M.B. HAYNES CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN
401k plan membership statisitcs for M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN
| Measure | Date | Value |
|---|
| 2021: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-09-01 | 501 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 503 |
| Number of retired or separated participants receiving benefits | 2021-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2021-09-01 | 0 |
| Total of all active and inactive participants | 2021-09-01 | 504 |
| 2020: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-01 | 489 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 502 |
| Number of retired or separated participants receiving benefits | 2020-09-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2020-09-01 | 0 |
| Total of all active and inactive participants | 2020-09-01 | 509 |
| 2019: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 591 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 496 |
| Number of retired or separated participants receiving benefits | 2019-09-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2019-09-01 | 0 |
| Total of all active and inactive participants | 2019-09-01 | 503 |
| 2018: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 599 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 587 |
| Number of retired or separated participants receiving benefits | 2018-09-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2018-09-01 | 0 |
| Total of all active and inactive participants | 2018-09-01 | 592 |
| 2017: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 595 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 614 |
| Number of retired or separated participants receiving benefits | 2017-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-09-01 | 0 |
| Total of all active and inactive participants | 2017-09-01 | 614 |
| 2016: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 526 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 595 |
| Number of retired or separated participants receiving benefits | 2016-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 0 |
| Total of all active and inactive participants | 2016-09-01 | 595 |
| 2015: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 505 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 526 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 527 |
| 2014: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 454 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 514 |
| Number of retired or separated participants receiving benefits | 2014-09-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2014-09-01 | 0 |
| Total of all active and inactive participants | 2014-09-01 | 516 |
| 2013: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-09-01 | 423 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 450 |
| Number of retired or separated participants receiving benefits | 2013-09-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2013-09-01 | 0 |
| Total of all active and inactive participants | 2013-09-01 | 452 |
| 2012: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-09-01 | 414 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 423 |
| Number of retired or separated participants receiving benefits | 2012-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-09-01 | 0 |
| Total of all active and inactive participants | 2012-09-01 | 423 |
| 2010: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-09-01 | 418 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-09-01 | 449 |
| Number of retired or separated participants receiving benefits | 2010-09-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2010-09-01 | 0 |
| Total of all active and inactive participants | 2010-09-01 | 453 |
| 2009: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 427 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 403 |
| Number of retired or separated participants receiving benefits | 2009-09-01 | 17 |
| Number of other retired or separated participants entitled to future benefits | 2009-09-01 | 0 |
| Total of all active and inactive participants | 2009-09-01 | 420 |
| 2021: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2021 form 5500 responses |
|---|
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2020 form 5500 responses |
|---|
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2019 form 5500 responses |
|---|
| 2019-09-01 | Type of plan entity | Single employer plan |
| 2019-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2018 form 5500 responses |
|---|
| 2018-09-01 | Type of plan entity | Single employer plan |
| 2018-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2017 form 5500 responses |
|---|
| 2017-09-01 | Type of plan entity | Single employer plan |
| 2017-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2016 form 5500 responses |
|---|
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2015 form 5500 responses |
|---|
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2014 form 5500 responses |
|---|
| 2014-09-01 | Type of plan entity | Single employer plan |
| 2014-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2013 form 5500 responses |
|---|
| 2013-09-01 | Type of plan entity | Single employer plan |
| 2013-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2012 form 5500 responses |
|---|
| 2012-09-01 | Type of plan entity | Single employer plan |
| 2012-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2010 form 5500 responses |
|---|
| 2010-09-01 | Type of plan entity | Single employer plan |
| 2010-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: M.B. HAYNES CORPORATION MEDICAL AND DENTAL CARE PLAN 2009 form 5500 responses |
|---|
| 2009-09-01 | Type of plan entity | Single employer plan |
| 2009-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 509 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $23,674 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $355,835 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,674 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010SSLS |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010SSLS | | Number of Individuals Covered | 504 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $521,703 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 475 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $24,342 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $369,978 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,342 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010SSLS |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010SSLS | | Number of Individuals Covered | 516 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $529,253 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010SSLS |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010SSLS | | Number of Individuals Covered | 502 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $458,859 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 584 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $27,126 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $408,471 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,126 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010SSLS |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010SSLS | | Number of Individuals Covered | 586 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $488,174 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 599 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $11,308 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $171,712 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,308 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010 SSL |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010 SSL | | Number of Individuals Covered | 593 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $401,725 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 601 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $26,204 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $390,769 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 529 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $41,418 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $533,392 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,418 | | Insurance broker organization code? | 3 | | Insurance broker name | INSURANCE SERVICE OF ASHEVILLE |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010 SSL |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010 SSL | | Number of Individuals Covered | 527 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $355,930 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010 SSL |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010 SSL | | Number of Individuals Covered | 498 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $291,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 514 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $37,282 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $473,287 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,282 | | Insurance broker organization code? | 3 | | Insurance broker name | INSURANCE SERVICE OF ASHEVILLE |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010 SSL |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010 SSL | | Number of Individuals Covered | 433 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $292,934 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 452 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $34,094 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $430,210 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,094 | | Insurance broker organization code? | 3 | | Insurance broker name | INSURANCE SERVICE OF ASHEVILLE |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 423 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $32,984 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $415,543 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,984 | | Insurance broker organization code? | 3 | | Insurance broker name | INSURANCE SERVICE OF ASHEVILLE |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010 SLA |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010 SLA | | Number of Individuals Covered | 419 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $250,428 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 402092 0010 SLA |
| Policy instance | 1 |
| Insurance contract or identification number | 402092 0010 SLA | | Number of Individuals Covered | 453 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $251,566 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | G 00607439 |
| Policy instance | 2 |
| Insurance contract or identification number | G 00607439 | | Number of Individuals Covered | 458 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $32,119 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $402,742 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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