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DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 401k Plan overview

Plan NameDIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN
Plan identification number 505

DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN Benefits

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

401k Sponsoring company profile

DIVERSIFIED TECHNOLOGIES, INC. DBA SUDENGA INDUSTIRES, INC. has sponsored the creation of one or more 401k plans.

Company Name:DIVERSIFIED TECHNOLOGIES, INC. DBA SUDENGA INDUSTIRES, INC.
Employer identification number (EIN):421278787
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Additional information about DIVERSIFIED TECHNOLOGIES, INC. DBA SUDENGA INDUSTIRES, INC.

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1986-05-21
Company Identification Number: 108883
Legal Registered Office Address: 2002 KINGBIRD AVENUE
PO BOX 111
GEORGE
United States of America (USA)
51237

More information about DIVERSIFIED TECHNOLOGIES, INC. DBA SUDENGA INDUSTIRES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052021-01-01
5052020-01-01
5052019-01-01
5052018-01-01CHARLES SJOGREN CHARLES SJOGREN2019-07-05
5052017-01-01LARRY KRUSE LARRY KRUSE2018-06-26
5052016-01-01LARRY KRUSE LARRY KRUSE2017-07-21
5052015-01-01
5052014-01-01
5052013-01-01
5052012-01-01LARRY KRUSE
5052011-01-01LARRY KRUSE
5052010-01-01LARRY KRUSE
5052009-01-01MIKAL CLAAR MIKAL CLAAR2013-10-15
5052008-01-01LARRY KRUSE
5052007-01-01LARRY KRUSE
5052006-01-01LARRY KRUSE
5052005-01-01LARRY KRUSE
5052004-01-01LARRY KRUSE
5052003-01-01LARRY KRUSE
5052002-01-01LARRY KRUSE
5052001-01-01LARRY KRUSE
5052000-01-01LARRY KRUSE
5051999-01-01LARRY KRUSE
5051998-01-01LARRY KRUSE
5051997-01-01LARRY KRUSE
5051996-01-01LARRY KRUSE
5051995-01-01LARRY KRUSE
5051994-01-01LARRY KRUSE
5051993-01-01LARRY KRUSE
5051992-01-01LARRY KRUSE
5051991-01-01LARRY KRUSE
5051990-01-01LARRY KRUSE
5051989-01-01LARRY KRUSE
5051988-01-01LARRY KRUSE

Plan Statistics for DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN

401k plan membership statisitcs for DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN

Measure Date Value
2021: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01205
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-010
2020: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01225
Total number of active participants reported on line 7a of the Form 55002020-01-01205
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01205
2019: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01239
Total number of active participants reported on line 7a of the Form 55002019-01-01225
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01225
2018: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01242
Total number of active participants reported on line 7a of the Form 55002018-01-01239
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01239
2017: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01231
Total number of active participants reported on line 7a of the Form 55002017-01-01242
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01242
2016: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01237
Total number of active participants reported on line 7a of the Form 55002016-01-01231
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01231
2015: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01238
Total number of active participants reported on line 7a of the Form 55002015-01-01237
Total of all active and inactive participants2015-01-01237
2014: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01236
Total number of active participants reported on line 7a of the Form 55002014-01-01238
Total of all active and inactive participants2014-01-01238
2013: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01237
Total number of active participants reported on line 7a of the Form 55002013-01-01236
Total of all active and inactive participants2013-01-01236
2012: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01251
Total number of active participants reported on line 7a of the Form 55002012-01-01237
Total of all active and inactive participants2012-01-01237
2011: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01194
Total number of active participants reported on line 7a of the Form 55002011-01-01251
Total of all active and inactive participants2011-01-01251
2010: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01177
Total number of active participants reported on line 7a of the Form 55002010-01-01194
Total of all active and inactive participants2010-01-01194
2009: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01173
Total number of active participants reported on line 7a of the Form 55002009-01-01177
Total of all active and inactive participants2009-01-01177
2008: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01170
Total number of active participants reported on line 7a of the Form 55002008-01-01173
Total of all active and inactive participants2008-01-01173
2007: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01170
Total number of active participants reported on line 7a of the Form 55002007-01-01170
Total of all active and inactive participants2007-01-01170
2006: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01145
Total number of active participants reported on line 7a of the Form 55002006-01-01170
Total of all active and inactive participants2006-01-01170
2005: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01139
Total number of active participants reported on line 7a of the Form 55002005-01-01145
Total of all active and inactive participants2005-01-01145
2004: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01141
Total number of active participants reported on line 7a of the Form 55002004-01-01139
Total of all active and inactive participants2004-01-01139
2003: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01152
Total number of active participants reported on line 7a of the Form 55002003-01-01141
Total of all active and inactive participants2003-01-01141
2002: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01150
Total number of active participants reported on line 7a of the Form 55002002-01-01152
Total of all active and inactive participants2002-01-01152
2001: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2001 401k membership
Total participants, beginning-of-year2001-01-01151
Total number of active participants reported on line 7a of the Form 55002001-01-01150
Total of all active and inactive participants2001-01-01150
2000: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2000 401k membership
Total participants, beginning-of-year2000-01-01151
Total number of active participants reported on line 7a of the Form 55002000-01-01150
Total of all active and inactive participants2000-01-01150
1999: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1999 401k membership
Total participants, beginning-of-year1999-01-01169
Total number of active participants reported on line 7a of the Form 55001999-01-01151
Total of all active and inactive participants1999-01-01151
1998: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1998 401k membership
Total participants, beginning-of-year1998-01-01189
Total number of active participants reported on line 7a of the Form 55001998-01-01169
Total of all active and inactive participants1998-01-01169
1997: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1997 401k membership
Total participants, beginning-of-year1997-01-01172
Total number of active participants reported on line 7a of the Form 55001997-01-01189
Total of all active and inactive participants1997-01-01189
1996: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1996 401k membership
Total participants, beginning-of-year1996-01-01173
Total number of active participants reported on line 7a of the Form 55001996-01-01172
Total of all active and inactive participants1996-01-01172
1995: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1995 401k membership
Total participants, beginning-of-year1995-01-01155
Total number of active participants reported on line 7a of the Form 55001995-01-01173
Total of all active and inactive participants1995-01-01173
1994: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1994 401k membership
Total participants, beginning-of-year1994-01-01155
Total number of active participants reported on line 7a of the Form 55001994-01-01155
Total of all active and inactive participants1994-01-01155
1993: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1993 401k membership
Total participants, beginning-of-year1993-01-01155
Total number of active participants reported on line 7a of the Form 55001993-01-01155
Total of all active and inactive participants1993-01-01155
1992: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1992 401k membership
Total participants, beginning-of-year1992-01-01138
Total number of active participants reported on line 7a of the Form 55001992-01-01155
Total of all active and inactive participants1992-01-01155
1991: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1991 401k membership
Total participants, beginning-of-year1991-01-01123
Total number of active participants reported on line 7a of the Form 55001991-01-01138
Total of all active and inactive participants1991-01-01138
1990: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1990 401k membership
Total participants, beginning-of-year1990-01-01103
Total number of active participants reported on line 7a of the Form 55001990-01-01123
Total of all active and inactive participants1990-01-01123
1989: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1989 401k membership
Total participants, beginning-of-year1989-01-01111
Total number of active participants reported on line 7a of the Form 55001989-01-01103
Total of all active and inactive participants1989-01-01103
1988: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1988 401k membership
Total participants, beginning-of-year1988-01-010
Total number of active participants reported on line 7a of the Form 55001988-01-01111
Total of all active and inactive participants1988-01-01111

Form 5500 Responses for DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN

2021: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 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: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 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 – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 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 – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 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 – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes
2004: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – InsuranceYes
2003: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Plan funding arrangement – InsuranceYes
2003-01-01Plan benefit arrangement – InsuranceYes
2002: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2002 form 5500 responses
2002-01-01Type of plan entitySingle employer plan
2002-01-01Plan funding arrangement – InsuranceYes
2002-01-01Plan benefit arrangement – InsuranceYes
2001: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Plan funding arrangement – InsuranceYes
2001-01-01Plan benefit arrangement – InsuranceYes
2000: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 2000 form 5500 responses
2000-01-01Type of plan entitySingle employer plan
2000-01-01Plan funding arrangement – InsuranceYes
2000-01-01Plan benefit arrangement – InsuranceYes
1999: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1999 form 5500 responses
1999-01-01Type of plan entitySingle employer plan
1999-01-01Plan funding arrangement – InsuranceYes
1999-01-01Plan benefit arrangement – InsuranceYes
1998: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1998 form 5500 responses
1998-01-01Type of plan entitySingle employer plan
1998-01-01Plan funding arrangement – InsuranceYes
1998-01-01Plan benefit arrangement – InsuranceYes
1997: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1997 form 5500 responses
1997-01-01Type of plan entitySingle employer plan
1997-01-01Plan funding arrangement – InsuranceYes
1997-01-01Plan benefit arrangement – InsuranceYes
1996: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1996 form 5500 responses
1996-01-01Type of plan entitySingle employer plan
1996-01-01Plan funding arrangement – InsuranceYes
1996-01-01Plan benefit arrangement – InsuranceYes
1995: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1995 form 5500 responses
1995-01-01Type of plan entitySingle employer plan
1995-01-01Plan funding arrangement – InsuranceYes
1995-01-01Plan benefit arrangement – InsuranceYes
1994: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1994 form 5500 responses
1994-01-01Type of plan entitySingle employer plan
1994-01-01Plan funding arrangement – InsuranceYes
1994-01-01Plan benefit arrangement – InsuranceYes
1993: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1993 form 5500 responses
1993-01-01Type of plan entitySingle employer plan
1993-01-01Plan funding arrangement – InsuranceYes
1993-01-01Plan benefit arrangement – InsuranceYes
1992: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1992 form 5500 responses
1992-01-01Type of plan entitySingle employer plan
1992-01-01Plan funding arrangement – InsuranceYes
1992-01-01Plan benefit arrangement – InsuranceYes
1991: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1991 form 5500 responses
1991-01-01Type of plan entitySingle employer plan
1991-01-01Plan funding arrangement – InsuranceYes
1991-01-01Plan benefit arrangement – InsuranceYes
1990: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1990 form 5500 responses
1990-01-01Type of plan entitySingle employer plan
1990-01-01Plan funding arrangement – InsuranceYes
1990-01-01Plan benefit arrangement – InsuranceYes
1989: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1989 form 5500 responses
1989-01-01Type of plan entitySingle employer plan
1989-01-01Plan funding arrangement – InsuranceYes
1989-01-01Plan benefit arrangement – InsuranceYes
1988: DIVERSIFIED TECHNOLOGIES, INC. LIFE INSURANCE PLAN 1988 form 5500 responses
1988-01-01Type of plan entitySingle employer plan
1988-01-01First time form 5500 has been submittedYes
1988-01-01Plan funding arrangement – InsuranceYes
1988-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0B449
Policy instance 2
Insurance contract or identification numberGVTL0B449
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,039
Total amount of fees paid to insurance companyUSD $2,863
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOLUNTARY LIFE, DEPENDENT LIFE
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 $47,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,039
Amount paid for insurance broker fees2863
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B449
Policy instance 1
Insurance contract or identification numberGLUG0B449
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $641
Total amount of fees paid to insurance companyUSD $413
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $641
Amount paid for insurance broker fees413
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0B449
Policy instance 2
Insurance contract or identification numberGVTL0B449
Number of Individuals Covered165
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,095
Total amount of fees paid to insurance companyUSD $3,516
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOLUNTARY LIFE, DEPENDENT LIFE
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 $47,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,095
Amount paid for insurance broker fees3516
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B449
Policy instance 1
Insurance contract or identification numberGLUG0B449
Number of Individuals Covered205
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $688
Total amount of fees paid to insurance companyUSD $520
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $688
Amount paid for insurance broker fees520
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0B449
Policy instance 2
Insurance contract or identification numberGVTL0B449
Number of Individuals Covered180
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,314
Total amount of fees paid to insurance companyUSD $3,212
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, VOLUNTARY TERM LIFE
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 $50,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,314
Amount paid for insurance broker fees3212
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B449
Policy instance 1
Insurance contract or identification numberGLUG0B449
Number of Individuals Covered225
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $742
Total amount of fees paid to insurance companyUSD $452
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $7,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $742
Amount paid for insurance broker fees452
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0B449
Policy instance 2
Insurance contract or identification numberGVTL0B449
Number of Individuals Covered211
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,512
Total amount of fees paid to insurance companyUSD $2,006
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, VOLUNTARY TERM LIFE
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 $53,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,512
Amount paid for insurance broker fees2006
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B449
Policy instance 1
Insurance contract or identification numberGLUG0B449
Number of Individuals Covered239
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $754
Total amount of fees paid to insurance companyUSD $262
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $7,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $754
Amount paid for insurance broker fees262
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0B449
Policy instance 2
Insurance contract or identification numberGVTL0B449
Number of Individuals Covered227
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,347
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, VOLUNTARY TERM LIFE
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 $50,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,347
Insurance broker organization code?3
Insurance broker nameSILVERSTONE GROUP, INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B449
Policy instance 1
Insurance contract or identification numberGLUG0B449
Number of Individuals Covered242
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $760
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $7,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $760
Insurance broker organization code?3
Insurance broker nameSILVERSTONE GROUP, INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number235529
Policy instance 1
Insurance contract or identification number235529
Number of Individuals Covered237
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,780
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,551
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameSILVERSTONE GROUP INCORPORATED
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number235529
Policy instance 2
Insurance contract or identification number235529
Number of Individuals Covered238
Insurance policy start date2014-04-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,083
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 $34,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,083
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMIDWEST EMPLOYEE BENEFITS INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5456565
Policy instance 1
Insurance contract or identification number5456565
Number of Individuals Covered240
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $1,188
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 $9,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,188
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMIDWEST EMPLOYEE BENEFITS INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5456565
Policy instance 1
Insurance contract or identification number5456565
Number of Individuals Covered236
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,245
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 $31,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,551
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMIDWEST EMPLOYEE BENEFITS INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5456565
Policy instance 1
Insurance contract or identification number5456565
Number of Individuals Covered237
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,968
Total amount of fees paid to insurance companyUSD $566
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 $29,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,968
Amount paid for insurance broker fees566
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN GRP MARKETING SRVCS OF
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5456565
Policy instance 1
Insurance contract or identification number5456565
Number of Individuals Covered251
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,315
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 $25,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number402875 0010
Policy instance 1
Insurance contract or identification number402875 0010
Number of Individuals Covered194
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $905
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 $8,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI96022
Policy instance 1
Insurance contract or identification numberCLI96022
Number of Individuals Covered173
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $786
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 $7,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $786
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameNWGM
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCL196022
Policy instance 1
Insurance contract or identification numberCL196022
Number of Individuals Covered170
Insurance policy start date2007-01-01
Insurance policy end date2007-12-31
Total amount of commissions paid to insurance brokerUSD $761
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 $7,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $761
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameNWGM
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract numberJL-744
Policy instance 1
Insurance contract or identification numberJL-744
Number of Individuals Covered170
Insurance policy start date2006-01-01
Insurance policy end date2006-12-31
Total amount of commissions paid to insurance brokerUSD $756
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 $7,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $756
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameNWGM
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract numberJL-744
Policy instance 1
Insurance contract or identification numberJL-744
Number of Individuals Covered145
Insurance policy start date2005-01-01
Insurance policy end date2005-12-31
Total amount of commissions paid to insurance brokerUSD $649
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 $6,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $649
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameNWGM
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )
Policy contract number20383-020
Policy instance 1
Insurance contract or identification number20383-020
Number of Individuals Covered139
Insurance policy start date2004-01-01
Insurance policy end date2004-12-31
Total amount of commissions paid to insurance brokerUSD $646
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 $6,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $646
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameNWGM
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )
Policy contract number20383-020
Policy instance 1
Insurance contract or identification number20383-020
Number of Individuals Covered141
Insurance policy start date2003-01-01
Insurance policy end date2003-12-31
Total amount of commissions paid to insurance brokerUSD $635
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 $6,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $635
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameNWGM

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