total participants, beginning-of-year1989-07-01171
Total number of active participants reported on line 7a of the Form 55001989-07-01179
Number of retired or separated participants receiving benefits1989-07-010
Number of other retired or separated participants entitled to future benefits1989-07-010
Total of all active and inactive participants1989-07-01179
1988: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1988 401k membership
Total participants, beginning-of-year1988-07-01164
Total number of active participants reported on line 7a of the Form 55001988-07-01171
Number of retired or separated participants receiving benefits1988-07-010
Number of other retired or separated participants entitled to future benefits1988-07-010
Total of all active and inactive participants1988-07-01171

Form 5500 Responses for LAKELAND ENGINEERING EMPLOYEE LTD PLAN

2015: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes
2014: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes
2011: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedNo
2011-08-01This submission is the final filingNo
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes
2010: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Submission has been amendedNo
2010-08-01This submission is the final filingNo
2010-08-01This return/report is a short plan year return/report (less than 12 months)No
2010-08-01Plan is a collectively bargained planNo
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – InsuranceYes
2009: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Submission has been amendedNo
2009-08-01This submission is the final filingNo
2009-08-01This return/report is a short plan year return/report (less than 12 months)No
2009-08-01Plan is a collectively bargained planNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes
2008: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01Submission has been amendedNo
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)No
2008-07-01Plan is a collectively bargained planNo
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan benefit arrangement – InsuranceYes
2007: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2007 form 5500 responses
2007-07-01Type of plan entitySingle employer plan
2007-07-01Submission has been amendedNo
2007-07-01This submission is the final filingNo
2007-07-01This return/report is a short plan year return/report (less than 12 months)No
2007-07-01Plan is a collectively bargained planNo
2007-07-01Plan funding arrangement – InsuranceYes
2007-07-01Plan benefit arrangement – InsuranceYes
2006: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2006 form 5500 responses
2006-07-01Type of plan entitySingle employer plan
2006-07-01Submission has been amendedNo
2006-07-01This submission is the final filingNo
2006-07-01This return/report is a short plan year return/report (less than 12 months)No
2006-07-01Plan is a collectively bargained planNo
2006-07-01Plan funding arrangement – InsuranceYes
2006-07-01Plan benefit arrangement – InsuranceYes
2005: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2005 form 5500 responses
2005-07-01Type of plan entitySingle employer plan
2005-07-01Submission has been amendedNo
2005-07-01This submission is the final filingNo
2005-07-01This return/report is a short plan year return/report (less than 12 months)No
2005-07-01Plan is a collectively bargained planNo
2005-07-01Plan funding arrangement – InsuranceYes
2005-07-01Plan benefit arrangement – InsuranceYes
2005-03-01Type of plan entitySingle employer plan
2005-03-01Submission has been amendedNo
2005-03-01This submission is the final filingNo
2005-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2005-03-01Plan is a collectively bargained planNo
2005-03-01Plan funding arrangement – InsuranceYes
2005-03-01Plan benefit arrangement – InsuranceYes
2004: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2004 form 5500 responses
2004-03-01Type of plan entitySingle employer plan
2004-03-01Submission has been amendedNo
2004-03-01This submission is the final filingNo
2004-03-01This return/report is a short plan year return/report (less than 12 months)No
2004-03-01Plan is a collectively bargained planNo
2004-03-01Plan funding arrangement – InsuranceYes
2004-03-01Plan benefit arrangement – InsuranceYes
2003: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2003 form 5500 responses
2003-03-01Type of plan entitySingle employer plan
2003-03-01Submission has been amendedNo
2003-03-01This submission is the final filingNo
2003-03-01This return/report is a short plan year return/report (less than 12 months)No
2003-03-01Plan is a collectively bargained planNo
2003-03-01Plan funding arrangement – InsuranceYes
2003-03-01Plan benefit arrangement – InsuranceYes
2002: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2002 form 5500 responses
2002-03-01Type of plan entitySingle employer plan
2002-03-01Submission has been amendedNo
2002-03-01This submission is the final filingNo
2002-03-01This return/report is a short plan year return/report (less than 12 months)No
2002-03-01Plan is a collectively bargained planNo
2002-03-01Plan funding arrangement – InsuranceYes
2002-03-01Plan benefit arrangement – InsuranceYes
2001: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2001 form 5500 responses
2001-03-01Type of plan entitySingle employer plan
2001-03-01Submission has been amendedNo
2001-03-01This submission is the final filingNo
2001-03-01This return/report is a short plan year return/report (less than 12 months)No
2001-03-01Plan is a collectively bargained planNo
2001-03-01Plan funding arrangement – InsuranceYes
2001-03-01Plan benefit arrangement – InsuranceYes
2000: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 2000 form 5500 responses
2000-03-01Type of plan entitySingle employer plan
2000-03-01Submission has been amendedYes
2000-03-01This submission is the final filingNo
2000-03-01This return/report is a short plan year return/report (less than 12 months)No
2000-03-01Plan is a collectively bargained planNo
2000-03-01Plan funding arrangement – InsuranceYes
2000-03-01Plan benefit arrangement – InsuranceYes
1999: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1999 form 5500 responses
1999-07-01Type of plan entitySingle employer plan
1999-07-01Submission has been amendedYes
1999-07-01This submission is the final filingNo
1999-07-01This return/report is a short plan year return/report (less than 12 months)Yes
1999-07-01Plan is a collectively bargained planNo
1999-07-01Plan funding arrangement – InsuranceYes
1999-07-01Plan benefit arrangement – InsuranceYes
1998: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1998 form 5500 responses
1998-07-01Type of plan entitySingle employer plan
1998-07-01Submission has been amendedNo
1998-07-01This submission is the final filingNo
1998-07-01This return/report is a short plan year return/report (less than 12 months)No
1998-07-01Plan is a collectively bargained planNo
1998-07-01Plan funding arrangement – InsuranceYes
1998-07-01Plan benefit arrangement – InsuranceYes
1997: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1997 form 5500 responses
1997-07-01Type of plan entitySingle employer plan
1997-07-01Submission has been amendedNo
1997-07-01This submission is the final filingNo
1997-07-01This return/report is a short plan year return/report (less than 12 months)No
1997-07-01Plan is a collectively bargained planNo
1997-07-01Plan funding arrangement – InsuranceYes
1997-07-01Plan benefit arrangement – InsuranceYes
1996: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1996 form 5500 responses
1996-07-01Type of plan entitySingle employer plan
1996-07-01Submission has been amendedNo
1996-07-01This submission is the final filingNo
1996-07-01This return/report is a short plan year return/report (less than 12 months)No
1996-07-01Plan is a collectively bargained planNo
1996-07-01Plan funding arrangement – InsuranceYes
1996-07-01Plan benefit arrangement – InsuranceYes
1995: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1995 form 5500 responses
1995-07-01Type of plan entitySingle employer plan
1995-07-01Submission has been amendedNo
1995-07-01This submission is the final filingNo
1995-07-01This return/report is a short plan year return/report (less than 12 months)No
1995-07-01Plan is a collectively bargained planNo
1995-07-01Plan funding arrangement – InsuranceYes
1995-07-01Plan benefit arrangement – InsuranceYes
1994: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1994 form 5500 responses
1994-07-01Type of plan entitySingle employer plan
1994-07-01Submission has been amendedNo
1994-07-01This submission is the final filingNo
1994-07-01This return/report is a short plan year return/report (less than 12 months)No
1994-07-01Plan is a collectively bargained planNo
1994-07-01Plan funding arrangement – InsuranceYes
1994-07-01Plan benefit arrangement – InsuranceYes
1993: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1993 form 5500 responses
1993-07-01Type of plan entitySingle employer plan
1993-07-01Submission has been amendedNo
1993-07-01This submission is the final filingNo
1993-07-01This return/report is a short plan year return/report (less than 12 months)No
1993-07-01Plan is a collectively bargained planNo
1993-07-01Plan funding arrangement – InsuranceYes
1993-07-01Plan benefit arrangement – InsuranceYes
1992: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1992 form 5500 responses
1992-07-01Type of plan entitySingle employer plan
1992-07-01Submission has been amendedNo
1992-07-01This submission is the final filingNo
1992-07-01This return/report is a short plan year return/report (less than 12 months)No
1992-07-01Plan is a collectively bargained planNo
1992-07-01Plan funding arrangement – InsuranceYes
1992-07-01Plan benefit arrangement – InsuranceYes
1991: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1991 form 5500 responses
1991-07-01Type of plan entitySingle employer plan
1991-07-01Submission has been amendedNo
1991-07-01This submission is the final filingNo
1991-07-01This return/report is a short plan year return/report (less than 12 months)No
1991-07-01Plan is a collectively bargained planNo
1991-07-01Plan funding arrangement – InsuranceYes
1991-07-01Plan benefit arrangement – InsuranceYes
1990: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1990 form 5500 responses
1990-07-01Type of plan entitySingle employer plan
1990-07-01Submission has been amendedNo
1990-07-01This submission is the final filingNo
1990-07-01This return/report is a short plan year return/report (less than 12 months)No
1990-07-01Plan is a collectively bargained planNo
1990-07-01Plan funding arrangement – InsuranceYes
1990-07-01Plan benefit arrangement – InsuranceYes
1989: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1989 form 5500 responses
1989-07-01Type of plan entitySingle employer plan
1989-07-01Submission has been amendedYes
1989-07-01This submission is the final filingNo
1989-07-01This return/report is a short plan year return/report (less than 12 months)No
1989-07-01Plan is a collectively bargained planNo
1989-07-01Plan funding arrangement – InsuranceYes
1989-07-01Plan benefit arrangement – InsuranceYes
1988: LAKELAND ENGINEERING EMPLOYEE LTD PLAN 1988 form 5500 responses
1988-07-01Type of plan entitySingle employer plan
1988-07-01Submission has been amendedNo
1988-07-01This submission is the final filingNo
1988-07-01This return/report is a short plan year return/report (less than 12 months)No
1988-07-01Plan is a collectively bargained planNo
1988-07-01Plan funding arrangement – InsuranceYes
1988-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number158517
Policy instance 1
Insurance contract or identification number158517
Number of Individuals Covered321
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $4,432
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 $4,432
Insurance broker organization code?3
Insurance broker nameRH AHMANN COMPANY
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number158517
Policy instance 1
Insurance contract or identification number158517
Number of Individuals Covered318
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $4,490
Total amount of fees paid to insurance companyUSD $996
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
Welfare Benefit Premiums Paid to CarrierUSD $49,792
Commission paid to Insurance BrokerUSD $4,490
Amount paid for insurance broker fees996
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?3
Insurance broker nameRH AHMANN COMPANY
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5439924
Policy instance 1
Insurance contract or identification number5439924
Number of Individuals Covered295
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $4,548
Total amount of fees paid to insurance companyUSD $1,280
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
Welfare Benefit Premiums Paid to CarrierUSD $54,789
Commission paid to Insurance BrokerUSD $4,548
Amount paid for insurance broker fees1280
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?3
Insurance broker nameRH AHMANN COMPANY
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5439924
Policy instance 1
Insurance contract or identification number5439924
Number of Individuals Covered295
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $4,598
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
Welfare Benefit Premiums Paid to CarrierUSD $59,825
Commission paid to Insurance BrokerUSD $4,598
Insurance broker organization code?3
Insurance broker nameRH AHMANN COMPANY
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5439924
Policy instance 1
Insurance contract or identification number5439924
Number of Individuals Covered303
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $4,505
Total amount of fees paid to insurance companyUSD $461
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
Welfare Benefit Premiums Paid to CarrierUSD $46,090
Commission paid to Insurance BrokerUSD $4,505
Amount paid for insurance broker fees461
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?3
Insurance broker nameRJ AHMANN BENEFITS LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5439924
Policy instance 1
Insurance contract or identification number5439924
Number of Individuals Covered266
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $3,801
Total amount of fees paid to insurance companyUSD $1,052
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
Welfare Benefit Premiums Paid to CarrierUSD $36,026
Commission paid to Insurance BrokerUSD $3,801
Amount paid for insurance broker fees1052
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?3
Insurance broker nameRJ AHMANN BENEFITS LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5439924
Policy instance 1
Insurance contract or identification number5439924
Number of Individuals Covered243
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $3,799
Total amount of fees paid to insurance companyUSD $739
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
Welfare Benefit Premiums Paid to CarrierUSD $35,975
Commission paid to Insurance BrokerUSD $3,799
Amount paid for insurance broker fees739
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?3
Insurance broker nameRJ AHMANN BENEFITS LLC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH24279
Policy instance 1
Insurance contract or identification numberH24279
Number of Individuals Covered294
Insurance policy start date2009-07-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $463
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
Welfare Benefit Premiums Paid to CarrierUSD $3,210
Commission paid to Insurance BrokerUSD $463
Insurance broker organization code?3
Insurance broker nameRJ AHMANN BENEFITS LLC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH24279
Policy instance 1
Insurance contract or identification numberH24279
Number of Individuals Covered307
Insurance policy start date2008-07-01
Insurance policy end date2009-06-30
Total amount of commissions paid to insurance brokerUSD $2,903
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
Welfare Benefit Premiums Paid to CarrierUSD $40,422
Commission paid to Insurance BrokerUSD $2,613
Insurance broker organization code?3
Insurance broker nameRJ AHMANN BENEFITS LLC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH24279
Policy instance 1
Insurance contract or identification numberH24279
Number of Individuals Covered353
Insurance policy start date2007-07-01
Insurance policy end date2008-06-30
Total amount of commissions paid to insurance brokerUSD $2,749
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
Welfare Benefit Premiums Paid to CarrierUSD $34,239
Commission paid to Insurance BrokerUSD $2,749
Insurance broker organization code?3
Insurance broker nameNORTHERN UNDERWRITERS
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH24279
Policy instance 1
Insurance contract or identification numberH24279
Number of Individuals Covered294
Insurance policy start date2006-07-01
Insurance policy end date2007-06-30
Total amount of commissions paid to insurance brokerUSD $2,623
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
Welfare Benefit Premiums Paid to CarrierUSD $29,389
Commission paid to Insurance BrokerUSD $2,623
Insurance broker organization code?3
Insurance broker nameNORTHERN UNDERWRITERS
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number24279
Policy instance 1
Insurance contract or identification number24279
Number of Individuals Covered259
Insurance policy start date2005-07-01
Insurance policy end date2006-06-30
Total amount of commissions paid to insurance brokerUSD $2,878
Total amount of fees paid to insurance companyUSD $421
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
Welfare Benefit Premiums Paid to CarrierUSD $28,433
Commission paid to Insurance BrokerUSD $2,878
Amount paid for insurance broker fees421
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameNORTHERN CAPITAL LIFE & HEALTH
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number4026159
Policy instance 1
Insurance contract or identification number4026159
Number of Individuals Covered252
Insurance policy start date2005-03-01
Insurance policy end date2005-06-30
Total amount of commissions paid to insurance brokerUSD $1,492
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
Welfare Benefit Premiums Paid to CarrierUSD $17,195
Commission paid to Insurance BrokerUSD $1,492
Insurance broker organization code?3
Insurance broker nameNORTHERN CAPITAL LIFE & HEALTH
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number4026159
Policy instance 1
Insurance contract or identification number4026159
Number of Individuals Covered250
Insurance policy start date2004-03-01
Insurance policy end date2005-02-28
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
Welfare Benefit Premiums Paid to CarrierUSD $41,304
Insurance broker organization code?3
Insurance broker nameNORTHERN CAPITAL LIFE & HEALTH
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number4026159
Policy instance 1
Insurance contract or identification number4026159
Number of Individuals Covered233
Insurance policy start date2003-03-01
Insurance policy end date2004-02-29
Total amount of commissions paid to insurance brokerUSD $3,042
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
Welfare Benefit Premiums Paid to CarrierUSD $40,276
Commission paid to Insurance BrokerUSD $3,042
Insurance broker organization code?3
Insurance broker nameNORTHERN CAPITAL LIFE & HEALTH
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number4026159
Policy instance 1
Insurance contract or identification number4026159
Number of Individuals Covered244
Insurance policy start date2002-03-01
Insurance policy end date2003-02-28
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?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
Welfare Benefit Premiums Paid to CarrierUSD $46,405
Insurance broker organization code?3
Insurance broker nameNORTHERN CAPITAL LIFE & HEALTH
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number4026159
Policy instance 1
Insurance contract or identification number4026159
Number of Individuals Covered260
Insurance policy start date2001-03-01
Insurance policy end date2002-02-28
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
Welfare Benefit Premiums Paid to CarrierUSD $42,957
Insurance broker organization code?3
Insurance broker nameNORTHERN CAPITAL LIFE & HEALTH
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number4026159
Policy instance 1
Insurance contract or identification number4026159
Number of Individuals Covered254
Insurance policy start date2000-03-01
Insurance policy end date2001-02-28
Total amount of commissions paid to insurance brokerUSD $2,818
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
Welfare Benefit Premiums Paid to CarrierUSD $42,841
Commission paid to Insurance BrokerUSD $2,818
Insurance broker organization code?3
Insurance broker nameNORTHERN CAPITAL LIFE & HEALTH
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered254
Insurance policy start date1999-07-01
Insurance policy end date2000-02-28
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered249
Insurance policy start date1998-07-01
Insurance policy end date1999-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered241
Insurance policy start date1997-07-01
Insurance policy end date1998-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered233
Insurance policy start date1996-07-01
Insurance policy end date1997-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered225
Insurance policy start date1995-07-01
Insurance policy end date1996-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered218
Insurance policy start date1994-07-01
Insurance policy end date1995-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered210
Insurance policy start date1993-07-01
Insurance policy end date1994-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered202
Insurance policy start date1992-07-01
Insurance policy end date1993-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered195
Insurance policy start date1991-07-01
Insurance policy end date1992-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered187
Insurance policy start date1990-07-01
Insurance policy end date1991-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered179
Insurance policy start date1989-07-01
Insurance policy end date1990-06-30
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
Welfare Benefit Premiums Paid to CarrierUSD $0
ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered171
Insurance policy start date1988-07-01
Insurance policy end date1989-06-30
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
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

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