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ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 401k Plan overview

Plan NameST. PAUL EYE CLINIC LIFE & LTD SECTION 125
Plan identification number 501

ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Long-term disability cover

401k Sponsoring company profile

ST. PAUL EYE CLINIC P. A. has sponsored the creation of one or more 401k plans.

Company Name:ST. PAUL EYE CLINIC P. A.
Employer identification number (EIN):410949282
NAIC Classification:621320
NAIC Description:Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. PAUL EYE CLINIC LIFE & LTD SECTION 125

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-01-01SCOTT UTTLEY2020-05-08
5012018-01-01PAUL HOWARD
5012017-01-01PAUL HOWARD
5012016-01-01PAUL HOWARD
5012015-01-01PAUL HOWARD
5012014-01-01PAUL HOWARD
5012013-01-01
5012012-01-01PAUL HOWARD
5012011-01-01PAUL HOWARD
5012010-01-01THOMAS RICE
5012009-01-01THOMAS RICE

Plan Statistics for ST. PAUL EYE CLINIC LIFE & LTD SECTION 125

401k plan membership statisitcs for ST. PAUL EYE CLINIC LIFE & LTD SECTION 125

Measure Date Value
2019: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2019 401k membership
Total participants, beginning-of-year2019-01-01130
Total number of active participants reported on line 7a of the Form 55002019-01-01135
Total of all active and inactive participants2019-01-01135
Total participants2019-01-01135
2018: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2018 401k membership
Total participants, beginning-of-year2018-01-01130
Total number of active participants reported on line 7a of the Form 55002018-01-01130
Total of all active and inactive participants2018-01-01130
Total participants2018-01-01130
2017: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2017 401k membership
Total participants, beginning-of-year2017-01-01122
Total number of active participants reported on line 7a of the Form 55002017-01-01130
Total of all active and inactive participants2017-01-01130
Total participants2017-01-01130
2016: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2016 401k membership
Total participants, beginning-of-year2016-01-01117
Total number of active participants reported on line 7a of the Form 55002016-01-01122
Total of all active and inactive participants2016-01-01122
Total participants2016-01-01122
2015: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2015 401k membership
Total participants, beginning-of-year2015-01-01112
Total number of active participants reported on line 7a of the Form 55002015-01-01117
Total of all active and inactive participants2015-01-01117
Total participants2015-01-01117
2014: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2014 401k membership
Total participants, beginning-of-year2014-01-01110
Total number of active participants reported on line 7a of the Form 55002014-01-01112
Total of all active and inactive participants2014-01-01112
Total participants2014-01-01112
2013: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2013 401k membership
Total participants, beginning-of-year2013-01-01110
Total number of active participants reported on line 7a of the Form 55002013-01-01110
Total of all active and inactive participants2013-01-01110
Total participants2013-01-01110
2012: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2012 401k membership
Total participants, beginning-of-year2012-01-01110
Total number of active participants reported on line 7a of the Form 55002012-01-01109
Total of all active and inactive participants2012-01-01109
Total participants2012-01-01109
2011: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2011 401k membership
Total participants, beginning-of-year2011-01-01110
Total number of active participants reported on line 7a of the Form 55002011-01-01110
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01110
2010: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2010 401k membership
Total participants, beginning-of-year2010-01-01111
Total number of active participants reported on line 7a of the Form 55002010-01-01110
Total of all active and inactive participants2010-01-01110
Total participants2010-01-01110
2009: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2009 401k membership
Total participants, beginning-of-year2009-01-01110
Total number of active participants reported on line 7a of the Form 55002009-01-01111
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01111
Total participants2009-01-01111

Form 5500 Responses for ST. PAUL EYE CLINIC LIFE & LTD SECTION 125

2019: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: ST. PAUL EYE CLINIC LIFE & LTD SECTION 125 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164412
Policy instance 1
Insurance contract or identification number164412
Number of Individuals Covered135
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,601
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,601
Amount paid for insurance broker fees623
Additional information about fees paid to insurance brokerTOTAL CONTINGENT COMPENSATION PAID
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164412
Policy instance 2
Insurance contract or identification number164412
Number of Individuals Covered130
Insurance policy start date2018-09-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,943
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,943
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number20125651
Policy instance 1
Insurance contract or identification number20125651
Number of Individuals Covered130
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,607
Total amount of fees paid to insurance companyUSD $75
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,607
Amount paid for insurance broker fees75
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number20125651
Policy instance 1
Insurance contract or identification number20125651
Number of Individuals Covered130
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,649
Total amount of fees paid to insurance companyUSD $120
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,649
Amount paid for insurance broker fees120
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?3
Insurance broker nameSEVEN HILLS BENEFIT PARTNERS
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberLIF / LTD 32040
Policy instance 1
Insurance contract or identification numberLIF / LTD 32040
Number of Individuals Covered117
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,929
Total amount of fees paid to insurance companyUSD $120
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare 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 $5,929
Amount paid for insurance broker fees120
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?3
Insurance broker namePAUL SWANSON AGENCY, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberLIF / LTD 32040
Policy instance 1
Insurance contract or identification numberLIF / LTD 32040
Number of Individuals Covered112
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,633
Total amount of fees paid to insurance companyUSD $120
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare 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 $5,633
Amount paid for insurance broker fees120
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?3
Insurance broker namePAUL SWANSON AGENCY, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number
Policy instance 1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,527
Total amount of fees paid to insurance companyUSD $120
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D AND DEPENDENT LIFE
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 $0
Amount paid for insurance broker fees120
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?5
Insurance broker namePAUL SWANSON
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number32040
Policy instance 1
Insurance contract or identification number32040
Number of Individuals Covered109
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,434
Total amount of fees paid to insurance companyUSD $120
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,434
Amount paid for insurance broker fees120
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?3
Insurance broker namePAUL SWANSON
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberLTD32040
Policy instance 2
Insurance contract or identification numberLTD32040
Number of Individuals Covered110
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,588
Total amount of fees paid to insurance companyUSD $120
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberLIF32040
Policy instance 1
Insurance contract or identification numberLIF32040
Number of Individuals Covered110
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,064
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberLTD32040
Policy instance 2
Insurance contract or identification numberLTD32040
Number of Individuals Covered110
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,982
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,982
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker namePAUL SWANSON
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberLIF32040
Policy instance 1
Insurance contract or identification numberLIF32040
Number of Individuals Covered110
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $752
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $752
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker namePAUL SWANSON

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