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| Plan Name | GROUP LIFE |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | D. M. DICKASON STAFF LEASING COMPANY |
| Employer identification number (EIN): | 742282450 |
| NAIC Classification: | 561300 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-08-01 | KELLY VALDEZ | 2024-11-06 | ||
| 501 | 2022-08-01 | KELLY VALDEZ | 2023-11-03 | ||
| 501 | 2021-08-01 | KELLY VALDEZ | 2022-12-19 | ||
| 501 | 2020-08-01 | KELLY VALDEZ | 2022-01-07 | ||
| 501 | 2019-08-01 | KELLY VALDEZ | 2021-01-08 | ||
| 501 | 2018-08-01 | KELLY VALDEZ | 2020-04-28 | ||
| 501 | 2017-08-01 | DONALD DICKASON | 2019-05-09 |
| 2023: GROUP LIFE 2023 form 5500 responses | ||
|---|---|---|
| 2023-08-01 | Type of plan entity | Single employer plan |
| 2023-08-01 | Plan funding arrangement – Insurance | Yes |
| 2023-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: GROUP LIFE 2022 form 5500 responses | ||
| 2022-08-01 | Type of plan entity | Single employer plan |
| 2022-08-01 | Plan funding arrangement – Insurance | Yes |
| 2022-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GROUP LIFE 2021 form 5500 responses | ||
| 2021-08-01 | Type of plan entity | Single employer plan |
| 2021-08-01 | Plan funding arrangement – Insurance | Yes |
| 2021-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GROUP LIFE 2020 form 5500 responses | ||
| 2020-08-01 | Type of plan entity | Single employer plan |
| 2020-08-01 | Plan funding arrangement – Insurance | Yes |
| 2020-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP LIFE 2019 form 5500 responses | ||
| 2019-08-01 | Type of plan entity | Single employer plan |
| 2019-08-01 | Plan funding arrangement – Insurance | Yes |
| 2019-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP LIFE 2018 form 5500 responses | ||
| 2018-08-01 | Type of plan entity | Single employer plan |
| 2018-08-01 | Plan funding arrangement – Insurance | Yes |
| 2018-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP LIFE 2017 form 5500 responses | ||
| 2017-08-01 | Type of plan entity | Single employer plan |
| 2017-08-01 | First time form 5500 has been submitted | Yes |
| 2017-08-01 | Plan funding arrangement – Insurance | Yes |
| 2017-08-01 | Plan benefit arrangement – Insurance | Yes |
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 ) | |||||||||||||||||||||
| Policy contract number | 272 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
| |||||||||||||||||||||
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 ) | |||||||||||||||||||||
| Policy contract number | 272 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 ) | |||||||||||||||||||||
| Policy contract number | 272 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 ) | |||||||||||||||||||||
| Policy contract number | 272 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 ) | |||||||||||||||||||||
| Policy contract number | 0272 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
| SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 ) | |||||||||||||||||||||
| Policy contract number | G000104695 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |||||||||||||||||||||
| Policy contract number | 59874 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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