WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN
401k plan membership statisitcs for WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN
| Measure | Date | Value |
|---|
| 2021: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-12-01 | 764 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 713 |
| Total of all active and inactive participants | 2021-12-01 | 713 |
| Total participants | 2021-12-01 | 713 |
| 2020: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-01 | 791 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 764 |
| Total of all active and inactive participants | 2020-12-01 | 764 |
| Total participants | 2020-12-01 | 764 |
| 2019: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-01 | 863 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 791 |
| Total of all active and inactive participants | 2019-12-01 | 791 |
| Total participants | 2019-12-01 | 791 |
| 2018: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-01 | 916 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 863 |
| Total of all active and inactive participants | 2018-12-01 | 863 |
| Total participants | 2018-12-01 | 863 |
| 2017: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-01 | 732 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 916 |
| Total of all active and inactive participants | 2017-12-01 | 916 |
| Total participants | 2017-12-01 | 916 |
| 2016: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-12-01 | 638 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 732 |
| Total of all active and inactive participants | 2016-12-01 | 732 |
| Total participants | 2016-12-01 | 732 |
| 2015: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-12-01 | 644 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 638 |
| Total of all active and inactive participants | 2015-12-01 | 638 |
| Total participants | 2015-12-01 | 638 |
| 2014: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-01 | 562 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 644 |
| Total of all active and inactive participants | 2014-12-01 | 644 |
| Total participants | 2014-12-01 | 644 |
| 2013: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-12-01 | 516 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-12-01 | 562 |
| Total of all active and inactive participants | 2013-12-01 | 562 |
| Total participants | 2013-12-01 | 562 |
| 2012: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-12-01 | 679 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-12-01 | 516 |
| Total of all active and inactive participants | 2012-12-01 | 516 |
| Total participants | 2012-12-01 | 516 |
| 2011: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-12-01 | 674 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-12-01 | 679 |
| Total of all active and inactive participants | 2011-12-01 | 679 |
| Total participants | 2011-12-01 | 679 |
| 2010: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-12-01 | 693 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-12-01 | 674 |
| Total of all active and inactive participants | 2010-12-01 | 674 |
| Total participants | 2010-12-01 | 674 |
| 2009: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-12-01 | 645 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-12-01 | 693 |
| Total of all active and inactive participants | 2009-12-01 | 693 |
| Total participants | 2009-12-01 | 693 |
| 2008: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-12-01 | 618 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-12-01 | 645 |
| Total of all active and inactive participants | 2008-12-01 | 645 |
| Total participants | 2008-12-01 | 645 |
| 2007: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-12-01 | 591 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-12-01 | 618 |
| Total of all active and inactive participants | 2007-12-01 | 618 |
| Total participants | 2007-12-01 | 618 |
| 2006: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-12-01 | 725 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-12-01 | 591 |
| Total of all active and inactive participants | 2006-12-01 | 591 |
| Total participants | 2006-12-01 | 591 |
| 2005: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-12-01 | 396 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-12-01 | 725 |
| Total of all active and inactive participants | 2005-12-01 | 725 |
| Total participants | 2005-12-01 | 725 |
| 2004: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-12-01 | 319 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-12-01 | 396 |
| Total of all active and inactive participants | 2004-12-01 | 396 |
| Total participants | 2004-12-01 | 396 |
| 2003: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-12-01 | 229 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-12-01 | 319 |
| Total of all active and inactive participants | 2003-12-01 | 319 |
| Total participants | 2003-12-01 | 319 |
| 2002: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2002 401k membership |
|---|
| Total participants, beginning-of-year | 2002-12-01 | 242 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-12-01 | 229 |
| Total of all active and inactive participants | 2002-12-01 | 229 |
| Total participants | 2002-12-01 | 229 |
| 2001: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2001 401k membership |
|---|
| Total participants, beginning-of-year | 2001-12-01 | 224 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-12-01 | 242 |
| Total of all active and inactive participants | 2001-12-01 | 242 |
| Total participants | 2001-12-01 | 242 |
| 2000: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2000 401k membership |
|---|
| Total participants, beginning-of-year | 2000-12-01 | 180 |
| Total number of active participants reported on line 7a of the Form 5500 | 2000-12-01 | 224 |
| Total of all active and inactive participants | 2000-12-01 | 224 |
| Total participants | 2000-12-01 | 224 |
| 1999: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 1999 401k membership |
|---|
| Total participants, beginning-of-year | 1999-12-01 | 146 |
| Total number of active participants reported on line 7a of the Form 5500 | 1999-12-01 | 180 |
| Total of all active and inactive participants | 1999-12-01 | 180 |
| Total participants | 1999-12-01 | 180 |
| 2021: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2021 form 5500 responses |
|---|
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | Submission has been amended | No |
| 2021-12-01 | This submission is the final filing | No |
| 2021-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-12-01 | Plan is a collectively bargained plan | No |
| 2021-12-01 | Plan funding arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2020 form 5500 responses |
|---|
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | Submission has been amended | No |
| 2020-12-01 | This submission is the final filing | No |
| 2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-12-01 | Plan is a collectively bargained plan | No |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2019 form 5500 responses |
|---|
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | Submission has been amended | No |
| 2019-12-01 | This submission is the final filing | No |
| 2019-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-12-01 | Plan is a collectively bargained plan | No |
| 2019-12-01 | Plan funding arrangement – Insurance | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2018 form 5500 responses |
|---|
| 2018-12-01 | Type of plan entity | Single employer plan |
| 2018-12-01 | Submission has been amended | No |
| 2018-12-01 | This submission is the final filing | No |
| 2018-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-12-01 | Plan is a collectively bargained plan | No |
| 2018-12-01 | Plan funding arrangement – Insurance | Yes |
| 2018-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2017 form 5500 responses |
|---|
| 2017-12-01 | Type of plan entity | Single employer plan |
| 2017-12-01 | Submission has been amended | No |
| 2017-12-01 | This submission is the final filing | No |
| 2017-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-12-01 | Plan is a collectively bargained plan | No |
| 2017-12-01 | Plan funding arrangement – Insurance | Yes |
| 2017-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2016 form 5500 responses |
|---|
| 2016-12-01 | Type of plan entity | Single employer plan |
| 2016-12-01 | Submission has been amended | No |
| 2016-12-01 | This submission is the final filing | No |
| 2016-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-12-01 | Plan is a collectively bargained plan | No |
| 2016-12-01 | Plan funding arrangement – Insurance | Yes |
| 2016-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2015 form 5500 responses |
|---|
| 2015-12-01 | Type of plan entity | Single employer plan |
| 2015-12-01 | Submission has been amended | No |
| 2015-12-01 | This submission is the final filing | No |
| 2015-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-12-01 | Plan is a collectively bargained plan | No |
| 2015-12-01 | Plan funding arrangement – Insurance | Yes |
| 2015-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2014 form 5500 responses |
|---|
| 2014-12-01 | Type of plan entity | Single employer plan |
| 2014-12-01 | Submission has been amended | No |
| 2014-12-01 | This submission is the final filing | No |
| 2014-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-12-01 | Plan is a collectively bargained plan | No |
| 2014-12-01 | Plan funding arrangement – Insurance | Yes |
| 2014-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2013 form 5500 responses |
|---|
| 2013-12-01 | Type of plan entity | Single employer plan |
| 2013-12-01 | Submission has been amended | No |
| 2013-12-01 | This submission is the final filing | No |
| 2013-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-12-01 | Plan is a collectively bargained plan | No |
| 2013-12-01 | Plan funding arrangement – Insurance | Yes |
| 2013-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2012 form 5500 responses |
|---|
| 2012-12-01 | Type of plan entity | Single employer plan |
| 2012-12-01 | Submission has been amended | No |
| 2012-12-01 | This submission is the final filing | No |
| 2012-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-12-01 | Plan is a collectively bargained plan | No |
| 2012-12-01 | Plan funding arrangement – Insurance | Yes |
| 2012-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2011 form 5500 responses |
|---|
| 2011-12-01 | Type of plan entity | Single employer plan |
| 2011-12-01 | Plan funding arrangement – Insurance | Yes |
| 2011-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2010 form 5500 responses |
|---|
| 2010-12-01 | Type of plan entity | Single employer plan |
| 2010-12-01 | Plan funding arrangement – Insurance | Yes |
| 2010-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2009 form 5500 responses |
|---|
| 2009-12-01 | Type of plan entity | Single employer plan |
| 2009-12-01 | Plan funding arrangement – Insurance | Yes |
| 2009-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2008 form 5500 responses |
|---|
| 2008-12-01 | Type of plan entity | Single employer plan |
| 2008-12-01 | Plan funding arrangement – Insurance | Yes |
| 2008-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2007 form 5500 responses |
|---|
| 2007-12-01 | Type of plan entity | Single employer plan |
| 2007-12-01 | Plan funding arrangement – Insurance | Yes |
| 2007-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2006 form 5500 responses |
|---|
| 2006-12-01 | Type of plan entity | Single employer plan |
| 2006-12-01 | Plan funding arrangement – Insurance | Yes |
| 2006-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2005 form 5500 responses |
|---|
| 2005-12-01 | Type of plan entity | Single employer plan |
| 2005-12-01 | Submission has been amended | Yes |
| 2005-12-01 | Plan funding arrangement – Insurance | Yes |
| 2005-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2004 form 5500 responses |
|---|
| 2004-12-01 | Type of plan entity | Single employer plan |
| 2004-12-01 | Submission has been amended | Yes |
| 2004-12-01 | Plan funding arrangement – Insurance | Yes |
| 2004-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2003 form 5500 responses |
|---|
| 2003-12-01 | Type of plan entity | Single employer plan |
| 2003-12-01 | Submission has been amended | Yes |
| 2003-12-01 | Plan funding arrangement – Insurance | Yes |
| 2003-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2002: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2002 form 5500 responses |
|---|
| 2002-12-01 | Type of plan entity | Single employer plan |
| 2002-12-01 | Submission has been amended | Yes |
| 2002-12-01 | Plan funding arrangement – Insurance | Yes |
| 2002-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2001: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2001 form 5500 responses |
|---|
| 2001-12-01 | Type of plan entity | Single employer plan |
| 2001-12-01 | Submission has been amended | Yes |
| 2001-12-01 | Plan funding arrangement – Insurance | Yes |
| 2001-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2000: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 2000 form 5500 responses |
|---|
| 2000-12-01 | Type of plan entity | Single employer plan |
| 2000-12-01 | Submission has been amended | Yes |
| 2000-12-01 | Plan funding arrangement – Insurance | Yes |
| 2000-12-01 | Plan benefit arrangement – Insurance | Yes |
| 1999: WINSTON-SALEM INDUSTRIES FOR THE BLIND, INC. LIFE INSURANCE PLAN 1999 form 5500 responses |
|---|
| 1999-12-01 | Type of plan entity | Single employer plan |
| 1999-12-01 | Plan funding arrangement – Insurance | Yes |
| 1999-12-01 | Plan benefit arrangement – Insurance | Yes |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $12,859 | | Total amount of fees paid to insurance company | USD $876 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $110,794 | | 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 | | Amount paid for insurance broker fees | 186 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5925143 |
| Policy instance | 1 |
| Insurance contract or identification number | 5925143 | | Number of Individuals Covered | 713 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2022-11-30 | | Total amount of commissions paid to insurance broker | USD $17,783 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $175,565 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,783 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5925143 |
| Policy instance | 2 |
| Insurance contract or identification number | 5925143 | | Number of Individuals Covered | 764 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Total amount of commissions paid to insurance broker | USD $20,168 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ADD | | 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 Carrier | USD $203,521 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,168 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 1 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 235 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $14,750 | | Total amount of fees paid to insurance company | USD $632 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $138,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $144 | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $21,083 | | Total amount of fees paid to insurance company | USD $1,440 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $152,533 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5925143 |
| Policy instance | 1 |
| Insurance contract or identification number | 5925143 | | Number of Individuals Covered | 791 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $19,082 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $191,460 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 1 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 282 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $25,709 | | Total amount of fees paid to insurance company | USD $2,690 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $155,106 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $64 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 51 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5925143 |
| Policy instance | 2 |
| Insurance contract or identification number | 5925143 | | Number of Individuals Covered | 863 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $35,287 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $204,815 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,287 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5925143 |
| Policy instance | 1 |
| Insurance contract or identification number | 5925143 | | Number of Individuals Covered | 916 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $163,421 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0284718 |
| Policy instance | 2 |
| Insurance contract or identification number | 0284718 | | Number of Individuals Covered | 726 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $1,421 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $29,013 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700/5388 |
| Policy instance | 3 |
| Insurance contract or identification number | E7951700/5388 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $17,298 | | Total amount of fees paid to insurance company | USD $1,964 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $126,657 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 1 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 644 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $15,974 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $152,974 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,974 | | Insurance broker organization code? | 3 | | Insurance broker name | GOOGE FINANCIAL SERVICES, INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700/5388 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700/5388 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $17,950 | | Total amount of fees paid to insurance company | USD $2,525 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $112,778 | | 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 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker name | GLENN ZIMMERMAN, INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700/5388 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700/5388 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $16,156 | | Total amount of fees paid to insurance company | USD $1,255 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $107,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,546 | | Amount paid for insurance broker fees | 1026 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | THE ESTATE OF EUGENE MARTIN |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 1 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 562 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $23,923 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $159,482 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,923 | | Insurance broker organization code? | 3 | | Insurance broker name | GOOGE FINANCIAL SERVICES, INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700/5388 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700/5388 | | Number of Individuals Covered | 203 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $12,151 | | Total amount of fees paid to insurance company | USD $204 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $111,729 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,618 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 86 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker name | THE ESTATE OF EUGENE MARTIN |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 1 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 516 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-11-30 | | Total amount of commissions paid to insurance broker | USD $25,577 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $150,453 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,468 | | Insurance broker organization code? | 3 | | Insurance broker name | CAROLINA CONSULTING SERVICES, INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 215 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $16,974 | | Total amount of fees paid to insurance company | USD $529 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $112,251 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 1 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 679 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-11-30 | | Total amount of commissions paid to insurance broker | USD $23,662 | | 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 $139,189 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $16,115 | | Total amount of fees paid to insurance company | USD $3,256 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 1 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 674 | | Insurance policy start date | 2010-12-01 | | Insurance policy end date | 2011-11-30 | | Total amount of commissions paid to insurance broker | USD $22,854 | | 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 $134,434 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 3 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 172 | | Insurance policy start date | 2008-11-01 | | Insurance policy end date | 2009-10-31 | | Total amount of commissions paid to insurance broker | USD $14,123 | | Total amount of fees paid to insurance company | USD $3,380 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,595 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,314 | | Amount paid for insurance broker fees | 2628 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | EUGENE MARTIN |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010097784 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010097784 | | Number of Individuals Covered | 645 | | Insurance policy start date | 2008-12-01 | | Insurance policy end date | 2009-11-30 | | Total amount of commissions paid to insurance broker | USD $5,160 | | Total amount of fees paid to insurance company | USD $1,032 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $51,599 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,160 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1032 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker name | CAROLINA CONSULTING SERVICES, INC. |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 2 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2008-12-01 | | Insurance policy end date | 2009-11-30 | | Total amount of commissions paid to insurance broker | USD $11,013 | | 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 $64,576 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,661 | | Insurance broker organization code? | 3 | | Insurance broker name | CAROLINA CONSULTING SERVICES, INC. |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 2 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2007-12-01 | | Insurance policy end date | 2008-11-30 | | Total amount of commissions paid to insurance broker | USD $9,806 | | 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 $57,678 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,629 | | Insurance broker organization code? | 3 | | Insurance broker name | CAROLINA CONSULTING SERVICES, INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 3 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2007-11-01 | | Insurance policy end date | 2008-10-31 | | Total amount of commissions paid to insurance broker | USD $12,033 | | Total amount of fees paid to insurance company | USD $2,930 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,967 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,907 | | Amount paid for insurance broker fees | 1709 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | EUGENE MARTIN |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010097784 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010097784 | | Number of Individuals Covered | 618 | | Insurance policy start date | 2007-12-01 | | Insurance policy end date | 2008-11-30 | | Total amount of commissions paid to insurance broker | USD $5,070 | | Total amount of fees paid to insurance company | USD $1,014 | | 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 $50,698 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,070 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1014 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker name | CAROLINA CONSULTING SERVICES, INC. |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 1 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 591 | | Insurance policy start date | 2006-12-01 | | Insurance policy end date | 2007-11-30 | | Total amount of commissions paid to insurance broker | USD $16,257 | | 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 $95,628 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,306 | | Insurance broker organization code? | 3 | | Insurance broker name | CAROLINA CONSULTING SERVICES, INC. |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 156 | | Insurance policy start date | 2006-11-01 | | Insurance policy end date | 2007-10-31 | | Total amount of commissions paid to insurance broker | USD $12,849 | | Total amount of fees paid to insurance company | USD $2,142 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,426 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,301 | | Amount paid for insurance broker fees | 1361 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | EUGENE MARTIN |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2005-11-01 | | Insurance policy end date | 2006-10-31 | | Total amount of commissions paid to insurance broker | USD $30,861 | | Total amount of fees paid to insurance company | USD $17,256 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,952 | | Amount paid for insurance broker fees | 10611 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | EUGENE MARTIN |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 1 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 725 | | Insurance policy start date | 2005-12-01 | | Insurance policy end date | 2006-11-30 | | Total amount of commissions paid to insurance broker | USD $14,874 | | 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 $80,951 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,223 | | Insurance broker organization code? | 3 | | Insurance broker name | CAROLINA CONSULTING SERVICES, INC. |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 03735 |
| Policy instance | 1 |
| Insurance contract or identification number | 03735 | | Number of Individuals Covered | 396 | | Insurance policy start date | 2004-12-01 | | Insurance policy end date | 2005-11-30 | | Total amount of commissions paid to insurance broker | USD $7,308 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,431 | | Insurance broker organization code? | 3 | | Insurance broker name | CAROLINA CONSULTING SERVICES, INC. |
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| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 4034663 |
| Policy instance | 1 |
| Insurance contract or identification number | 4034663 | | Number of Individuals Covered | 319 | | Insurance policy start date | 2002-12-01 | | Insurance policy end date | 2003-11-30 | | Total amount of commissions paid to insurance broker | USD $11,368 | | 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 $76,340 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,368 | | Insurance broker organization code? | 3 | | Insurance broker name | GOOGE FINANCIAL SERVICES, INC. |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7951700 |
| Policy instance | 2 |
| Insurance contract or identification number | E7951700 | | Insurance policy start date | 2003-11-01 | | Insurance policy end date | 2004-10-31 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 4034663 |
| Policy instance | 1 |
| Insurance contract or identification number | 4034663 | | Number of Individuals Covered | 229 | | Insurance policy start date | 2002-12-01 | | Insurance policy end date | 2003-11-30 | | Total amount of commissions paid to insurance broker | USD $7,050 | | 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 $47,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,050 | | Insurance broker organization code? | 3 | | Insurance broker name | GOOGE FINANCIAL SERVICES, INC. |
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| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 4034663 |
| Policy instance | 1 |
| Insurance contract or identification number | 4034663 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2001-12-01 | | Insurance policy end date | 2002-11-30 | | Total amount of commissions paid to insurance broker | USD $5,219 | | 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 $34,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,219 | | Insurance broker organization code? | 3 | | Insurance broker name | GOOGE FINANCIAL SERVICES, INC. |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 549075 |
| Policy instance | 1 |
| Insurance contract or identification number | 549075 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2000-12-01 | | Insurance policy end date | 2001-11-30 | | Total amount of commissions paid to insurance broker | USD $5,277 | | 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 $45,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,277 | | Insurance broker organization code? | 3 | | Insurance broker name | GOOGE FINANCIAL SERVICES, INC. |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 549075 |
| Policy instance | 1 |
| Insurance contract or identification number | 549075 | | Number of Individuals Covered | 180 | | Insurance policy start date | 1999-12-01 | | Insurance policy end date | 2000-11-30 | | Total amount of commissions paid to insurance broker | USD $3,583 | | 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 $31,215 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,583 | | Insurance broker organization code? | 3 | | Insurance broker name | GOOGE FINANCIAL SERVICES, INC. |
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