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DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 401k Plan overview

Plan NameDETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE
Plan identification number 505

DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance

401k Sponsoring company profile

DETHMERS MANUFACTURING CO has sponsored the creation of one or more 401k plans.

Company Name:DETHMERS MANUFACTURING CO
Employer identification number (EIN):420891425
NAIC Classification:333100

Additional information about DETHMERS MANUFACTURING CO

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1964-10-28
Company Identification Number: 011327
Legal Registered Office Address: 315 9TH ST

SIBLEY
United States of America (USA)
51249

More information about DETHMERS MANUFACTURING CO

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052020-02-01
5052019-02-01
5052018-02-01
5052017-02-01KEVIN TEN HAKEN KEVIN TEN HAKEN2018-08-07
5052016-02-01KEVIN TEN HAKEN KEVIN TEN HAKEN2017-08-02
5052015-02-01KEVIN TEN HAKEN KEVIN TEN HAKEN2016-07-26
5052014-02-01KEVIN TEN HAKEN KEVIN TEN HAKEN2015-07-08
5052013-02-01KEVIN TEN HAKEN KEVIN TEN HAKEN2014-07-23
5052012-02-01KEVIN TEN HAKEN KEVIN TEN HAKEN2013-08-15
5052011-02-01KEVIN TEN HAKEN KEVIN TEN HAKEN2012-07-30
5052010-11-01KEVIN TEN HAKEN KEVIN TEN HAKEN2011-07-15
5052009-11-01KEVIN TEN HAKEN KEVIN TEN HAKEN2011-06-27
5052007-11-01KEVIN TEN HAKEN KEVIN TEN HAKEN2011-06-27
5052006-11-01KEVIN TEN HAKEN KEVIN TEN HAKEN2011-06-27
5052005-11-01KEVIN TEN HAKEN KEVIN TEN HAKEN2011-06-27
5052003-11-01KEVIN TEN HAKEN KEVIN TEN HAKEN2011-06-27
5052001-11-01KEVIN TEN HAKEN KEVIN TEN HAKEN2011-06-27
5051999-11-01KEVIN TEN HAKEN KEVIN TEN HAKEN2011-06-27

Plan Statistics for DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE

401k plan membership statisitcs for DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE

Measure Date Value
2020: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-02-01306
Total number of active participants reported on line 7a of the Form 55002020-02-010
Total of all active and inactive participants2020-02-010
2019: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-02-01275
Total number of active participants reported on line 7a of the Form 55002019-02-01306
Total of all active and inactive participants2019-02-01306
2018: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-02-01262
Total number of active participants reported on line 7a of the Form 55002018-02-01275
Total of all active and inactive participants2018-02-01275
2017: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-02-01250
Total number of active participants reported on line 7a of the Form 55002017-02-01262
Total of all active and inactive participants2017-02-01262
2016: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-02-01203
Total number of active participants reported on line 7a of the Form 55002016-02-01250
Total of all active and inactive participants2016-02-01250
2015: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-02-01235
Total number of active participants reported on line 7a of the Form 55002015-02-01203
Total of all active and inactive participants2015-02-01203
2014: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-02-01272
Total number of active participants reported on line 7a of the Form 55002014-02-01235
Total of all active and inactive participants2014-02-01235
2013: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-02-01262
Total number of active participants reported on line 7a of the Form 55002013-02-01272
Total of all active and inactive participants2013-02-01272
2012: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-02-01293
Total number of active participants reported on line 7a of the Form 55002012-02-01262
Total of all active and inactive participants2012-02-01262
2011: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-02-01275
Total number of active participants reported on line 7a of the Form 55002011-02-01293
Total of all active and inactive participants2011-02-01293
2010: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-11-01262
Total number of active participants reported on line 7a of the Form 55002010-11-01275
Total of all active and inactive participants2010-11-01275
2009: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-11-01287
Total number of active participants reported on line 7a of the Form 55002009-11-01262
Total of all active and inactive participants2009-11-01262
2007: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2007 401k membership
Total participants, beginning-of-year2007-11-01244
Total number of active participants reported on line 7a of the Form 55002007-11-01290
Total of all active and inactive participants2007-11-01290
2006: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2006 401k membership
Total participants, beginning-of-year2006-11-01265
Total number of active participants reported on line 7a of the Form 55002006-11-01244
Total of all active and inactive participants2006-11-01244
2005: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2005 401k membership
Total participants, beginning-of-year2005-11-01233
Total number of active participants reported on line 7a of the Form 55002005-11-01265
Total of all active and inactive participants2005-11-01265
2003: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2003 401k membership
Total participants, beginning-of-year2003-11-01227
Total number of active participants reported on line 7a of the Form 55002003-11-01233
Total of all active and inactive participants2003-11-01233
2001: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2001 401k membership
Total participants, beginning-of-year2001-11-01301
Total number of active participants reported on line 7a of the Form 55002001-11-01286
Total of all active and inactive participants2001-11-01286
1999: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 1999 401k membership
Total participants, beginning-of-year1999-11-01220
Total number of active participants reported on line 7a of the Form 55001999-11-01286
Total of all active and inactive participants1999-11-01286

Form 5500 Responses for DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE

2020: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01This submission is the final filingYes
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan benefit arrangement – InsuranceYes
2019: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan benefit arrangement – InsuranceYes
2018: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – InsuranceYes
2017: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – InsuranceYes
2015: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – InsuranceYes
2014: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan benefit arrangement – InsuranceYes
2013: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan benefit arrangement – InsuranceYes
2012: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan benefit arrangement – InsuranceYes
2011: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan benefit arrangement – InsuranceYes
2010: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2010 form 5500 responses
2010-11-01Type of plan entitySingle employer plan
2010-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2010-11-01Plan funding arrangement – InsuranceYes
2010-11-01Plan benefit arrangement – InsuranceYes
2009: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – InsuranceYes
2007: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2007 form 5500 responses
2007-11-01Type of plan entitySingle employer plan
2007-11-01Plan funding arrangement – InsuranceYes
2007-11-01Plan benefit arrangement – InsuranceYes
2006: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2006 form 5500 responses
2006-11-01Type of plan entitySingle employer plan
2006-11-01Plan funding arrangement – InsuranceYes
2006-11-01Plan benefit arrangement – InsuranceYes
2005: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2005 form 5500 responses
2005-11-01Type of plan entitySingle employer plan
2005-11-01Plan funding arrangement – InsuranceYes
2005-11-01Plan benefit arrangement – InsuranceYes
2003: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2003 form 5500 responses
2003-11-01Type of plan entitySingle employer plan
2003-11-01Plan funding arrangement – InsuranceYes
2003-11-01Plan benefit arrangement – InsuranceYes
2001: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 2001 form 5500 responses
2001-11-01Type of plan entitySingle employer plan
2001-11-01Plan funding arrangement – InsuranceYes
2001-11-01Plan benefit arrangement – InsuranceYes
1999: DETHMERS MANUFACTURING GROUP TERM LIFE INSURANCE 1999 form 5500 responses
1999-11-01Type of plan entitySingle employer plan
1999-11-01First time form 5500 has been submittedYes
1999-11-01Plan funding arrangement – InsuranceYes
1999-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ATYY
Policy instance 1
Insurance contract or identification numberG000ATYY
Number of Individuals Covered317
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $8,213
Total amount of fees paid to insurance companyUSD $4,862
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,213
Amount paid for insurance broker fees4862
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ATYY
Policy instance 1
Insurance contract or identification numberG000ATYY
Number of Individuals Covered306
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $8,033
Total amount of fees paid to insurance companyUSD $3,833
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,033
Amount paid for insurance broker fees3833
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ATYY
Policy instance 1
Insurance contract or identification numberG000ATYY
Number of Individuals Covered275
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $7,595
Total amount of fees paid to insurance companyUSD $3,353
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,595
Amount paid for insurance broker fees3353
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ATYY
Policy instance 1
Insurance contract or identification numberG000ATYY
Number of Individuals Covered262
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,367
Total amount of fees paid to insurance companyUSD $696
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,367
Amount paid for insurance broker fees696
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameSILVERSTONE GROUP INCORPORATED
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number152901
Policy instance 1
Insurance contract or identification number152901
Number of Individuals Covered203
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $2,912
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 $2,912
Insurance broker organization code?3
Insurance broker nameSILVERSTONE GROUP INCORPORATED
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number152901
Policy instance 1
Insurance contract or identification number152901
Number of Individuals Covered235
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $3,072
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,072
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameSILVERSTONE GROUP INCORPORATED
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number152901
Policy instance 1
Insurance contract or identification number152901
Number of Individuals Covered272
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $3,045
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,045
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameSILVERSTONE GROUP INCORPORATED
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number152901
Policy instance 1
Insurance contract or identification number152901
Number of Individuals Covered262
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $3,010
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,010
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameSILVERSTONE GROUP INCORPORATED
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number152901
Policy instance 1
Insurance contract or identification number152901
Number of Individuals Covered293
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $3,033
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number088310
Policy instance 1
Insurance contract or identification number088310
Number of Individuals Covered275
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $13,230
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,659
Insurance broker organization code?3
Insurance broker nameDAKOTACARE ADMINISTRATIVE SERVICES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number088310
Policy instance 1
Insurance contract or identification number088310
Number of Individuals Covered262
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $11,402
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,882
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameDAKOTACARE ADMINISTRATIVE SERVICES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number088310
Policy instance 1
Insurance contract or identification number088310
Number of Individuals Covered287
Insurance policy start date2008-02-01
Insurance policy end date2009-01-31
Total amount of commissions paid to insurance brokerUSD $9,867
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,867
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameDAKOTACARE
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number088310
Policy instance 1
Insurance contract or identification number088310
Number of Individuals Covered290
Insurance policy start date2007-02-01
Insurance policy end date2008-01-31
Total amount of commissions paid to insurance brokerUSD $8,454
Total amount of fees paid to insurance companyUSD $804
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,454
Amount paid for insurance broker fees804
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameDAKOTACARE
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number088310
Policy instance 1
Insurance contract or identification number088310
Number of Individuals Covered244
Insurance policy start date2006-02-01
Insurance policy end date2007-01-31
Total amount of commissions paid to insurance brokerUSD $8,028
Total amount of fees paid to insurance companyUSD $839
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,028
Amount paid for insurance broker fees839
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameDAKOTACARE
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number088310
Policy instance 1
Insurance contract or identification number088310
Number of Individuals Covered265
Insurance policy start date2005-02-01
Insurance policy end date2006-01-31
Total amount of commissions paid to insurance brokerUSD $3,497
Total amount of fees paid to insurance companyUSD $734
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,497
Amount paid for insurance broker fees734
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameDAKOTACARE
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number088310
Policy instance 1
Insurance contract or identification number088310
Number of Individuals Covered233
Insurance policy start date2004-02-01
Insurance policy end date2005-01-31
Total amount of commissions paid to insurance brokerUSD $3,347
Total amount of fees paid to insurance companyUSD $792
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,347
Amount paid for insurance broker fees792
Insurance broker organization code?3
Insurance broker nameDAKOTACARE
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number088310
Policy instance 2
Insurance contract or identification number088310
Number of Individuals Covered233
Insurance policy start date2003-02-01
Insurance policy end date2004-01-31
Total amount of commissions paid to insurance brokerUSD $3,230
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,230
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameDAKOTACARE
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG#4019933
Policy instance 1
Insurance contract or identification numberG#4019933
Number of Individuals Covered232
Insurance policy start date2003-01-01
Insurance policy end date2003-01-31
Total amount of commissions paid to insurance brokerUSD $343
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $343
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLAMAIR MULOCK CONDON CO
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG#4019933
Policy instance 1
Insurance contract or identification numberG#4019933
Number of Individuals Covered227
Insurance policy start date2002-01-01
Insurance policy end date2002-12-31
Total amount of commissions paid to insurance brokerUSD $3,560
Total amount of fees paid to insurance companyUSD $1,637
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,560
Amount paid for insurance broker fees1637
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLAMAIR MULOCK CONDON CO
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG#4019933
Policy instance 1
Insurance contract or identification numberG#4019933
Number of Individuals Covered286
Insurance policy start date2001-01-01
Insurance policy end date2001-12-31
Total amount of commissions paid to insurance brokerUSD $3,302
Total amount of fees paid to insurance companyUSD $1,651
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,302
Amount paid for insurance broker fees1651
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLAMAIR MULOCK CONDON CO
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG#4019933
Policy instance 1
Insurance contract or identification numberG#4019933
Number of Individuals Covered301
Insurance policy start date2000-01-01
Insurance policy end date2000-12-31
Total amount of commissions paid to insurance brokerUSD $3,209
Total amount of fees paid to insurance companyUSD $1,580
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,146
Amount paid for insurance broker fees1580
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameASSUREX INTERNATIONAL
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG#4019933
Policy instance 1
Insurance contract or identification numberG#4019933
Number of Individuals Covered286
Insurance policy start date1999-01-01
Insurance policy end date1999-12-31
Total amount of commissions paid to insurance brokerUSD $3,298
Total amount of fees paid to insurance companyUSD $266
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,911
Amount paid for insurance broker fees266
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameASSUREX INTERNATIONAL

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