401k Plan data: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN plan

TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN
Plan identification number	502

TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

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

Company Name: TELEPHONE ELECTRONICS CORPORATION

Employer identification number (EIN): 640527889

NAIC Classification: 517000

Additional information about TELEPHONE ELECTRONICS CORPORATION

Jurisdiction of Incorporation: California Department of State

Incorporation Date: 1973-09-12

Company Identification Number: C0689028

Legal Registered Office Address: 350 Sansome St.

San Francisco
United States of America (USA)
94104

More information about TELEPHONE ELECTRONICS CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2022-01-01
502 2021-01-01
502 2020-01-01
502 2019-01-01
502 2018-01-01
502 2017-01-01 JOSEPH C PIRO JOSEPH C PIRO 2018-07-18
502 2016-01-01 JOSEPH C PIRO JOSEPH C PIRO 2017-07-07
502 2015-01-01 JOSEPH C PIRO JOSEPH C PIRO 2016-05-26
502 2014-01-01 JOSEPH C PIRO JOSEPH C PIRO 2015-07-16
502 2013-01-01 JOSEPH C PIRO JOSEPH C PIRO 2014-09-02
502 2012-01-01 JOSEPH C PIRO JOSEPH C PIRO 2013-07-25
502 2011-01-01 JOSEPH C PIRO JOSEPH C PIRO 2012-07-17
502 2009-01-01 JOSEPH C PIRO JOSEPH C PIRO 2010-07-31
502 2009-01-01 JOSEPH C PIRO JOSEPH C PIRO 2010-07-31

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
502	2022-01-01
502	2021-01-01
502	2020-01-01
502	2019-01-01
502	2018-01-01
502	2017-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2018-07-18
502	2016-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2017-07-07
502	2015-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2016-05-26
502	2014-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2015-07-16
502	2013-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2014-09-02
502	2012-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2013-07-25
502	2011-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2012-07-17
502	2009-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2010-07-31
502	2009-01-01	JOSEPH C PIRO	JOSEPH C PIRO	2010-07-31

Plan Statistics for TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN

Measure Date Value
2022: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 167
Number of retired or separated participants receiving benefits 2022-01-01 3
Total of all active and inactive participants 2022-01-01 170
2021: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 204
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 184
Number of retired or separated participants receiving benefits 2021-01-01 2
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 186
2020: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 197
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 203
Number of other retired or separated participants entitled to future benefits 2020-01-01 1
Total of all active and inactive participants 2020-01-01 204
2019: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 197
Number of other retired or separated participants entitled to future benefits 2019-01-01 2
Total of all active and inactive participants 2019-01-01 199
2018: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 193
Number of retired or separated participants receiving benefits 2018-01-01 3
Total of all active and inactive participants 2018-01-01 196
2017: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 194
Number of retired or separated participants receiving benefits 2017-01-01 2
Total of all active and inactive participants 2017-01-01 196
2016: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 198
Number of retired or separated participants receiving benefits 2016-01-01 1
Total of all active and inactive participants 2016-01-01 199
2015: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 206
Number of retired or separated participants receiving benefits 2015-01-01 1
Total of all active and inactive participants 2015-01-01 207
2014: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 222
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 217
Number of retired or separated participants receiving benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 220
2013: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 223
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 221
Number of retired or separated participants receiving benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 222
2012: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 228
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 222
Number of retired or separated participants receiving benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 223
2011: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 236
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 227
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 228
2009: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 228
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 237
Number of retired or separated participants receiving benefits 2009-01-01 4
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 241

Measure	Date	Value
2022: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	167
Number of retired or separated participants receiving benefits	2022-01-01	3
Total of all active and inactive participants	2022-01-01	170
2021: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	204
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	184
Number of retired or separated participants receiving benefits	2021-01-01	2
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	186
2020: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	203
Number of other retired or separated participants entitled to future benefits	2020-01-01	1
Total of all active and inactive participants	2020-01-01	204
2019: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	197
Number of other retired or separated participants entitled to future benefits	2019-01-01	2
Total of all active and inactive participants	2019-01-01	199
2018: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	193
Number of retired or separated participants receiving benefits	2018-01-01	3
Total of all active and inactive participants	2018-01-01	196
2017: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	194
Number of retired or separated participants receiving benefits	2017-01-01	2
Total of all active and inactive participants	2017-01-01	196
2016: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	198
Number of retired or separated participants receiving benefits	2016-01-01	1
Total of all active and inactive participants	2016-01-01	199
2015: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	206
Number of retired or separated participants receiving benefits	2015-01-01	1
Total of all active and inactive participants	2015-01-01	207
2014: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	222
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	217
Number of retired or separated participants receiving benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	220
2013: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	223
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	221
Number of retired or separated participants receiving benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	222
2012: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	228
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	222
Number of retired or separated participants receiving benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	223
2011: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	236
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	227
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	228
2009: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	228
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	237
Number of retired or separated participants receiving benefits	2009-01-01	4
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	241

Form 5500 Responses for TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN

2022: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: TELEPHONE ELECTRONICS CORPORATION EMPLOYEE BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	170
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $370
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,467
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $370
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	170
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,329
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,329
Insurance broker organization code?	3

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

LZ011

Policy instance

Insurance contract or identification number	LZ011
Number of Individuals Covered	94
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $15,612
Total amount of fees paid to insurance company	USD $84
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $106,663
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,704
Insurance broker organization code?	3
Amount paid for insurance broker fees	42
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-20220-CN

Policy instance

Insurance contract or identification number	7500-20220-CN
Number of Individuals Covered	170
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $33,997
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,997
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS21-C

Policy instance

Insurance contract or identification number	7500-MS21-C
Number of Individuals Covered	184
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $35,061
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $35,061
Insurance broker organization code?	3

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

LZ011

Policy instance

Insurance contract or identification number	LZ011
Number of Individuals Covered	117
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $14,613
Total amount of fees paid to insurance company	USD $160
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $119,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,670
Insurance broker organization code?	3
Amount paid for insurance broker fees	80
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	184
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,430
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,430
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	184
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $379
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $379
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	203
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $343
Total amount of fees paid to insurance company	USD $51
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $343
Amount paid for insurance broker fees	51
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	203
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $3,378
Total amount of fees paid to insurance company	USD $592
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,378
Amount paid for insurance broker fees	592
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

LZ011

Policy instance

Insurance contract or identification number	LZ011
Number of Individuals Covered	125
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $20,617
Total amount of fees paid to insurance company	USD $92
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $132,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,587
Insurance broker organization code?	3
Amount paid for insurance broker fees	30
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS200-C

Policy instance

Insurance contract or identification number	7500-MS200-C
Number of Individuals Covered	203
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $32,151
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,151
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS190-C

Policy instance

Insurance contract or identification number	7500-MS190-C
Number of Individuals Covered	197
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $29,653
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,653
Insurance broker organization code?	3

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

LZ011

Policy instance

Insurance contract or identification number	LZ011
Number of Individuals Covered	132
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $19,378
Total amount of fees paid to insurance company	USD $58
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $130,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,962
Insurance broker organization code?	3
Amount paid for insurance broker fees	20
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	197
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $5,089
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $33,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,089
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	197
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $435
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $435
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS170-C

Policy instance

Insurance contract or identification number	7500-MS170-C
Number of Individuals Covered	193
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $24,545
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,545
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	193
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,804
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,804
Insurance broker organization code?	3

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

LZ011

Policy instance

Insurance contract or identification number	LZ011
Number of Individuals Covered	124
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $13,590
Total amount of fees paid to insurance company	USD $59
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $104,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,115
Insurance broker organization code?	3
Amount paid for insurance broker fees	29
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	193
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $240
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $1,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $240
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	194
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $363
Total amount of fees paid to insurance company	USD $24
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $363
Amount paid for insurance broker fees	24
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	194
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,248
Total amount of fees paid to insurance company	USD $211
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,248
Amount paid for insurance broker fees	211
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

LZ011

Policy instance

Insurance contract or identification number	LZ011
Number of Individuals Covered	124
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $18,086
Total amount of fees paid to insurance company	USD $248
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $126,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,943
Insurance broker organization code?	3
Amount paid for insurance broker fees	69
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker name	TANYA L MARTINSON

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS170-C

Policy instance

Insurance contract or identification number	7500-MS170-C
Number of Individuals Covered	194
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $23,408
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,408
Insurance broker organization code?	3
Insurance broker name	ROSS & YERGER INSURANCE, INC.

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS120-C

Policy instance

Insurance contract or identification number	7500-MS120-C
Number of Individuals Covered	206
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $25,539
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,539
Insurance broker organization code?	3
Insurance broker name	ROSS & YERGER INSURANCE, INC.

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

LZ011

Policy instance

Insurance contract or identification number	LZ011
Number of Individuals Covered	141
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $21,677
Total amount of fees paid to insurance company	USD $226
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $128,592
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,144
Amount paid for insurance broker fees	72
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	RICHARD RUSSELL HOGAN

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	206
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,377
Total amount of fees paid to insurance company	USD $414
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,377
Amount paid for insurance broker fees	414
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	206
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $377
Total amount of fees paid to insurance company	USD $46
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $377
Amount paid for insurance broker fees	46
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS120-C

Policy instance

Insurance contract or identification number	7500-MS120-C
Number of Individuals Covered	217
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $25,698
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,698
Insurance broker organization code?	3
Insurance broker name	ROSS & YERGER INSURANCE, INC.

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	143
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $12,363
Total amount of fees paid to insurance company	USD $403
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $91,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,571
Insurance broker organization code?	3
Amount paid for insurance broker fees	126
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker name	CAREY H MCALEXANDER

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	217
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,544
Total amount of fees paid to insurance company	USD $229
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,544
Amount paid for insurance broker fees	229
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	217
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $358
Total amount of fees paid to insurance company	USD $25
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $358
Amount paid for insurance broker fees	25
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	221
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $381
Total amount of fees paid to insurance company	USD $45
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $381
Amount paid for insurance broker fees	45
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS120-C

Policy instance

Insurance contract or identification number	7500-MS120-C
Number of Individuals Covered	219
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $24,106
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,106
Insurance broker organization code?	3
Insurance broker name	ROSS & YERGER INSURANCE, INC.

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	151
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $19,994
Total amount of fees paid to insurance company	USD $47
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $129,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,216
Insurance broker organization code?	3
Amount paid for insurance broker fees	15
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker name	GARTH KEMP

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	221
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,431
Total amount of fees paid to insurance company	USD $406
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,431
Amount paid for insurance broker fees	406
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	157
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $17,990
Total amount of fees paid to insurance company	USD $493
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $113,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,288
Amount paid for insurance broker fees	154
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	GARTH KEMP

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	222
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,480
Total amount of fees paid to insurance company	USD $407
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,480
Amount paid for insurance broker fees	407
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

7500-MS120-C

Policy instance

Insurance contract or identification number	7500-MS120-C
Number of Individuals Covered	225
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $22,837
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,837
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ROSS & YERGER INSURANCE, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	222
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $387
Total amount of fees paid to insurance company	USD $45
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $387
Amount paid for insurance broker fees	45
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	226
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $388
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	226
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,493
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

58-0663085

Policy instance

Insurance contract or identification number	58-0663085
Number of Individuals Covered	149
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $17,362
Total amount of fees paid to insurance company	USD $428
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $102,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LONDON LIFE REINSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 76694 )

Policy contract number

8513-MS100-L

Policy instance

Insurance contract or identification number	8513-MS100-L
Number of Individuals Covered	228
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $22,457
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK600983

Policy instance

Insurance contract or identification number	SOK600983
Number of Individuals Covered	231
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $389
Total amount of fees paid to insurance company	USD $52
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	AD & D
Welfare Benefit Premiums Paid to Carrier	USD $2,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $389
Amount paid for insurance broker fees	52
Additional information about fees paid to insurance broker	SALES & SERVICE
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

58-0663085

Policy instance

Insurance contract or identification number	58-0663085
Number of Individuals Covered	144
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $15,672
Total amount of fees paid to insurance company	USD $452
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENT & CANCER
Welfare Benefit Premiums Paid to Carrier	USD $94,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,183
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	FEES, AWARDS, PRIZES OR OTHER FORMS OF NON-MONETARY COMPENSATIONS
Insurance broker name	GARTH KEMP

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM601674

Policy instance

Insurance contract or identification number	SGM601674
Number of Individuals Covered	231
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,496
Total amount of fees paid to insurance company	USD $464
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,496
Amount paid for insurance broker fees	464
Additional information about fees paid to insurance broker	SALES & SERVICE
Insurance broker organization code?	3
Insurance broker name	ROSS AND YERGER INSURANCE INC

LONDON LIFE REINSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 76694 )

Policy contract number

8513-MS100-L

Policy instance

Insurance contract or identification number	8513-MS100-L
Number of Individuals Covered	236
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $23,233
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,233
Insurance broker organization code?	3
Insurance broker name	ROSS & YERGER INSURANCE, INC.

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Company Name:	TELEPHONE ELECTRONICS CORPORATION
Employer identification number (EIN):	640527889
NAIC Classification:	517000

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:	1973-09-12
Company Identification Number:	C0689028
Legal Registered Office Address:	350 Sansome St. San Francisco United States of America (USA) 94104