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REPLANET HOLDINGS, INC EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameREPLANET HOLDINGS, INC EMPLOYEE BENEFIT PLAN
Plan identification number 501

REPLANET HOLDINGS, INC EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    REPLANET HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

    Company Name:REPLANET HOLDINGS, INC.
    Employer identification number (EIN):464050037
    NAIC Classification:423930
    NAIC Description:Recyclable Material Merchant Wholesalers

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan REPLANET HOLDINGS, INC EMPLOYEE BENEFIT PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5012019-05-01DAVID LAWRENCE2020-09-16
    5012018-05-01DAVID LAWRENCE2019-09-10
    5012017-05-01
    5012016-05-01
    5012015-05-01

    Plan Statistics for REPLANET HOLDINGS, INC EMPLOYEE BENEFIT PLAN

    401k plan membership statisitcs for REPLANET HOLDINGS, INC EMPLOYEE BENEFIT PLAN

    Measure Date Value
    2019
    Total participants, beginning-of-year2019-05-01657
    Total number of active participants reported on line 7a of the Form 55002019-05-010
    Number of retired or separated participants receiving benefits2019-05-010
    Number of other retired or separated participants entitled to future benefits2019-05-010
    Total of all active and inactive participants2019-05-010
    Number of employers contributing to the scheme2019-05-010
    2018
    Total participants, beginning-of-year2018-05-01758
    Total number of active participants reported on line 7a of the Form 55002018-05-01749
    Number of retired or separated participants receiving benefits2018-05-010
    Number of other retired or separated participants entitled to future benefits2018-05-010
    Total of all active and inactive participants2018-05-01749
    Number of employers contributing to the scheme2018-05-010
    2017
    Total participants, beginning-of-year2017-05-01874
    Total number of active participants reported on line 7a of the Form 55002017-05-01758
    Number of retired or separated participants receiving benefits2017-05-010
    Number of other retired or separated participants entitled to future benefits2017-05-010
    Total of all active and inactive participants2017-05-01758
    2016
    Total participants, beginning-of-year2016-05-01695
    Total number of active participants reported on line 7a of the Form 55002016-05-01874
    Number of retired or separated participants receiving benefits2016-05-010
    Number of other retired or separated participants entitled to future benefits2016-05-010
    Total of all active and inactive participants2016-05-01874
    2015
    Total participants, beginning-of-year2015-05-01945
    Total number of active participants reported on line 7a of the Form 55002015-05-01695
    Number of retired or separated participants receiving benefits2015-05-013
    Number of other retired or separated participants entitled to future benefits2015-05-010
    Total of all active and inactive participants2015-05-01698

    Form 5500 Responses

    2019
    2019-05-01Type of plan entitySingle employer plan
    2019-05-01This submission is the final filingYes
    2019-05-01Plan funding arrangement – InsuranceYes
    2019-05-01Plan benefit arrangement – InsuranceYes
    2018
    2018-05-01Type of plan entitySingle employer plan
    2018-05-01Plan funding arrangement – InsuranceYes
    2018-05-01Plan benefit arrangement – InsuranceYes
    2017
    2017-05-01Type of plan entitySingle employer plan
    2017-05-01Plan funding arrangement – InsuranceYes
    2017-05-01Plan funding arrangement – General assets of the sponsorYes
    2017-05-01Plan benefit arrangement – InsuranceYes
    2017-05-01Plan benefit arrangement – General assets of the sponsorYes
    2016
    2016-05-01Type of plan entitySingle employer plan
    2016-05-01Submission has been amendedNo
    2016-05-01This submission is the final filingNo
    2016-05-01This return/report is a short plan year return/report (less than 12 months)No
    2016-05-01Plan is a collectively bargained planNo
    2016-05-01Plan funding arrangement – InsuranceYes
    2016-05-01Plan benefit arrangement – InsuranceYes
    2015
    2015-05-01Type of plan entitySingle employer plan
    2015-05-01Submission has been amendedNo
    2015-05-01This submission is the final filingNo
    2015-05-01This return/report is a short plan year return/report (less than 12 months)No
    2015-05-01Plan is a collectively bargained planNo
    2015-05-01Plan funding arrangement – InsuranceYes
    2015-05-01Plan funding arrangement – General assets of the sponsorYes
    2015-05-01Plan benefit arrangement – InsuranceYes
    2015-05-01Plan benefit arrangement – General assets of the sponsorYes

    Insurance Providers Used on plan

    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberSGM603949
    Policy instance 3
    Insurance contract or identification numberSGM603949
    Number of Individuals Covered657
    Insurance policy start date2019-05-01
    Insurance policy end date2020-04-30
    Total amount of commissions paid to insurance brokerUSD $8,996
    Total amount of fees paid to insurance companyUSD $1,697
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $59,976
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $7,934
    Amount paid for insurance broker fees1697
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker organization code?3
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number231686
    Policy instance 2
    Insurance contract or identification number231686
    Number of Individuals Covered152
    Insurance policy start date2019-05-01
    Insurance policy end date2020-04-30
    Total amount of commissions paid to insurance brokerUSD $38,365
    Total amount of fees paid to insurance companyUSD $332
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $692,301
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $28,266
    Amount paid for insurance broker fees249
    Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
    Insurance broker organization code?3
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number231686HNO
    Policy instance 1
    Insurance contract or identification number231686HNO
    Number of Individuals Covered66
    Insurance policy start date2019-05-01
    Insurance policy end date2020-04-30
    Total amount of commissions paid to insurance brokerUSD $50,942
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,105,518
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $45,450
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberSGM603949
    Policy instance 3
    Insurance contract or identification numberSGM603949
    Number of Individuals Covered749
    Insurance policy start date2018-05-01
    Insurance policy end date2019-04-30
    Total amount of commissions paid to insurance brokerUSD $19,217
    Total amount of fees paid to insurance companyUSD $695
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $128,112
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number231686
    Policy instance 2
    Insurance contract or identification number231686
    Number of Individuals Covered778
    Insurance policy start date2018-05-01
    Insurance policy end date2019-04-30
    Total amount of commissions paid to insurance brokerUSD $58,437
    Total amount of fees paid to insurance companyUSD $26
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,096,000
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number231686HNO
    Policy instance 1
    Insurance contract or identification number231686HNO
    Number of Individuals Covered509
    Insurance policy start date2018-05-01
    Insurance policy end date2019-04-30
    Total amount of commissions paid to insurance brokerUSD $103,035
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $2,654,868
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberSGM603949
    Policy instance 3
    Insurance contract or identification numberSGM603949
    Number of Individuals Covered758
    Insurance policy start date2017-05-01
    Insurance policy end date2018-04-30
    Total amount of commissions paid to insurance brokerUSD $22,758
    Total amount of fees paid to insurance companyUSD $3,141
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $151,720
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $19,744
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker nameHUB INTERNATIONAL INS. SVCES., INC.
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number0231686
    Policy instance 2
    Insurance contract or identification number0231686
    Number of Individuals Covered758
    Insurance policy start date2017-05-01
    Insurance policy end date2018-04-30
    Total amount of commissions paid to insurance brokerUSD $54,620
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,033,694
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $54,620
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameTOLMAN & WIKER INS. SERVICES, LLC
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number0231686
    Policy instance 1
    Insurance contract or identification number0231686
    Number of Individuals Covered502
    Insurance policy start date2017-05-01
    Insurance policy end date2018-04-30
    Total amount of commissions paid to insurance brokerUSD $71,550
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,828,907
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $71,550
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameTOLMAN & WIKER INS. SERVICES, LLC
    KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number258756
    Policy instance 9
    Insurance contract or identification number258756
    Number of Individuals Covered90
    Insurance policy start date2014-12-01
    Insurance policy end date2015-11-30
    Total amount of commissions paid to insurance brokerUSD $18,556
    Total amount of fees paid to insurance companyUSD $229
    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 BenefitYes
    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
    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 $478,222
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $18,556
    Amount paid for insurance broker fees229
    Additional information about fees paid to insurance brokerBONUS
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL OF CALIFORNIA
    CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 )
    Policy contract number0608495
    Policy instance 8
    Insurance contract or identification number0608495
    Number of Individuals Covered1
    Insurance policy start date2015-05-01
    Insurance policy end date2016-04-30
    Total amount of commissions paid to insurance brokerUSD $22
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    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 $220
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $22
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL
    CIGNA DENTAL HEALTH OF CALIFORNIA,INC (National Association of Insurance Commissioners NAIC id number: NA )
    Policy contract number0608495
    Policy instance 7
    Insurance contract or identification number0608495
    Number of Individuals Covered20
    Insurance policy start date2015-05-01
    Insurance policy end date2016-04-30
    Total amount of commissions paid to insurance brokerUSD $7,509
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    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 $75,091
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $7,509
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL
    CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
    Policy contract number0608495
    Policy instance 6
    Insurance contract or identification number0608495
    Number of Individuals Covered589
    Insurance policy start date2015-05-01
    Insurance policy end date2016-04-30
    Total amount of commissions paid to insurance brokerUSD $41,579
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    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 $419,272
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $41,579
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberLK 751621
    Policy instance 5
    Insurance contract or identification numberLK 751621
    Number of Individuals Covered912
    Insurance policy start date2015-05-01
    Insurance policy end date2016-04-30
    Total amount of commissions paid to insurance brokerUSD $4,959
    Total amount of fees paid to insurance companyUSD $1,060
    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 providedSHORT TERM DISABILITY
    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 $33,060
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,959
    Amount paid for insurance broker fees1060
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL OF CALI
    CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
    Policy contract number00608495
    Policy instance 4
    Insurance contract or identification number00608495
    Number of Individuals Covered684
    Insurance policy start date2015-05-01
    Insurance policy end date2016-04-30
    Total amount of commissions paid to insurance brokerUSD $182,801
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    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
    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 $1,374,869
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $182,801
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberSGD603923
    Policy instance 3
    Insurance contract or identification numberSGD603923
    Number of Individuals Covered912
    Insurance policy start date2015-05-01
    Insurance policy end date2016-04-30
    Total amount of commissions paid to insurance brokerUSD $11,271
    Total amount of fees paid to insurance companyUSD $119
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $75,143
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $11,271
    Amount paid for insurance broker fees119
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL OF CALI
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberSGM603949
    Policy instance 2
    Insurance contract or identification numberSGM603949
    Number of Individuals Covered912
    Insurance policy start date2015-05-01
    Insurance policy end date2016-04-30
    Total amount of commissions paid to insurance brokerUSD $11,956
    Total amount of fees paid to insurance companyUSD $234
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare 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 $79,706
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $11,956
    Amount paid for insurance broker fees234
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL OF CALI
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberSOK602572
    Policy instance 1
    Insurance contract or identification numberSOK602572
    Number of Individuals Covered912
    Insurance policy start date2015-05-01
    Insurance policy end date2016-04-30
    Total amount of commissions paid to insurance brokerUSD $1,657
    Total amount of fees paid to insurance companyUSD $11
    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 providedACCIDENTAL DEATH
    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 $11,050
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,657
    Amount paid for insurance broker fees11
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker organization code?3
    Insurance broker nameHUB INTERNATIONAL OF CALI

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