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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 401k Plan overview

Plan NameCOLONIAL LIFE & ACCIDENT INSURANCE COMPANY
Plan identification number 502

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

CAPITAL REGION MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:CAPITAL REGION MEDICAL CENTER
Employer identification number (EIN):440546366
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLONIAL LIFE & ACCIDENT INSURANCE COMPANY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-01-01
5022020-01-01
5022020-01-01
5022019-01-01
5022018-01-01SARAH MORROW SARAH MORROW2019-04-26
5022017-01-01SARAH MORROW SARAH MORROW2018-07-30
5022016-01-01SARAH MORROW SARAH MORROW2017-08-23
5022015-01-01SARAH MORROW SARAH MORROW2016-08-01
5022014-01-01ROBERT MAZUR
5022013-01-01ROBERT MAZUR
5022012-01-01ROBERT MAZUR
5022011-01-01ROBERT MAZUR
5022010-01-01ROBERT MAZUR
5022009-01-01ROBERT MAZUR
5022009-01-01 ROBERT MAZUR2010-09-27

Plan Statistics for COLONIAL LIFE & ACCIDENT INSURANCE COMPANY

401k plan membership statisitcs for COLONIAL LIFE & ACCIDENT INSURANCE COMPANY

Measure Date Value
2021: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2021 401k membership
Total participants, beginning-of-year2021-01-01170
Total number of active participants reported on line 7a of the Form 55002021-01-01161
Total of all active and inactive participants2021-01-01161
Total participants2021-01-01161
2020: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2020 401k membership
Total participants, beginning-of-year2020-01-01173
Total number of active participants reported on line 7a of the Form 55002020-01-01170
Total of all active and inactive participants2020-01-01170
Total participants2020-01-01170
2019: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2019 401k membership
Total participants, beginning-of-year2019-01-01183
Total number of active participants reported on line 7a of the Form 55002019-01-01173
Total of all active and inactive participants2019-01-01173
Total participants2019-01-01173
2018: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2018 401k membership
Total participants, beginning-of-year2018-01-01174
Total number of active participants reported on line 7a of the Form 55002018-01-01183
Total of all active and inactive participants2018-01-01183
Total participants2018-01-01183
2017: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2017 401k membership
Total participants, beginning-of-year2017-01-01190
Total number of active participants reported on line 7a of the Form 55002017-01-01174
Total of all active and inactive participants2017-01-01174
Total participants2017-01-01174
2016: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2016 401k membership
Total participants, beginning-of-year2016-01-01202
Total number of active participants reported on line 7a of the Form 55002016-01-01190
Total of all active and inactive participants2016-01-01190
Total participants2016-01-01190
2015: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2015 401k membership
Total participants, beginning-of-year2015-01-01214
Total number of active participants reported on line 7a of the Form 55002015-01-01202
Total of all active and inactive participants2015-01-01202
Total participants2015-01-01202
2014: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2014 401k membership
Total participants, beginning-of-year2014-01-01223
Total number of active participants reported on line 7a of the Form 55002014-01-01214
Total of all active and inactive participants2014-01-01214
Total participants2014-01-01214
2013: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2013 401k membership
Total participants, beginning-of-year2013-01-01230
Total number of active participants reported on line 7a of the Form 55002013-01-01223
Total of all active and inactive participants2013-01-01223
Total participants2013-01-01223
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2012 401k membership
Total participants, beginning-of-year2012-01-01254
Total number of active participants reported on line 7a of the Form 55002012-01-01230
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01230
2011: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2011 401k membership
Total participants, beginning-of-year2011-01-01264
Total number of active participants reported on line 7a of the Form 55002011-01-01254
Total of all active and inactive participants2011-01-01254
Total participants2011-01-01254
2010: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2010 401k membership
Total participants, beginning-of-year2010-01-01273
Total number of active participants reported on line 7a of the Form 55002010-01-01264
Total of all active and inactive participants2010-01-01264
Total participants2010-01-01264
2009: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2009 401k membership
Total participants, beginning-of-year2009-01-01313
Total number of active participants reported on line 7a of the Form 55002009-01-01273
Total of all active and inactive participants2009-01-01273
Total participants2009-01-01273

Form 5500 Responses for COLONIAL LIFE & ACCIDENT INSURANCE COMPANY

2021: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01First time form 5500 has been submittedYes
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
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: COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
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

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered161
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $17,036
Total amount of fees paid to insurance companyUSD $844
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $119,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $135
Amount paid for insurance broker fees9
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered170
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $15,855
Total amount of fees paid to insurance companyUSD $695
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $128,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2
Insurance broker organization code?3
Amount paid for insurance broker fees474
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered173
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $18,279
Total amount of fees paid to insurance companyUSD $1,061
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $125,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $72
Insurance broker organization code?3
Amount paid for insurance broker fees670
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered183
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $15,250
Total amount of fees paid to insurance companyUSD $1,010
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHEALTH & ACCIDENT
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 $115,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,938
Amount paid for insurance broker fees317
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered174
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $14,657
Total amount of fees paid to insurance companyUSD $696
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHEALTH AND ACCIDENT
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 $115,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $117
Amount paid for insurance broker fees9
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS AND NON-CASH INCENTIVE
Insurance broker nameLANA WILHITE
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered202
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $16,737
Total amount of fees paid to insurance companyUSD $590
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHEALTH AND ACCIDENT
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 $123,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $197
Amount paid for insurance broker fees34
Additional information about fees paid to insurance brokerBONUS AND NON-CASH INCENTIVES
Insurance broker organization code?3
Insurance broker nameLANA L WIHITE LLC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered214
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $16,570
Total amount of fees paid to insurance companyUSD $791
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHEALTH AND ACCIDENT
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 $120,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1
Amount paid for insurance broker fees17
Additional information about fees paid to insurance brokerBONUS AND NON-CASH INCENTIVE
Insurance broker organization code?3
Insurance broker nameLANA L WILHITE LLC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered223
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $14,064
Total amount of fees paid to insurance companyUSD $884
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHEALTH AND ACCIDENT
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 $122,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,973
Amount paid for insurance broker fees262
Additional information about fees paid to insurance brokerBONUS AND NON-CASH INCENTIVES
Insurance broker organization code?3
Insurance broker nameASSURANCE AGENCY LTD
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered230
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $16,490
Total amount of fees paid to insurance companyUSD $1,054
Other welfare benefits providedHEALTH AND ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $138,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,892
Amount paid for insurance broker fees338
Additional information about fees paid to insurance brokerBONUS AND NON-CASH INCENTIVES
Insurance broker organization code?3
Insurance broker nameRON BOWLING
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered254
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $15,255
Total amount of fees paid to insurance companyUSD $1,041
Other welfare benefits providedHEALTH AND ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $133,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7184054
Policy instance 1
Insurance contract or identification numberE7184054
Number of Individuals Covered256
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $14,116
Total amount of fees paid to insurance companyUSD $883
Other welfare benefits providedHEALTH AND ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $130,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,064
Amount paid for insurance broker fees250
Additional information about fees paid to insurance brokerBONUS AND NON-CASH INCENTIVES
Insurance broker organization code?3
Insurance broker nameRON BOWLING

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