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CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 401k Plan overview

Plan NameCROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN
Plan identification number 502

CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN Benefits

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

401k Sponsoring company profile

CROSS TELEPHONE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:CROSS TELEPHONE COMPANY
Employer identification number (EIN):730638767
NAIC Classification:517000

Additional information about CROSS TELEPHONE COMPANY

Jurisdiction of Incorporation: Oklahoma Secretary Of State
Incorporation Date:
Company Identification Number: 1900140668

More information about CROSS TELEPHONE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022012-09-01SARAH KLING
5022011-09-01SARAH KLING
5022009-09-01SARAH KLING
5022008-09-01SARAH KLING
5022007-09-01SARAH KLING
5022006-09-01SARAH KLING
5022005-09-01SARAH KLING
5022004-09-01SARAH KLING
5022003-09-01SARAH KLING
5022002-09-01SARAH KLING
5022001-09-01SARAH KLING
5022000-09-01SARAH KLING
5021999-09-01SARAH KLING

Plan Statistics for CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN

401k plan membership statisitcs for CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN

Measure Date Value
2012: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01463
Total number of active participants reported on line 7a of the Form 55002012-09-01449
Number of retired or separated participants receiving benefits2012-09-010
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-01449
2011: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01423
Total number of active participants reported on line 7a of the Form 55002011-09-01463
Number of retired or separated participants receiving benefits2011-09-010
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-01463
2009: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-01445
Total number of active participants reported on line 7a of the Form 55002009-09-01442
Number of retired or separated participants receiving benefits2009-09-010
Number of other retired or separated participants entitled to future benefits2009-09-010
Total of all active and inactive participants2009-09-01442
2008: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2008 401k membership
Total participants, beginning-of-year2008-09-01473
Total number of active participants reported on line 7a of the Form 55002008-09-01445
Number of retired or separated participants receiving benefits2008-09-010
Number of other retired or separated participants entitled to future benefits2008-09-010
Total of all active and inactive participants2008-09-01445
2007: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2007 401k membership
Total participants, beginning-of-year2007-09-01333
Total number of active participants reported on line 7a of the Form 55002007-09-01473
Number of retired or separated participants receiving benefits2007-09-010
Number of other retired or separated participants entitled to future benefits2007-09-010
Total of all active and inactive participants2007-09-01473
2006: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2006 401k membership
Total participants, beginning-of-year2006-09-01333
Total number of active participants reported on line 7a of the Form 55002006-09-01333
Number of retired or separated participants receiving benefits2006-09-010
Number of other retired or separated participants entitled to future benefits2006-09-010
Total of all active and inactive participants2006-09-01333
2005: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2005 401k membership
Total participants, beginning-of-year2005-09-010
Total number of active participants reported on line 7a of the Form 55002005-09-010
Number of retired or separated participants receiving benefits2005-09-010
Number of other retired or separated participants entitled to future benefits2005-09-010
Total of all active and inactive participants2005-09-010
2004: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2004 401k membership
Total participants, beginning-of-year2004-09-01328
Total number of active participants reported on line 7a of the Form 55002004-09-01328
Number of retired or separated participants receiving benefits2004-09-010
Number of other retired or separated participants entitled to future benefits2004-09-010
Total of all active and inactive participants2004-09-01328
2003: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2003 401k membership
Total participants, beginning-of-year2003-09-010
Total number of active participants reported on line 7a of the Form 55002003-09-010
Number of retired or separated participants receiving benefits2003-09-010
Number of other retired or separated participants entitled to future benefits2003-09-010
Total of all active and inactive participants2003-09-010
2002: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2002 401k membership
Total participants, beginning-of-year2002-09-010
Total number of active participants reported on line 7a of the Form 55002002-09-010
Number of retired or separated participants receiving benefits2002-09-010
Number of other retired or separated participants entitled to future benefits2002-09-010
Total of all active and inactive participants2002-09-010
2001: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2001 401k membership
Total participants, beginning-of-year2001-09-010
Total of all active and inactive participants2001-09-010
2000: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2000 401k membership
Total number of active participants reported on line 7a of the Form 55002000-09-01106
Number of retired or separated participants receiving benefits2000-09-010
Number of other retired or separated participants entitled to future benefits2000-09-010
Total of all active and inactive participants2000-09-01106
1999: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 1999 401k membership
Total participants, beginning-of-year1999-09-010
Total number of active participants reported on line 7a of the Form 55001999-09-010
Number of retired or separated participants receiving benefits1999-09-010
Number of other retired or separated participants entitled to future benefits1999-09-010
Total of all active and inactive participants1999-09-010

Form 5500 Responses for CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN

2012: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingYes
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2009: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes
2008: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2008 form 5500 responses
2008-09-01Type of plan entitySingle employer plan
2008-09-01Submission has been amendedNo
2008-09-01This submission is the final filingNo
2008-09-01This return/report is a short plan year return/report (less than 12 months)No
2008-09-01Plan is a collectively bargained planNo
2008-09-01Plan funding arrangement – InsuranceYes
2008-09-01Plan benefit arrangement – InsuranceYes
2007: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2007 form 5500 responses
2007-09-01Type of plan entitySingle employer plan
2007-09-01Submission has been amendedNo
2007-09-01This submission is the final filingNo
2007-09-01This return/report is a short plan year return/report (less than 12 months)No
2007-09-01Plan is a collectively bargained planNo
2007-09-01Plan funding arrangement – InsuranceYes
2007-09-01Plan benefit arrangement – InsuranceYes
2006: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2006 form 5500 responses
2006-09-01Type of plan entitySingle employer plan
2006-09-01Submission has been amendedNo
2006-09-01This submission is the final filingNo
2006-09-01This return/report is a short plan year return/report (less than 12 months)No
2006-09-01Plan is a collectively bargained planNo
2006-09-01Plan funding arrangement – InsuranceYes
2006-09-01Plan benefit arrangement – InsuranceYes
2005: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2005 form 5500 responses
2005-09-01Type of plan entitySingle employer plan
2005-09-01Submission has been amendedNo
2005-09-01This submission is the final filingNo
2005-09-01This return/report is a short plan year return/report (less than 12 months)No
2005-09-01Plan is a collectively bargained planNo
2005-09-01Plan funding arrangement – InsuranceYes
2005-09-01Plan benefit arrangement – InsuranceYes
2004: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2004 form 5500 responses
2004-09-01Type of plan entitySingle employer plan
2004-09-01Submission has been amendedNo
2004-09-01This submission is the final filingNo
2004-09-01This return/report is a short plan year return/report (less than 12 months)No
2004-09-01Plan is a collectively bargained planNo
2004-09-01Plan funding arrangement – InsuranceYes
2004-09-01Plan benefit arrangement – InsuranceYes
2003: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2003 form 5500 responses
2003-09-01Type of plan entitySingle employer plan
2003-09-01Submission has been amendedNo
2003-09-01This submission is the final filingNo
2003-09-01This return/report is a short plan year return/report (less than 12 months)No
2003-09-01Plan is a collectively bargained planNo
2003-09-01Plan funding arrangement – InsuranceYes
2003-09-01Plan benefit arrangement – InsuranceYes
2002: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2002 form 5500 responses
2002-09-01Type of plan entitySingle employer plan
2002-09-01Submission has been amendedNo
2002-09-01This submission is the final filingNo
2002-09-01This return/report is a short plan year return/report (less than 12 months)No
2002-09-01Plan is a collectively bargained planNo
2002-09-01Plan funding arrangement – InsuranceYes
2002-09-01Plan benefit arrangement – InsuranceYes
2001: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2001 form 5500 responses
2001-09-01Type of plan entitySingle employer plan
2001-09-01Submission has been amendedNo
2001-09-01This submission is the final filingNo
2001-09-01This return/report is a short plan year return/report (less than 12 months)No
2001-09-01Plan is a collectively bargained planNo
2001-09-01Plan funding arrangement – InsuranceYes
2001-09-01Plan benefit arrangement – InsuranceYes
2000: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 2000 form 5500 responses
2000-09-01Type of plan entitySingle employer plan
2000-09-01Submission has been amendedNo
2000-09-01This submission is the final filingNo
2000-09-01This return/report is a short plan year return/report (less than 12 months)No
2000-09-01Plan is a collectively bargained planNo
2000-09-01Plan funding arrangement – InsuranceYes
2000-09-01Plan benefit arrangement – InsuranceYes
1999: CROSS TELEPHONE COMPANY LIFE AND DISABILITY PLAN 1999 form 5500 responses
1999-09-01Type of plan entitySingle employer plan
1999-09-01First time form 5500 has been submittedYes
1999-09-01Submission has been amendedNo
1999-09-01This submission is the final filingNo
1999-09-01This return/report is a short plan year return/report (less than 12 months)No
1999-09-01Plan is a collectively bargained planNo
1999-09-01Plan funding arrangement – InsuranceYes
1999-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered449
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $9,010
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 BenefitNo
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 $45,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,010
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameCHARLES BOWMAN INSURANCE AGENCY
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered463
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $6,529
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 BenefitNo
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 $48,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered423
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $7,537
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 BenefitNo
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 $47,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,537
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameCHARLES BOWMAN INSURANCE AGENCY
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered442
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $7,582
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 BenefitNo
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 $48,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,582
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameCHARLES BOWMAN INSURANCE AGENCY
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered445
Insurance policy start date2008-09-01
Insurance policy end date2009-08-31
Total amount of commissions paid to insurance brokerUSD $7,706
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 BenefitNo
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 $48,778
Commission paid to Insurance BrokerUSD $7,706
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameCHARLES BOWMAN INSURANCE AGENCY
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered473
Insurance policy start date2007-09-01
Insurance policy end date2008-08-31
Total amount of commissions paid to insurance brokerUSD $6,173
Total amount of fees paid to insurance companyUSD $881
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 BenefitNo
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 $42,891
Commission paid to Insurance BrokerUSD $4,472
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameCHARLES L. BOWMAN
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered333
Insurance policy start date2006-09-01
Insurance policy end date2007-08-31
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 BenefitNo
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 $36,297
Commission paid to Insurance BrokerUSD $5,783
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameCHARLES L. BOWMAN
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered328
Insurance policy start date2004-09-01
Insurance policy end date2005-08-31
Total amount of commissions paid to insurance brokerUSD $7,012
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 BenefitNo
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 $44,195
Commission paid to Insurance BrokerUSD $7,012
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameCHARLES L. BOWMAN
LIBERTY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61492 )
Policy contract numberBGGR960910
Policy instance 1
Insurance contract or identification numberBGGR960910
Number of Individuals Covered106
Insurance policy start date2000-09-01
Insurance policy end date2001-08-31
Total amount of commissions paid to insurance brokerUSD $5,253
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 BenefitNo
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 $33,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,253
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
Insurance broker organization code?3
Insurance broker nameCHARLES L. BOWMAN

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