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CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 401k Plan overview

Plan NameCRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN
Plan identification number 508

CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN Benefits

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

401k Sponsoring company profile

CRUTCHFIELD CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:CRUTCHFIELD CORPORATION
Employer identification number (EIN):540960335
NAIC Classification:443142
NAIC Description:Electronics Stores

Additional information about CRUTCHFIELD CORPORATION

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1974-02-26
Company Identification Number: 0151069
Legal Registered Office Address: 1 CRUTCHFIELD PK
P.O. CALLER 1
CHARLOTTESVILLE
United States of America (USA)
22911

More information about CRUTCHFIELD CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5082021-10-01
5082020-10-01
5082019-10-01
5082018-10-01
5082017-10-01
5082016-10-01RICHARD STAVITSKI RICHARD STAVITSKI2018-04-25
5082015-10-01RICHARD STAVITSKI RICHARD STAVITSKI2017-04-25
5082014-10-01RICHARD STAVITSKI RICHARD STAVITSKI2016-04-27
5082013-10-01RICHARD STAVITSKI RICHARD STAVITSKI2015-04-28
5082012-10-01RICHARD STAVITSKI RICHARD STAVITSKI2014-04-18
5082011-10-01RICHARD STAVITSKI RICHARD STAVITSKI2013-04-29
5082009-10-01RICHARD STAVITSKI RICHARD STAVITSKI2011-04-26
5082009-10-01RICHARD STAVITSKI RICHARD STAVITSKI2011-04-26

Plan Statistics for CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN

401k plan membership statisitcs for CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN

Measure Date Value
2021: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01444
Total number of active participants reported on line 7a of the Form 55002021-10-01442
Total of all active and inactive participants2021-10-01442
Total participants2021-10-01442
2020: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01411
Total number of active participants reported on line 7a of the Form 55002020-10-01419
Total of all active and inactive participants2020-10-01419
Total participants2020-10-01419
2019: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01411
Total number of active participants reported on line 7a of the Form 55002019-10-01411
Total of all active and inactive participants2019-10-01411
Total participants2019-10-01411
2018: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01386
Total number of active participants reported on line 7a of the Form 55002018-10-01563
Total of all active and inactive participants2018-10-01563
Total participants2018-10-01563
2017: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01370
Total number of active participants reported on line 7a of the Form 55002017-10-01386
Total of all active and inactive participants2017-10-01386
Total participants2017-10-01386
2016: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01387
Total number of active participants reported on line 7a of the Form 55002016-10-01370
Total of all active and inactive participants2016-10-01370
Total participants2016-10-01370
2015: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01377
Total number of active participants reported on line 7a of the Form 55002015-10-01372
Total of all active and inactive participants2015-10-01372
Total participants2015-10-01372
2014: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01392
Total number of active participants reported on line 7a of the Form 55002014-10-01385
Total of all active and inactive participants2014-10-01385
Total participants2014-10-01385
2013: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01378
Total number of active participants reported on line 7a of the Form 55002013-10-01390
Total of all active and inactive participants2013-10-01390
Total participants2013-10-01390
2012: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01466
Total number of active participants reported on line 7a of the Form 55002012-10-01378
Total of all active and inactive participants2012-10-01378
Total participants2012-10-01378
2011: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01357
Total number of active participants reported on line 7a of the Form 55002011-10-01466
Total of all active and inactive participants2011-10-01466
Total participants2011-10-01466
2009: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-010
Total number of active participants reported on line 7a of the Form 55002009-10-01362
Total of all active and inactive participants2009-10-01362
Total participants2009-10-01362

Form 5500 Responses for CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN

2021: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes
2020: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Submission has been amendedNo
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planNo
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2009: CRUTCHFIELD CORPORATION WEEKLY DISABILITY INCOME INSURANCE PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01First time form 5500 has been submittedYes
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT963264
Policy instance 1
Insurance contract or identification numberVDT963264
Number of Individuals Covered444
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $3,528
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $63,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,528
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered539
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $8,584
Total amount of fees paid to insurance companyUSD $1,408
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $64,677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,584
Amount paid for insurance broker fees1408
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered538
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $8,281
Total amount of fees paid to insurance companyUSD $1,354
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $73,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,281
Amount paid for insurance broker fees1354
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered563
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $7,643
Total amount of fees paid to insurance companyUSD $1,255
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $62,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,643
Amount paid for insurance broker fees1255
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered386
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $7,423
Total amount of fees paid to insurance companyUSD $1,224
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $61,218
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 number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered377
Total amount of commissions paid to insurance brokerUSD $7,313
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 BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $51,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,313
Insurance broker nameDIGITIAL INSURANCE, INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered385
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $6,340
Total amount of fees paid to insurance companyUSD $949
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 BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $51,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $514
Amount paid for insurance broker fees949
Insurance broker nameDIGITAL INSURANCE, INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered390
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $10,970
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 BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $51,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,970
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Insurance broker nameCHARLES L BONES
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered378
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $3,867
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 BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $53,835
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,867
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Insurance broker nameCHARLES L. BONES
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number096887
Policy instance 1
Insurance contract or identification number096887
Number of Individuals Covered466
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $4,328
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,247
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 number000010120492000
Policy instance 1
Insurance contract or identification number000010120492000
Number of Individuals Covered357
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $6,977
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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