G.O. CORPORATION INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan G.O. FRESH WELFARE BENEFIT PLAN
401k plan membership statisitcs for G.O. FRESH WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2021: G.O. FRESH WELFARE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 122 |
| Total of all active and inactive participants | 2021-07-01 | 122 |
| 2020: G.O. FRESH WELFARE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 114 |
| Total of all active and inactive participants | 2020-09-01 | 114 |
| 2019: G.O. FRESH WELFARE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 0 |
| Total of all active and inactive participants | 2019-09-01 | 0 |
| 2018: G.O. FRESH WELFARE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 129 |
| Total of all active and inactive participants | 2018-09-01 | 129 |
| 2017: G.O. FRESH WELFARE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 118 |
| Total of all active and inactive participants | 2017-09-01 | 118 |
| 2016: G.O. FRESH WELFARE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 120 |
| Total of all active and inactive participants | 2016-09-01 | 120 |
| 2015: G.O. FRESH WELFARE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 115 |
| Total of all active and inactive participants | 2015-09-01 | 115 |
| 2014: G.O. FRESH WELFARE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 116 |
| Total of all active and inactive participants | 2014-09-01 | 116 |
| 2013: G.O. FRESH WELFARE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-09-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 119 |
| Total of all active and inactive participants | 2013-09-01 | 119 |
| 2012: G.O. FRESH WELFARE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-09-01 | 122 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 118 |
| Total of all active and inactive participants | 2012-09-01 | 118 |
| 2011: G.O. FRESH WELFARE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-09-01 | 113 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 122 |
| Total of all active and inactive participants | 2011-09-01 | 122 |
| 2009: G.O. FRESH WELFARE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 130 |
| Total of all active and inactive participants | 2009-09-01 | 130 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 933634 |
| Policy instance | 2 |
| Insurance contract or identification number | 933634 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $3,641 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,394 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,348 | | Insurance broker organization code? | 3 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PKA20083 |
| Policy instance | 1 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 81 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $42,972 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $347,726 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,100 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 933634 |
| Policy instance | 2 |
| Insurance contract or identification number | 933634 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $3,518 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,518 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,626 | | Insurance broker organization code? | 3 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PKA20083 |
| Policy instance | 1 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $19,928 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $249,866 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,000 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PKA20083 |
| Policy instance | 1 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $20,400 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $297,608 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,400 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 879788 |
| Policy instance | 2 |
| Insurance contract or identification number | 879788 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $1,994 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEALTH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $18,242 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,994 | | Insurance broker organization code? | 3 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PKA20083 |
| Policy instance | 1 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $30,600 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $305,818 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,600 | | Insurance broker organization code? | 3 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PKA20083 |
| Policy instance | 1 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $22,015 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $341,570 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,600 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 879788 |
| Policy instance | 2 |
| Insurance contract or identification number | 879788 | | Number of Individuals Covered | 118 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $2,745 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEALTH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $19,610 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,426 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-06-30 | | Total amount of commissions paid to insurance broker | USD $413 | | Total amount of fees paid to insurance company | USD $20 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,570 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $413 | | Amount paid for insurance broker fees | 20 | | Insurance broker organization code? | 3 |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) |
| Policy contract number | 29479 |
| Policy instance | 4 |
| Insurance contract or identification number | 29479 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-06-30 | | Total amount of commissions paid to insurance broker | USD $1,416 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,404 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,416 | | Insurance broker organization code? | 3 |
|
| PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 ) |
| Policy contract number | PKA20083 |
| Policy instance | 1 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-06-30 | | Total amount of commissions paid to insurance broker | USD $19,285 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $417,998 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,285 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146715 00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010146715 00 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-06-30 | | Total amount of commissions paid to insurance broker | USD $634 | | Total amount of fees paid to insurance company | USD $23 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,172 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $634 | | Amount paid for insurance broker fees | 23 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146716 00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010146716 00 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $1,077 | | Total amount of fees paid to insurance company | USD $65 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $11,967 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,077 | | Amount paid for insurance broker fees | 65 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GROUP |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146715 00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010146715 00 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $604 | | Total amount of fees paid to insurance company | USD $17 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,021 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $604 | | Amount paid for insurance broker fees | 17 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GRP LLC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $370 | | Total amount of fees paid to insurance company | USD $12 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,467 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $370 | | Amount paid for insurance broker fees | 12 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GRP LLC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $379 | | Total amount of fees paid to insurance company | USD $12 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,528 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $379 | | Amount paid for insurance broker fees | 12 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GROUP |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) |
| Policy contract number | 29479 |
| Policy instance | 5 |
| Insurance contract or identification number | 29479 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $33,000 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $310,430 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $33,000 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GROUP |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) |
| Policy contract number | 29479 |
| Policy instance | 5 |
| Insurance contract or identification number | 29479 | | Number of Individuals Covered | 177 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $32,675 | | Total amount of fees paid to insurance company | USD $6,884 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $542,793 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,675 | | Amount paid for insurance broker fees | 6884 | | Insurance broker organization code? | 3 | | Insurance broker name | ERIK HINZ |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $372 | | Total amount of fees paid to insurance company | USD $71 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,478 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $372 | | Amount paid for insurance broker fees | 71 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GROUP |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146716 00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010146716 00 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $1,167 | | Total amount of fees paid to insurance company | USD $376 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $12,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,167 | | Amount paid for insurance broker fees | 376 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GROUP |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146715 00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010146715 00 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $740 | | Total amount of fees paid to insurance company | USD $110 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,701 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $740 | | Amount paid for insurance broker fees | 110 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GROUP |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $372 | | Total amount of fees paid to insurance company | USD $71 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,482 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $372 | | Amount paid for insurance broker fees | 71 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSOCIATED FINANCIAL GRP LLC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 119 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $336 | | Total amount of fees paid to insurance company | USD $64 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $279 | | Amount paid for insurance broker fees | 24 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| PREFERREDONE COMMUNITY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95724 ) |
| Policy contract number | PKA20083 |
| Policy instance | 1 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 179 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $15,620 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $654,711 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,750 | | Insurance broker name | ASSOCIATED FINANCIAL GROUP |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146716 00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010146716 00 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $1,313 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $14,585 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,313 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146715 00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010146715 00 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $855 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,277 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $855 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| PREFERREDONE COMMUNITY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95724 ) |
| Policy contract number | PKA20083 |
| Policy instance | 1 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $15,000 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $634,295 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,000 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA, |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 118 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $337 | | Total amount of fees paid to insurance company | USD $18 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,248 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $337 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 18 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $58 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $58 | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146715 00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010146715 00 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $129 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $643 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $129 | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146716 00 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010146716 00 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $201 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $2,230 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $201 | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146716 00 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010146716 00 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $1,161 | | Total amount of fees paid to insurance company | USD $105 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $12,896 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H01360 |
| Policy instance | 1 |
| Insurance contract or identification number | H01360 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $223 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,028 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PREFERREDONE COMMUNITY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95724 ) |
| Policy contract number | PKA20083 |
| Policy instance | 2 |
| Insurance contract or identification number | PKA20083 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $18,750 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $612,107 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146714 00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010146714 00 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $325 | | Total amount of fees paid to insurance company | USD $18 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010146715 00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010146715 00 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $745 | | Total amount of fees paid to insurance company | USD $33 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,722 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H01360 |
| Policy instance | 1 |
| Insurance contract or identification number | H01360 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $2,385 | | Total amount of fees paid to insurance company | USD $171 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,240 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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