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THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 401k Plan overview

Plan NameTHE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE
Plan identification number 507

THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

WILSON SENIOR CARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:WILSON SENIOR CARE, INC.
Employer identification number (EIN):570798718
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072022-02-01
5072021-02-01
5072020-02-01
5072019-02-01
5072018-02-01
5072017-02-01SUSAN WEESNER
5072016-02-01SUSAN WEESNER
5072015-02-01SUSAN WEESNER
5072014-02-01SUSAN WEESNER
5072013-02-01SUSAN WEESNER
5072012-02-01SUSAN WEESNER
5072011-02-01SUSAN WEESNER
5072010-02-01SUSAN WEESNER
5072009-02-01SUSAN WEESNER

Plan Statistics for THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE

401k plan membership statisitcs for THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE

Measure Date Value
2022: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2022 401k membership
Total participants, beginning-of-year2022-02-01311
Total number of active participants reported on line 7a of the Form 55002022-02-01365
Total of all active and inactive participants2022-02-01365
2021: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2021 401k membership
Total participants, beginning-of-year2021-02-01457
Total number of active participants reported on line 7a of the Form 55002021-02-01311
Total of all active and inactive participants2021-02-01311
2020: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2020 401k membership
Total participants, beginning-of-year2020-02-01515
Total number of active participants reported on line 7a of the Form 55002020-02-01457
Total of all active and inactive participants2020-02-01457
2019: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2019 401k membership
Total participants, beginning-of-year2019-02-01461
Total number of active participants reported on line 7a of the Form 55002019-02-01515
Total of all active and inactive participants2019-02-01515
2018: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2018 401k membership
Total participants, beginning-of-year2018-02-01516
Total number of active participants reported on line 7a of the Form 55002018-02-01461
Total of all active and inactive participants2018-02-01461
2017: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2017 401k membership
Total participants, beginning-of-year2017-02-01467
Total number of active participants reported on line 7a of the Form 55002017-02-01516
Total of all active and inactive participants2017-02-01516
2016: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2016 401k membership
Total participants, beginning-of-year2016-02-01372
Total number of active participants reported on line 7a of the Form 55002016-02-01467
Total of all active and inactive participants2016-02-01467
2015: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2015 401k membership
Total participants, beginning-of-year2015-02-01278
Total number of active participants reported on line 7a of the Form 55002015-02-01372
Total of all active and inactive participants2015-02-01372
2014: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2014 401k membership
Total participants, beginning-of-year2014-02-01271
Total number of active participants reported on line 7a of the Form 55002014-02-01278
Total of all active and inactive participants2014-02-01278
2013: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2013 401k membership
Total participants, beginning-of-year2013-02-01271
Total number of active participants reported on line 7a of the Form 55002013-02-01271
Number of retired or separated participants receiving benefits2013-02-010
Number of other retired or separated participants entitled to future benefits2013-02-010
Total of all active and inactive participants2013-02-01271
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-02-010
2012: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2012 401k membership
Total participants, beginning-of-year2012-02-01660
Total number of active participants reported on line 7a of the Form 55002012-02-01660
Number of retired or separated participants receiving benefits2012-02-010
Number of other retired or separated participants entitled to future benefits2012-02-010
Total of all active and inactive participants2012-02-01660
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-02-010
2011: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2011 401k membership
Total participants, beginning-of-year2011-02-01596
Total number of active participants reported on line 7a of the Form 55002011-02-01596
Number of retired or separated participants receiving benefits2011-02-010
Number of other retired or separated participants entitled to future benefits2011-02-010
Total of all active and inactive participants2011-02-01596
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-02-010
2010: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2010 401k membership
Total participants, beginning-of-year2010-02-01276
Total number of active participants reported on line 7a of the Form 55002010-02-01276
Number of retired or separated participants receiving benefits2010-02-010
Number of other retired or separated participants entitled to future benefits2010-02-010
Total of all active and inactive participants2010-02-01276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-02-010
2009: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2009 401k membership
Total participants, beginning-of-year2009-02-01263
Total number of active participants reported on line 7a of the Form 55002009-02-01263
Number of retired or separated participants receiving benefits2009-02-010
Number of other retired or separated participants entitled to future benefits2009-02-010
Total of all active and inactive participants2009-02-01263

Form 5500 Responses for THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE

2022: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan benefit arrangement – InsuranceYes
2021: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2021 form 5500 responses
2021-02-01Type of plan entitySingle employer plan
2021-02-01Plan funding arrangement – InsuranceYes
2021-02-01Plan benefit arrangement – InsuranceYes
2020: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan benefit arrangement – InsuranceYes
2019: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan benefit arrangement – InsuranceYes
2018: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – InsuranceYes
2017: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Submission has been amendedYes
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – InsuranceYes
2015: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – InsuranceYes
2014: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan benefit arrangement – InsuranceYes
2013: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01Submission has been amendedNo
2013-02-01This submission is the final filingNo
2013-02-01This return/report is a short plan year return/report (less than 12 months)No
2013-02-01Plan is a collectively bargained planNo
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan benefit arrangement – InsuranceYes
2012: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01Submission has been amendedNo
2012-02-01This submission is the final filingNo
2012-02-01This return/report is a short plan year return/report (less than 12 months)No
2012-02-01Plan is a collectively bargained planNo
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan benefit arrangement – InsuranceYes
2011: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01Submission has been amendedNo
2011-02-01This submission is the final filingNo
2011-02-01This return/report is a short plan year return/report (less than 12 months)No
2011-02-01Plan is a collectively bargained planNo
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan benefit arrangement – InsuranceYes
2010: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2010 form 5500 responses
2010-02-01Type of plan entitySingle employer plan
2010-02-01Submission has been amendedNo
2010-02-01This submission is the final filingNo
2010-02-01This return/report is a short plan year return/report (less than 12 months)No
2010-02-01Plan is a collectively bargained planNo
2010-02-01Plan funding arrangement – InsuranceYes
2010-02-01Plan benefit arrangement – InsuranceYes
2009: THE WILSON GROUP, INC. LIFE INSURANCE WELFARE BENE 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BANKERS FIDELITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61239 )
Policy contract numberW5306001
Policy instance 3
Insurance contract or identification numberW5306001
Number of Individuals Covered30
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $9,200
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,586
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0012395356
Policy instance 2
Insurance contract or identification number0012395356
Number of Individuals Covered85
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $350
Total amount of fees paid to insurance companyUSD $12
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $174
Insurance broker organization code?3
Amount paid for insurance broker fees12
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BPMQ
Policy instance 1
Insurance contract or identification numberG000BPMQ
Number of Individuals Covered365
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $37,890
Total amount of fees paid to insurance companyUSD $21,317
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $254,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,600
Insurance broker organization code?3
Amount paid for insurance broker fees9432
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00571934
Policy instance 1
Insurance contract or identification number00571934
Number of Individuals Covered197
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $24,903
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CANCER, & VCI
Welfare Benefit Premiums Paid to CarrierUSD $90,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,049
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BPMQ
Policy instance 2
Insurance contract or identification numberG000BPMQ
Number of Individuals Covered311
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $36,650
Total amount of fees paid to insurance companyUSD $13,337
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $246,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,149
Insurance broker organization code?3
Amount paid for insurance broker fees7409
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0012395356
Policy instance 3
Insurance contract or identification number0012395356
Number of Individuals Covered110
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,914
Total amount of fees paid to insurance companyUSD $151
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&A
Welfare Benefit Premiums Paid to CarrierUSD $17,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,728
Insurance broker organization code?3
Amount paid for insurance broker fees79
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BPMQ
Policy instance 2
Insurance contract or identification numberG000BPMQ
Number of Individuals Covered457
Insurance policy end date2021-01-01
Total amount of commissions paid to insurance brokerUSD $40,929
Total amount of fees paid to insurance companyUSD $5,434
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $275,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,595
Insurance broker organization code?3
Amount paid for insurance broker fees5434
Additional information about fees paid to insurance brokerADMINISTRATION
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00571934
Policy instance 1
Insurance contract or identification number00571934
Number of Individuals Covered259
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $64,977
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CANCER, & VCI
Welfare Benefit Premiums Paid to CarrierUSD $90,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,216
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number580
Policy instance 1
Insurance contract or identification number580
Number of Individuals Covered515
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $83,899
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $398,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $80,498
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number580
Policy instance 1
Insurance contract or identification number580
Number of Individuals Covered461
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $255,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number580
Policy instance 1
Insurance contract or identification number580
Number of Individuals Covered516
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $260,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number580
Policy instance 1
Insurance contract or identification number580
Number of Individuals Covered372
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $223,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameKEENAN SUGGS BOWERS ELKINS, LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number580
Policy instance 1
Insurance contract or identification number580
Number of Individuals Covered278
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $6,225
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $42,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,225
Insurance broker organization code?3
Insurance broker nameKEENAN SUGGS BOWERS ELKINS, LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number580
Policy instance 2
Insurance contract or identification number580
Number of Individuals Covered271
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $28,872
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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 CarrierUSD $192,480
Commission paid to Insurance BrokerUSD $14,750
Insurance broker organization code?3
Insurance broker nameJAMES A SCOTT & SON INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05982110
Policy instance 1
Insurance contract or identification numberTM05982110
Number of Individuals Covered0
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $4,815
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,815
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMARK FISCHMAN
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05982110
Policy instance 1
Insurance contract or identification numberTM05982110
Number of Individuals Covered660
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $27,664
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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 CarrierUSD $185,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,664
Insurance broker organization code?3
Insurance broker nameMARK FISCHMAN
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05982110
Policy instance 1
Insurance contract or identification numberTM05982110
Number of Individuals Covered596
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $23,160
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedADD
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $183,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number066673
Policy instance 3
Insurance contract or identification number066673
Number of Individuals Covered198
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $15,418
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $102,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,418
Insurance broker organization code?3
Insurance broker nameMARK FISCHMAN
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number066673
Policy instance 2
Insurance contract or identification number066673
Number of Individuals Covered167
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $6,197
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $40,935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,197
Insurance broker organization code?3
Insurance broker nameMARK FISCHMAN
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number066673
Policy instance 1
Insurance contract or identification number066673
Number of Individuals Covered276
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $11,689
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $77,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,689
Insurance broker organization code?3
Insurance broker nameMARK FISCHMAN

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