NATIONAL CABLE SATELLITE CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN
| Measure | Date | Value |
|---|
| 2022: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-02-01 | 165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 320 |
| Total of all active and inactive participants | 2022-02-01 | 320 |
| 2021: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-02-01 | 240 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 165 |
| Total of all active and inactive participants | 2021-02-01 | 165 |
| 2020: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-02-01 | 247 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 240 |
| Total of all active and inactive participants | 2020-02-01 | 240 |
| 2019: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-02-01 | 248 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 247 |
| Total of all active and inactive participants | 2019-02-01 | 247 |
| 2018: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-02-01 | 254 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 248 |
| Total of all active and inactive participants | 2018-02-01 | 248 |
| 2017: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-02-01 | 258 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 254 |
| Total of all active and inactive participants | 2017-02-01 | 254 |
| 2016: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-02-01 | 263 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 258 |
| Total of all active and inactive participants | 2016-02-01 | 258 |
| 2015: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-02-01 | 266 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 263 |
| Total of all active and inactive participants | 2015-02-01 | 263 |
| 2014: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-02-01 | 269 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 266 |
| Total of all active and inactive participants | 2014-02-01 | 266 |
| 2013: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-02-01 | 274 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 269 |
| Total of all active and inactive participants | 2013-02-01 | 269 |
| 2012: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-02-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 274 |
| Total of all active and inactive participants | 2012-02-01 | 274 |
| 2011: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-02-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 264 |
| Total of all active and inactive participants | 2011-02-01 | 264 |
| 2010: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-02-01 | 270 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-02-01 | 264 |
| Total of all active and inactive participants | 2010-02-01 | 264 |
| 2009: NATIONAL CABLE SATELLITE CORP CAFETERIA PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-02-01 | 311 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-02-01 | 270 |
| Total of all active and inactive participants | 2009-02-01 | 270 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 299437 |
| Policy instance | 5 |
| Insurance contract or identification number | 299437 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-10-01 | | Total amount of commissions paid to insurance broker | USD $8,736 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $92,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,736 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966560 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966560 | | Number of Individuals Covered | 320 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $216 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 216 | | Additional information about fees paid to insurance broker | SALES & SERVICE | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968082 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968082 | | Number of Individuals Covered | 320 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $33 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,886 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 33 | | Additional information about fees paid to insurance broker | SALES & SERVICE | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK964503/751769 |
| Policy instance | 2 |
| Insurance contract or identification number | LK964503/751769 | | Number of Individuals Covered | 320 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,010 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $118,384 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 1010 | | Additional information about fees paid to insurance broker | SALES & SERVICE | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3339626 |
| Policy instance | 1 |
| Insurance contract or identification number | 3339626 | | Number of Individuals Covered | 320 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $132 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $800,972 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 132 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3339626 |
| Policy instance | 1 |
| Insurance contract or identification number | 3339626 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $165 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $757,866 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 165 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK964503/751769 |
| Policy instance | 2 |
| Insurance contract or identification number | LK964503/751769 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,548 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,774 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1548 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968082 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968082 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $51 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $2,076 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 51 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966560 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966560 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $328 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,617 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 328 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 299437 |
| Policy instance | 5 |
| Insurance contract or identification number | 299437 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-10-01 | | Total amount of commissions paid to insurance broker | USD $10,931 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3339626 |
| Policy instance | 1 |
| Insurance contract or identification number | 3339626 | | Number of Individuals Covered | 240 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $154 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $769,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 154 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK964503/751769 |
| Policy instance | 2 |
| Insurance contract or identification number | LK964503/751769 | | Number of Individuals Covered | 240 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,416 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $175,956 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1416 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968082 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968082 | | Number of Individuals Covered | 240 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $47 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $5,810 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 47 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966560 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966560 | | Number of Individuals Covered | 240 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $271 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,620 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 271 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3339626 |
| Policy instance | 1 |
| Insurance contract or identification number | 3339626 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $149 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $707,412 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 149 | | Additional information about fees paid to insurance broker | SERVICE/GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK964503/751769 |
| Policy instance | 2 |
| Insurance contract or identification number | LK964503/751769 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $994 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $193,384 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 994 | | Additional information about fees paid to insurance broker | SERVICE FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968082 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968082 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $31 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $5,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 31 | | Additional information about fees paid to insurance broker | SERVICE FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966560 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966560 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $202 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,835 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 202 | | Additional information about fees paid to insurance broker | SERVICE FEES | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3339626 |
| Policy instance | 1 |
| Insurance contract or identification number | 3339626 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $138 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $672,976 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 138 | | Additional information about fees paid to insurance broker | SERVICE / GEN. AGENT FEES | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK964503/751769 |
| Policy instance | 2 |
| Insurance contract or identification number | LK964503/751769 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,394 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $196,027 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1394 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968082 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968082 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $48 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $6,633 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 48 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966560 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966560 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $274 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,585 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 274 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966560 |
| Policy instance | 5 |
| Insurance contract or identification number | FLX966560 | | Number of Individuals Covered | 257 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $300 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,179 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 300 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968082 |
| Policy instance | 4 |
| Insurance contract or identification number | OK 968082 | | Number of Individuals Covered | 257 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $54 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $6,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 54 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 5 | | Insurance broker name | TOWERS WATSON DELAWARE INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK964503/751769 |
| Policy instance | 3 |
| Insurance contract or identification number | LK964503/751769 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,584 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $193,293 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 1584 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE INC. |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3339626 |
| Policy instance | 2 |
| Insurance contract or identification number | 3339626 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $183 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $634,589 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 183 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE INC. |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | DIV#185 |
| Policy instance | 1 |
| Insurance contract or identification number | DIV#185 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE INC. |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | DIV#185 |
| Policy instance | 1 |
| Insurance contract or identification number | DIV#185 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $3,814 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,039 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,814 | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 299437 |
| Policy instance | 2 |
| Insurance contract or identification number | 299437 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $27,395 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $137,009 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,395 | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE INC. |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 1A72 |
| Policy instance | 3 |
| Insurance contract or identification number | 1A72 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $104 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $189,269 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 104 | | Additional information about fees paid to insurance broker | NON-MONETARY INCENTIVE AMOUNT | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968082 |
| Policy instance | 5 |
| Insurance contract or identification number | OK 968082 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $5,885 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966560 |
| Policy instance | 6 |
| Insurance contract or identification number | FLX966560 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,747 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 964503/75176 |
| Policy instance | 4 |
| Insurance contract or identification number | LK 964503/75176 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $171,644 | | 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 number | N66488 |
| Policy instance | 1 |
| Insurance contract or identification number | N66488 | | Number of Individuals Covered | 266 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Total amount of commissions paid to insurance broker | USD $702 | | Total amount of fees paid to insurance company | USD $776 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,806 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $389 | | Amount paid for insurance broker fees | 519 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 361757 |
| Policy instance | 2 |
| Insurance contract or identification number | 361757 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Total amount of commissions paid to insurance broker | USD $8,275 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $204,245 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,615 | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE INC. |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 1A72/66993 |
| Policy instance | 3 |
| Insurance contract or identification number | 1A72/66993 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Total amount of commissions paid to insurance broker | USD $10,529 | | Total amount of fees paid to insurance company | USD $10,507 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,094,377 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,529 | | Amount paid for insurance broker fees | 10507 | | Additional information about fees paid to insurance broker | MEDICAL CONTRACTS X PCPM 10,400 NON-MONETARY INCENTIVE AMOUNT 107 | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 361757 |
| Policy instance | 2 |
| Insurance contract or identification number | 361757 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-01-31 | | Total amount of commissions paid to insurance broker | USD $10,238 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $191,896 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,238 | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 1A72/66993 |
| Policy instance | 3 |
| Insurance contract or identification number | 1A72/66993 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-01-31 | | Total amount of commissions paid to insurance broker | USD $57,867 | | Total amount of fees paid to insurance company | USD $18,223 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | HEALTHY BLUE 2.0/CDH | | Welfare Benefit Premiums Paid to Carrier | USD $2,893,332 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $57,867 | | Amount paid for insurance broker fees | 18223 | | Additional information about fees paid to insurance broker | MEDICAL CONTRACTS X PCPM 14767, DENTAL CONTRACTS X PCPM 3350, NON-MON | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | N66488 |
| Policy instance | 1 |
| Insurance contract or identification number | N66488 | | Number of Individuals Covered | 269 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-01-31 | | Total amount of commissions paid to insurance broker | USD $711 | | Total amount of fees paid to insurance company | USD $788 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,418 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $711 | | Amount paid for insurance broker fees | 788 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 361757 |
| Policy instance | 2 |
| Insurance contract or identification number | 361757 | | Number of Individuals Covered | 266 | | Insurance policy start date | 2012-02-01 | | Insurance policy end date | 2013-01-31 | | Total amount of commissions paid to insurance broker | USD $10,238 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $171,288 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,238 | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | N66488 |
| Policy instance | 1 |
| Insurance contract or identification number | N66488 | | Number of Individuals Covered | 274 | | Insurance policy start date | 2012-02-01 | | Insurance policy end date | 2013-01-31 | | Total amount of commissions paid to insurance broker | USD $664 | | Total amount of fees paid to insurance company | USD $726 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,299 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $664 | | Amount paid for insurance broker fees | 726 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 1A72 |
| Policy instance | 3 |
| Insurance contract or identification number | 1A72 | | Number of Individuals Covered | 270 | | Insurance policy start date | 2012-02-01 | | Insurance policy end date | 2013-01-31 | | Total amount of commissions paid to insurance broker | USD $78,954 | | Total amount of fees paid to insurance company | USD $19,946 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,631,788 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $78,954 | | Amount paid for insurance broker fees | 19946 | | Additional information about fees paid to insurance broker | MEDICAL CONTRACTS X PCPM 16455, DENTAL CONTRACTS X PCPM 3380, NON-MON | | Insurance broker organization code? | 3 | | Insurance broker name | RUST INSURANCE AGENCY LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 361757 |
| Policy instance | 2 |
| Insurance contract or identification number | 361757 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-01-31 | | Total amount of commissions paid to insurance broker | USD $9,261 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $192,416 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 1A72 |
| Policy instance | 3 |
| Insurance contract or identification number | 1A72 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-01-31 | | Total amount of commissions paid to insurance broker | USD $83,409 | | Total amount of fees paid to insurance company | USD $14,603 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,780,298 | | 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 number | N66488 |
| Policy instance | 1 |
| Insurance contract or identification number | N66488 | | Number of Individuals Covered | 264 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-01-31 | | Total amount of commissions paid to insurance broker | USD $702 | | Total amount of fees paid to insurance company | USD $776 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,790 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 1A72 |
| Policy instance | 3 |
| Insurance contract or identification number | 1A72 | | Number of Individuals Covered | 245 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $75,712 | | Total amount of fees paid to insurance company | USD $13,672 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,523,729 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 361757 |
| Policy instance | 2 |
| Insurance contract or identification number | 361757 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $9,531 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $172,971 | | 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 number | N66488 |
| Policy instance | 1 |
| Insurance contract or identification number | N66488 | | Number of Individuals Covered | 264 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $633 | | Total amount of fees paid to insurance company | USD $684 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,196 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
