W. L. GORE & ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.
Additional information about W. L. GORE & ASSOCIATES, INC.
Submission information for form 5500 for 401k plan W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES
401k plan membership statisitcs for W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES
Measure | Date | Value |
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2018: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 6,377 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 6,755 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 174 |
Total of all active and inactive participants | 2018-01-01 | 6,929 |
2017: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 6,468 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 6,066 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 311 |
Total of all active and inactive participants | 2017-01-01 | 6,377 |
2016: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 6,623 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 6,310 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 158 |
Total of all active and inactive participants | 2016-01-01 | 6,468 |
2015: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 6,627 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 6,516 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 107 |
Total of all active and inactive participants | 2015-01-01 | 6,623 |
2014: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 6,426 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 6,521 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 106 |
Total of all active and inactive participants | 2014-01-01 | 6,627 |
2013: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 5,848 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 6,306 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 120 |
Total of all active and inactive participants | 2013-01-01 | 6,426 |
2012: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 5,975 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 5,717 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 131 |
Total of all active and inactive participants | 2012-01-01 | 5,848 |
2011: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 5,747 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 5,975 |
Total of all active and inactive participants | 2011-01-01 | 5,975 |
2009: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 5,823 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 5,687 |
Total of all active and inactive participants | 2009-01-01 | 5,687 |
2018: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Submission has been amended | Yes |
2018-01-01 | This submission is the final filing | Yes |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: W.L. GORE & ASSOCIATES, INC. AD & D PLAN FOR EMPLOYEES 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Submission has been amended | Yes |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 ) |
Policy contract number | 4EL-6043-18 |
Policy instance | 4 |
Insurance contract or identification number | 4EL-6043-18 | Number of Individuals Covered | 6755 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $647 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,311 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $647 | Insurance broker organization code? | 3 |
|
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 9065263 |
Policy instance | 3 |
Insurance contract or identification number | GTP 9065263 | Number of Individuals Covered | 6755 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,167 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,667 | 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 | Insurance broker organization code? | 3 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12294080 |
Policy instance | 2 |
Insurance contract or identification number | 12294080 | Number of Individuals Covered | 5021 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 334589 |
Policy instance | 1 |
Insurance contract or identification number | 334589 | Number of Individuals Covered | 10508 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $629,308 | Total amount of fees paid to insurance company | USD $87,404 | 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 $6,422,217 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $629,308 | Amount paid for insurance broker fees | 87404 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12294080 |
Policy instance | 2 |
Insurance contract or identification number | 12294080 | Number of Individuals Covered | 4589 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 9065263 |
Policy instance | 3 |
Insurance contract or identification number | GTP 9065263 | Number of Individuals Covered | 6066 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,203 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,812 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,203 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS LLC |
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FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 ) |
Policy contract number | 4EL-6043-17 |
Policy instance | 4 |
Insurance contract or identification number | 4EL-6043-17 | Number of Individuals Covered | 6066 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $266 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,776 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $266 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS LLC (CHICA |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 334589 |
Policy instance | 1 |
Insurance contract or identification number | 334589 | Number of Individuals Covered | 6313 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $621,155 | Total amount of fees paid to insurance company | USD $86,272 | 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 $6,880,181 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $621,155 | Amount paid for insurance broker fees | 86272 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS - PHI |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 334589 |
Policy instance | 1 |
Insurance contract or identification number | 334589 | Number of Individuals Covered | 6516 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $646,285 | Total amount of fees paid to insurance company | USD $68,922 | 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 $5,995,050 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $375,116 | Amount paid for insurance broker fees | 31260 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS - PHI |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12294080 |
Policy instance | 2 |
Insurance contract or identification number | 12294080 | Number of Individuals Covered | 4541 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 9065263 |
Policy instance | 3 |
Insurance contract or identification number | GTP 9065263 | Number of Individuals Covered | 6516 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $282 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,022 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $282 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS LLC THREE |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12294080 |
Policy instance | 2 |
Insurance contract or identification number | 12294080 | Number of Individuals Covered | 4469 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $928,983 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 334589 |
Policy instance | 1 |
Insurance contract or identification number | 334589 | Number of Individuals Covered | 6521 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $913,937 | Total amount of fees paid to insurance company | USD $76,161 | 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 $6,092,914 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $913,937 | Amount paid for insurance broker fees | 76161 | Insurance broker organization code? | 5 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 9065263 |
Policy instance | 3 |
Insurance contract or identification number | GTP 9065263 | Number of Individuals Covered | 6521 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $947 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,310 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 947 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
|
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 9065263 |
Policy instance | 3 |
Insurance contract or identification number | GTP 9065263 | Number of Individuals Covered | 6306 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $947 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,310 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $947 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12294080 |
Policy instance | 2 |
Insurance contract or identification number | 12294080 | Number of Individuals Covered | 4284 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 334589 |
Policy instance | 1 |
Insurance contract or identification number | 334589 | Number of Individuals Covered | 6306 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $775,299 | Total amount of fees paid to insurance company | USD $64,608 | 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 $5,168,660 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $775,299 | Amount paid for insurance broker fees | 64608 | Insurance broker organization code? | 5 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 334589 |
Policy instance | 1 |
Insurance contract or identification number | 334589 | Number of Individuals Covered | 5762 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $745,374 | Total amount of fees paid to insurance company | USD $62,114 | 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 $4,969,160 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $745,374 | Amount paid for insurance broker fees | 62114 | Insurance broker organization code? | 5 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 9065263 |
Policy instance | 3 |
Insurance contract or identification number | GTP 9065263 | Number of Individuals Covered | 5717 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $1,690 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,267 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,690 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12294080 |
Policy instance | 2 |
Insurance contract or identification number | 12294080 | Number of Individuals Covered | 3814 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 9065263 |
Policy instance | 3 |
Insurance contract or identification number | GTP 9065263 | Number of Individuals Covered | 5975 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,002 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,683 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12294080 |
Policy instance | 2 |
Insurance contract or identification number | 12294080 | Number of Individuals Covered | 3835 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 334589 |
Policy instance | 1 |
Insurance contract or identification number | 334589 | Number of Individuals Covered | 5929 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2012-01-01 | Total amount of commissions paid to insurance broker | USD $645,019 | Total amount of fees paid to insurance company | USD $53,752 | 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 $4,300,128 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 9065263 |
Policy instance | 3 |
Insurance contract or identification number | GTP 9065263 | Number of Individuals Covered | 5747 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $1,394 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,290 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 334589 |
Policy instance | 1 |
Insurance contract or identification number | 334589 | Number of Individuals Covered | 5747 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2011-01-01 | Total amount of commissions paid to insurance broker | USD $624,971 | Total amount of fees paid to insurance company | USD $58,836 | 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 $5,240,842 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12294080 |
Policy instance | 2 |
Insurance contract or identification number | 12294080 | Number of Individuals Covered | 3543 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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