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PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NamePLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN
Plan identification number 501

PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

PLACID REFINING COMPANY LLC has sponsored the creation of one or more 401k plans.

Company Name:PLACID REFINING COMPANY LLC
Employer identification number (EIN):752793350
NAIC Classification:324110
NAIC Description:Petroleum Refineries

Additional information about PLACID REFINING COMPANY LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date: 1998-12-15
Company Identification Number: 2980414
Legal Registered Office Address: Corporation Trust Center
1209 Orange St
Wilmington
United States of America (USA)
19801

More information about PLACID REFINING COMPANY LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01RITA O. PINION2024-10-03
5012022-01-01RITA 0. PINION2023-08-11
5012021-01-01RITA O. PINION2022-10-11
5012020-01-01RONALD D. HURST2021-08-19
5012019-01-01RONALD D. HURST2020-09-09
5012019-01-01RONALD D. HURST2020-09-09
5012019-01-01RONALD D. HURST2020-09-09
5012018-01-01RONALD D. HURST2019-10-03
5012017-01-01
5012016-01-01
5012015-01-01RONALD HURST
5012014-01-01RONALD HURST RONALD HURST2015-10-05
5012013-01-01RONALD HURST
5012012-01-01RONALD HURST
5012011-01-01RONALD HURST
5012010-01-01RONALD HURST
5012009-01-01RONALD HURST

Plan Statistics for PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN

Measure Date Value
2023: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01305
Total number of active participants reported on line 7a of the Form 55002023-01-01224
Number of retired or separated participants receiving benefits2023-01-0197
Total of all active and inactive participants2023-01-01321
Total participants2023-01-010
2022: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01306
Total number of active participants reported on line 7a of the Form 55002022-01-01208
Number of retired or separated participants receiving benefits2022-01-0198
Total of all active and inactive participants2022-01-01306
Total participants2022-01-01306
2021: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01311
Total number of active participants reported on line 7a of the Form 55002021-01-01224
Number of retired or separated participants receiving benefits2021-01-0193
Total of all active and inactive participants2021-01-01317
Total participants2021-01-01317
2020: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01307
Total number of active participants reported on line 7a of the Form 55002020-01-01224
Number of retired or separated participants receiving benefits2020-01-0188
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01312
Total participants2020-01-01312
2019: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01300
Total number of active participants reported on line 7a of the Form 55002019-01-01221
Number of retired or separated participants receiving benefits2019-01-0186
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01307
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-01308
Number of participants with account balances2019-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
Number of employers contributing to the scheme2019-01-010
2018: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01293
Total number of active participants reported on line 7a of the Form 55002018-01-01226
Number of retired or separated participants receiving benefits2018-01-0179
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-01306
2017: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01270
Total number of active participants reported on line 7a of the Form 55002017-01-01228
Number of retired or separated participants receiving benefits2017-01-0152
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-01281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-012
Total participants2017-01-01283
2016: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01274
Total number of active participants reported on line 7a of the Form 55002016-01-01228
Number of retired or separated participants receiving benefits2016-01-0147
Total of all active and inactive participants2016-01-01275
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-012
Total participants2016-01-01277
2015: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01369
Total number of active participants reported on line 7a of the Form 55002015-01-01235
Number of retired or separated participants receiving benefits2015-01-01107
Number of other retired or separated participants entitled to future benefits2015-01-0123
Total of all active and inactive participants2015-01-01365
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-0120
Total participants2015-01-01385
2014: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01367
Total number of active participants reported on line 7a of the Form 55002014-01-01235
Number of retired or separated participants receiving benefits2014-01-0192
Number of other retired or separated participants entitled to future benefits2014-01-0123
Total of all active and inactive participants2014-01-01350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-0119
Total participants2014-01-01369
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01382
Total number of active participants reported on line 7a of the Form 55002013-01-01219
Number of retired or separated participants receiving benefits2013-01-0192
Number of other retired or separated participants entitled to future benefits2013-01-0155
Total of all active and inactive participants2013-01-01366
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-011
Total participants2013-01-01367
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01372
Total number of active participants reported on line 7a of the Form 55002012-01-01218
Number of retired or separated participants receiving benefits2012-01-0197
Number of other retired or separated participants entitled to future benefits2012-01-0153
Total of all active and inactive participants2012-01-01368
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-0114
Total participants2012-01-01382
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01254
Total number of active participants reported on line 7a of the Form 55002011-01-01209
Number of retired or separated participants receiving benefits2011-01-0189
Number of other retired or separated participants entitled to future benefits2011-01-0162
Total of all active and inactive participants2011-01-01360
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-0112
Total participants2011-01-01372
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01251
Total number of active participants reported on line 7a of the Form 55002010-01-01207
Number of retired or separated participants receiving benefits2010-01-0146
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01253
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-011
Total participants2010-01-01254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01239
Total number of active participants reported on line 7a of the Form 55002009-01-01208
Number of retired or separated participants receiving benefits2009-01-0142
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01250
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-01251
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Form 5500 Responses for PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN

2023: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: PLACID REFINING COMPANY LLC WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D06ERC-ACTIVE
Policy instance 5
Insurance contract or identification number78D06ERC-ACTIVE
Number of Individuals Covered599
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Dental Insurance Welfare BenefitYes
Other welfare benefits providedMAJOR MEDICAL, DRUG
Welfare Benefit Premiums Paid to CarrierUSD $3,045,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D07ERC-RETIRE
Policy instance 4
Insurance contract or identification number78D07ERC-RETIRE
Number of Individuals Covered42
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Dental Insurance Welfare BenefitYes
Other welfare benefits providedMAJOR MEDICAL, DRUG
Welfare Benefit Premiums Paid to CarrierUSD $357,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberADDS08151
Policy instance 3
Insurance contract or identification numberADDS08151
Number of Individuals Covered159
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $14,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1165607
Policy instance 2
Insurance contract or identification number1165607
Number of Individuals Covered580
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,166
Total amount of fees paid to insurance companyUSD $1,016
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,607
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 number0137827
Policy instance 1
Insurance contract or identification number0137827
Number of Individuals Covered87
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $240,487
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 number0137827
Policy instance 1
Insurance contract or identification number0137827
Number of Individuals Covered83
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number444004
Policy instance 2
Insurance contract or identification number444004
Number of Individuals Covered248
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,195
Total amount of fees paid to insurance companyUSD $1,098
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1098
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $2,195
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number875472G
Policy instance 3
Insurance contract or identification number875472G
Number of Individuals Covered212
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $173,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D07ERC-RETIRE
Policy instance 4
Insurance contract or identification number78D07ERC-RETIRE
Number of Individuals Covered45
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Other welfare benefits providedMAJOR MEDICAL
Welfare Benefit Premiums Paid to CarrierUSD $131,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D06ERC-ACTIVE
Policy instance 5
Insurance contract or identification number78D06ERC-ACTIVE
Number of Individuals Covered566
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Other welfare benefits providedMAJOR MEDICAL
Welfare Benefit Premiums Paid to CarrierUSD $1,800,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number875472G
Policy instance 3
Insurance contract or identification number875472G
Number of Individuals Covered213
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $182,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberPLAC108
Policy instance 2
Insurance contract or identification numberPLAC108
Number of Individuals Covered248
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,323
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,323
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0137827
Policy instance 1
Insurance contract or identification number0137827
Number of Individuals Covered89
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $234,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberPLAC108
Policy instance 3
Insurance contract or identification numberPLAC108
Number of Individuals Covered253
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,338
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,338
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0137827
Policy instance 2
Insurance contract or identification number0137827
Number of Individuals Covered93
Insurance policy start date2020-01-01
Insurance policy end date2020-12-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $229,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number875472G
Policy instance 1
Insurance contract or identification number875472G
Number of Individuals Covered223
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $154,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number875472G
Policy instance 1
Insurance contract or identification number875472G
Number of Individuals Covered221
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $167,059
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 number0137827
Policy instance 2
Insurance contract or identification number0137827
Number of Individuals Covered94
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $225,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberPLAC108
Policy instance 3
Insurance contract or identification numberPLAC108
Number of Individuals Covered259
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,215
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,215
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number875472G
Policy instance 1
Insurance contract or identification number875472G
Number of Individuals Covered228
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $166,015
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 number0137827
Policy instance 2
Insurance contract or identification number0137827
Number of Individuals Covered97
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $225,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberPLAC108
Policy instance 3
Insurance contract or identification numberPLAC108
Number of Individuals Covered256
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,241
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,075
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberPLAC108
Policy instance 3
Insurance contract or identification numberPLAC108
Number of Individuals Covered248
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,871
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,711
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,871
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORY GROUP, LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0137827
Policy instance 2
Insurance contract or identification number0137827
Number of Individuals Covered98
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number875472G
Policy instance 1
Insurance contract or identification number875472G
Number of Individuals Covered226
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $165,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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