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ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 401k Plan overview

Plan NameESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN
Plan identification number 510

ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

HAWKINS, ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.

Company Name:HAWKINS, ASSOCIATES, INC.
Employer identification number (EIN):741951199
NAIC Classification:561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5102022-10-27
5102021-10-27
5102020-10-27
5102019-10-27
5102018-10-27
5102017-10-27
5102016-10-27
5102015-10-27
5102014-10-27

Plan Statistics for ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN

401k plan membership statisitcs for ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN

Measure Date Value
2022: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-27118
Total number of active participants reported on line 7a of the Form 55002022-10-27115
Number of retired or separated participants receiving benefits2022-10-270
Number of other retired or separated participants entitled to future benefits2022-10-270
Total of all active and inactive participants2022-10-27115
2021: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-27133
Total number of active participants reported on line 7a of the Form 55002021-10-27128
Number of retired or separated participants receiving benefits2021-10-270
Number of other retired or separated participants entitled to future benefits2021-10-270
Total of all active and inactive participants2021-10-27128
2020: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-27129
Total number of active participants reported on line 7a of the Form 55002020-10-27132
Number of retired or separated participants receiving benefits2020-10-270
Number of other retired or separated participants entitled to future benefits2020-10-270
Total of all active and inactive participants2020-10-27132
2019: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-27132
Total number of active participants reported on line 7a of the Form 55002019-10-27126
Number of retired or separated participants receiving benefits2019-10-270
Number of other retired or separated participants entitled to future benefits2019-10-270
Total of all active and inactive participants2019-10-27126
2018: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-27199
Total number of active participants reported on line 7a of the Form 55002018-10-27143
Number of retired or separated participants receiving benefits2018-10-270
Number of other retired or separated participants entitled to future benefits2018-10-270
Total of all active and inactive participants2018-10-27143
2017: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-27147
Total number of active participants reported on line 7a of the Form 55002017-10-27218
Number of retired or separated participants receiving benefits2017-10-270
Number of other retired or separated participants entitled to future benefits2017-10-270
Total of all active and inactive participants2017-10-27218
2016: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-27127
Total number of active participants reported on line 7a of the Form 55002016-10-27134
Number of retired or separated participants receiving benefits2016-10-270
Number of other retired or separated participants entitled to future benefits2016-10-270
Total of all active and inactive participants2016-10-27134
2015: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-27153
Total number of active participants reported on line 7a of the Form 55002015-10-27114
Number of retired or separated participants receiving benefits2015-10-270
Number of other retired or separated participants entitled to future benefits2015-10-270
Total of all active and inactive participants2015-10-27114
2014: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2014 401k membership
Total number of active participants reported on line 7a of the Form 55002014-10-27151
Number of retired or separated participants receiving benefits2014-10-270
Number of other retired or separated participants entitled to future benefits2014-10-270
Total of all active and inactive participants2014-10-27151

Form 5500 Responses for ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN

2022: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2022 form 5500 responses
2022-10-27Type of plan entitySingle employer plan
2022-10-27Submission has been amendedNo
2022-10-27This submission is the final filingNo
2022-10-27This return/report is a short plan year return/report (less than 12 months)No
2022-10-27Plan is a collectively bargained planNo
2022-10-27Plan funding arrangement – InsuranceYes
2022-10-27Plan benefit arrangement – InsuranceYes
2021: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2021 form 5500 responses
2021-10-27Type of plan entitySingle employer plan
2021-10-27Submission has been amendedNo
2021-10-27This submission is the final filingNo
2021-10-27This return/report is a short plan year return/report (less than 12 months)No
2021-10-27Plan is a collectively bargained planNo
2021-10-27Plan funding arrangement – InsuranceYes
2021-10-27Plan benefit arrangement – InsuranceYes
2020: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2020 form 5500 responses
2020-10-27Type of plan entitySingle employer plan
2020-10-27Submission has been amendedNo
2020-10-27This submission is the final filingNo
2020-10-27This return/report is a short plan year return/report (less than 12 months)No
2020-10-27Plan is a collectively bargained planNo
2020-10-27Plan funding arrangement – InsuranceYes
2020-10-27Plan benefit arrangement – InsuranceYes
2019: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2019 form 5500 responses
2019-10-27Type of plan entitySingle employer plan
2019-10-27Submission has been amendedNo
2019-10-27This submission is the final filingNo
2019-10-27This return/report is a short plan year return/report (less than 12 months)No
2019-10-27Plan is a collectively bargained planNo
2019-10-27Plan funding arrangement – InsuranceYes
2019-10-27Plan benefit arrangement – InsuranceYes
2018: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2018 form 5500 responses
2018-10-27Type of plan entitySingle employer plan
2018-10-27Submission has been amendedNo
2018-10-27This submission is the final filingNo
2018-10-27This return/report is a short plan year return/report (less than 12 months)No
2018-10-27Plan is a collectively bargained planNo
2018-10-27Plan funding arrangement – InsuranceYes
2018-10-27Plan benefit arrangement – InsuranceYes
2017: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2017 form 5500 responses
2017-10-27Type of plan entitySingle employer plan
2017-10-27Submission has been amendedNo
2017-10-27This submission is the final filingNo
2017-10-27This return/report is a short plan year return/report (less than 12 months)No
2017-10-27Plan is a collectively bargained planNo
2017-10-27Plan funding arrangement – InsuranceYes
2017-10-27Plan benefit arrangement – InsuranceYes
2016: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2016 form 5500 responses
2016-10-27Type of plan entitySingle employer plan
2016-10-27Submission has been amendedNo
2016-10-27This submission is the final filingNo
2016-10-27This return/report is a short plan year return/report (less than 12 months)No
2016-10-27Plan is a collectively bargained planNo
2016-10-27Plan funding arrangement – InsuranceYes
2016-10-27Plan benefit arrangement – InsuranceYes
2015: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2015 form 5500 responses
2015-10-27Type of plan entitySingle employer plan
2015-10-27Submission has been amendedNo
2015-10-27This submission is the final filingNo
2015-10-27This return/report is a short plan year return/report (less than 12 months)No
2015-10-27Plan is a collectively bargained planNo
2015-10-27Plan funding arrangement – InsuranceYes
2015-10-27Plan benefit arrangement – InsuranceYes
2014: ESSENTIAL STAFFCARE GROUP LIMITED BENEFIT PLAN 2014 form 5500 responses
2014-10-27Type of plan entitySingle employer plan
2014-10-27First time form 5500 has been submittedYes
2014-10-27Submission has been amendedNo
2014-10-27This submission is the final filingNo
2014-10-27This return/report is a short plan year return/report (less than 12 months)No
2014-10-27Plan is a collectively bargained planNo
2014-10-27Plan funding arrangement – InsuranceYes
2014-10-27Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract numberPAI-L 2902400
Policy instance 2
Insurance contract or identification numberPAI-L 2902400
Number of Individuals Covered49
Insurance policy start date2022-10-27
Insurance policy end date2023-10-26
Total amount of commissions paid to insurance brokerUSD $1,412
Total amount of fees paid to insurance companyUSD $890
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $6,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,412
Insurance broker organization code?3
Amount paid for insurance broker fees890
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberPAI-MDV 2902400
Policy instance 1
Insurance contract or identification numberPAI-MDV 2902400
Number of Individuals Covered115
Insurance policy start date2022-10-27
Insurance policy end date2023-10-26
Total amount of commissions paid to insurance brokerUSD $28,421
Total amount of fees paid to insurance companyUSD $20,394
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $140,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,421
Insurance broker organization code?3
Amount paid for insurance broker fees20394
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract numberPAI-L 2902400
Policy instance 2
Insurance contract or identification numberPAI-L 2902400
Number of Individuals Covered32
Insurance policy start date2021-10-27
Insurance policy end date2022-10-26
Total amount of commissions paid to insurance brokerUSD $1,385
Total amount of fees paid to insurance companyUSD $873
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $6,023
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,385
Insurance broker organization code?3
Amount paid for insurance broker fees873
Additional information about fees paid to insurance brokerFEES PAID TO THIRD PARTY ADMINISTRATION
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberPAI-MDV 2902400
Policy instance 1
Insurance contract or identification numberPAI-MDV 2902400
Number of Individuals Covered128
Insurance policy start date2021-10-27
Insurance policy end date2022-10-26
Total amount of commissions paid to insurance brokerUSD $29,608
Total amount of fees paid to insurance companyUSD $21,251
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $146,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,608
Insurance broker organization code?3
Amount paid for insurance broker fees21251
Additional information about fees paid to insurance brokerFEES PAID TO THIRD PARTY ADMINISTRATION
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract numberPAI-L 2902400
Policy instance 2
Insurance contract or identification numberPAI-L 2902400
Number of Individuals Covered29
Insurance policy start date2020-10-27
Insurance policy end date2021-10-26
Total amount of commissions paid to insurance brokerUSD $1,594
Total amount of fees paid to insurance companyUSD $1,007
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $6,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,594
Insurance broker organization code?3
Amount paid for insurance broker fees1007
Additional information about fees paid to insurance brokerFEES PAID TO THIRD PARTY ADMINISTRATION
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberPAI-MDV 2902400
Policy instance 1
Insurance contract or identification numberPAI-MDV 2902400
Number of Individuals Covered132
Insurance policy start date2020-10-27
Insurance policy end date2021-10-26
Total amount of commissions paid to insurance brokerUSD $34,265
Total amount of fees paid to insurance companyUSD $24,628
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $169,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,265
Insurance broker organization code?3
Amount paid for insurance broker fees24628
Additional information about fees paid to insurance brokerFEES PAID TO THIRD PARTY ADMINISTRATION
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberPAI-MDV 2902400
Policy instance 1
Insurance contract or identification numberPAI-MDV 2902400
Number of Individuals Covered143
Insurance policy start date2018-10-27
Insurance policy end date2019-10-26
Total amount of commissions paid to insurance brokerUSD $35,642
Total amount of fees paid to insurance companyUSD $26,352
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $181,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,642
Insurance broker organization code?3
Amount paid for insurance broker fees26352
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract numberPAI-L 2902400
Policy instance 2
Insurance contract or identification numberPAI-L 2902400
Number of Individuals Covered35
Insurance policy start date2018-10-27
Insurance policy end date2019-10-26
Total amount of commissions paid to insurance brokerUSD $1,394
Total amount of fees paid to insurance companyUSD $947
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $6,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,394
Insurance broker organization code?3
Amount paid for insurance broker fees947
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract numberPAI-L 2902400
Policy instance 2
Insurance contract or identification numberPAI-L 2902400
Number of Individuals Covered49
Insurance policy start date2017-10-27
Insurance policy end date2018-10-26
Total amount of commissions paid to insurance brokerUSD $953
Total amount of fees paid to insurance companyUSD $755
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $5,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $953
Insurance broker organization code?3
Amount paid for insurance broker fees755
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberPAI-MDV 2902400
Policy instance 1
Insurance contract or identification numberPAI-MDV 2902400
Number of Individuals Covered218
Insurance policy start date2017-10-27
Insurance policy end date2018-10-26
Total amount of commissions paid to insurance brokerUSD $31,426
Total amount of fees paid to insurance companyUSD $25,055
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $172,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,426
Insurance broker organization code?3
Amount paid for insurance broker fees25055
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract numberPAI-L-2902400
Policy instance 2
Insurance contract or identification numberPAI-L-2902400
Number of Individuals Covered30
Insurance policy start date2016-10-27
Insurance policy end date2017-10-26
Total amount of commissions paid to insurance brokerUSD $994
Total amount of fees paid to insurance companyUSD $804
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $5,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $994
Insurance broker organization code?3
Amount paid for insurance broker fees804
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberPAI-MDV 2902400
Policy instance 1
Insurance contract or identification numberPAI-MDV 2902400
Number of Individuals Covered134
Insurance policy start date2016-10-27
Insurance policy end date2017-10-26
Total amount of commissions paid to insurance brokerUSD $22,568
Total amount of fees paid to insurance companyUSD $18,221
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $125,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,568
Insurance broker organization code?3
Amount paid for insurance broker fees18221
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract numberPAI-L 2902400
Policy instance 2
Insurance contract or identification numberPAI-L 2902400
Number of Individuals Covered20
Insurance policy start date2015-10-27
Insurance policy end date2016-10-26
Total amount of commissions paid to insurance brokerUSD $817
Total amount of fees paid to insurance companyUSD $925
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $5,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees925
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $817
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberPAI-MDV 2902400
Policy instance 1
Insurance contract or identification numberPAI-MDV 2902400
Number of Individuals Covered114
Insurance policy start date2015-10-27
Insurance policy end date2016-10-26
Total amount of commissions paid to insurance brokerUSD $18,305
Total amount of fees paid to insurance companyUSD $18,792
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $126,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees18792
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $18,305
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract numberPAI-L 2902400
Policy instance 2
Insurance contract or identification numberPAI-L 2902400
Number of Individuals Covered151
Insurance policy start date2014-10-27
Insurance policy end date2015-10-26
Total amount of commissions paid to insurance brokerUSD $902
Total amount of fees paid to insurance companyUSD $1,140
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $7,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1140
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $902
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberPAI-MDV 2902400
Policy instance 1
Insurance contract or identification numberPAI-MDV 2902400
Number of Individuals Covered151
Insurance policy start date2014-10-27
Insurance policy end date2015-10-26
Total amount of commissions paid to insurance brokerUSD $17,650
Total amount of fees paid to insurance companyUSD $22,301
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $153,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees22301
Additional information about fees paid to insurance brokerFEES PAID FOR THIRD PARTY ADMINISTRATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $17,650

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