FRANK & CAMILLE'S INTERNATIONAL INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FRANK & CAMILLE'S INTERNATIONAL INC
| Measure | Date | Value |
|---|
| 2018: FRANK & CAMILLE'S INTERNATIONAL INC 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 6 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 8 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 8 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 8 |
| Number of participants with account balances | 2018-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
| Number of employers contributing to the scheme | 2018-01-01 | 0 |
| 2017: FRANK & CAMILLE'S INTERNATIONAL INC 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 6 |
| Total of all active and inactive participants | 2017-01-01 | 6 |
| Total participants | 2017-01-01 | 6 |
| 2016: FRANK & CAMILLE'S INTERNATIONAL INC 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 7 |
| Total of all active and inactive participants | 2016-01-01 | 7 |
| Total participants | 2016-01-01 | 7 |
| 2015: FRANK & CAMILLE'S INTERNATIONAL INC 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 7 |
| Total of all active and inactive participants | 2015-01-01 | 7 |
| Total participants | 2015-01-01 | 7 |
| 2014: FRANK & CAMILLE'S INTERNATIONAL INC 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 7 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 7 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 7 |
| Number of participants with account balances | 2014-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| Number of employers contributing to the scheme | 2014-01-01 | 0 |
| 2013: FRANK & CAMILLE'S INTERNATIONAL INC 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 10 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 7 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 7 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 7 |
| Number of participants with account balances | 2013-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| Number of employers contributing to the scheme | 2013-01-01 | 0 |
| 2012: FRANK & CAMILLE'S INTERNATIONAL INC 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 11 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 10 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 10 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 10 |
| Number of participants with account balances | 2012-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| Number of employers contributing to the scheme | 2012-01-01 | 0 |
| 2011: FRANK & CAMILLE'S INTERNATIONAL INC 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 12 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 11 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 11 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 11 |
| Number of participants with account balances | 2011-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| Number of employers contributing to the scheme | 2011-01-01 | 0 |
| 2010: FRANK & CAMILLE'S INTERNATIONAL INC 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 17 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 12 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 12 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 12 |
| Number of participants with account balances | 2010-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| Number of employers contributing to the scheme | 2010-01-01 | 0 |
| 2009: FRANK & CAMILLE'S INTERNATIONAL INC 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 17 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 17 |
| Total participants | 2009-01-01 | 17 |
| Number of participants with account balances | 2009-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Number of employers contributing to the scheme | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2018 : FRANK & CAMILLE'S INTERNATIONAL INC 2018 401k financial data |
|---|
| Transfers to/from the plan | 2018-12-31 | $0 |
| Total plan liabilities at end of year | 2018-12-31 | $0 |
| Total plan liabilities at beginning of year | 2018-12-31 | $0 |
| Total income from all sources | 2018-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $0 |
| Total plan assets at end of year | 2018-12-31 | $0 |
| Total plan assets at beginning of year | 2018-12-31 | $0 |
| Value of fidelity bond covering the plan | 2018-12-31 | $300,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $0 |
| Other income received | 2018-12-31 | $0 |
| Noncash contributions received | 2018-12-31 | $0 |
| Net income (gross income less expenses) | 2018-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2018-12-31 | $0 |
| Value of corrective distributions | 2018-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $0 |
| 2017 : FRANK & CAMILLE'S INTERNATIONAL INC 2017 401k financial data |
|---|
| Transfers to/from the plan | 2017-12-31 | $0 |
| Total plan liabilities at end of year | 2017-12-31 | $0 |
| Total plan liabilities at beginning of year | 2017-12-31 | $0 |
| Total income from all sources | 2017-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $0 |
| Total plan assets at end of year | 2017-12-31 | $0 |
| Total plan assets at beginning of year | 2017-12-31 | $0 |
| Value of fidelity bond covering the plan | 2017-12-31 | $300,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $0 |
| Other income received | 2017-12-31 | $0 |
| Noncash contributions received | 2017-12-31 | $0 |
| Net income (gross income less expenses) | 2017-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2017-12-31 | $0 |
| Value of corrective distributions | 2017-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $0 |
| 2016 : FRANK & CAMILLE'S INTERNATIONAL INC 2016 401k financial data |
|---|
| Transfers to/from the plan | 2016-12-31 | $0 |
| Total plan liabilities at end of year | 2016-12-31 | $0 |
| Total plan liabilities at beginning of year | 2016-12-31 | $0 |
| Total income from all sources | 2016-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $0 |
| Total plan assets at end of year | 2016-12-31 | $0 |
| Total plan assets at beginning of year | 2016-12-31 | $0 |
| Value of fidelity bond covering the plan | 2016-12-31 | $300,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $0 |
| Other income received | 2016-12-31 | $0 |
| Noncash contributions received | 2016-12-31 | $0 |
| Net income (gross income less expenses) | 2016-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2016-12-31 | $0 |
| Value of corrective distributions | 2016-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $0 |
| 2015 : FRANK & CAMILLE'S INTERNATIONAL INC 2015 401k financial data |
|---|
| Transfers to/from the plan | 2015-12-31 | $0 |
| Total plan liabilities at end of year | 2015-12-31 | $0 |
| Total plan liabilities at beginning of year | 2015-12-31 | $0 |
| Total income from all sources | 2015-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $0 |
| Total plan assets at end of year | 2015-12-31 | $0 |
| Total plan assets at beginning of year | 2015-12-31 | $0 |
| Value of fidelity bond covering the plan | 2015-12-31 | $300,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2015-12-31 | $0 |
| Other income received | 2015-12-31 | $0 |
| Noncash contributions received | 2015-12-31 | $0 |
| Net income (gross income less expenses) | 2015-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2015-12-31 | $0 |
| Value of corrective distributions | 2015-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $0 |
| 2014 : FRANK & CAMILLE'S INTERNATIONAL INC 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $0 |
| Total plan liabilities at end of year | 2014-12-31 | $0 |
| Total plan liabilities at beginning of year | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $0 |
| Total plan assets at end of year | 2014-12-31 | $0 |
| Total plan assets at beginning of year | 2014-12-31 | $0 |
| Value of fidelity bond covering the plan | 2014-12-31 | $300,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
| Other income received | 2014-12-31 | $0 |
| Noncash contributions received | 2014-12-31 | $0 |
| Net income (gross income less expenses) | 2014-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2014-12-31 | $0 |
| Value of corrective distributions | 2014-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $0 |
| 2013 : FRANK & CAMILLE'S INTERNATIONAL INC 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total plan liabilities at end of year | 2013-12-31 | $0 |
| Total plan liabilities at beginning of year | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $0 |
| Total plan assets at end of year | 2013-12-31 | $0 |
| Total plan assets at beginning of year | 2013-12-31 | $0 |
| Value of fidelity bond covering the plan | 2013-12-31 | $300,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $0 |
| Other income received | 2013-12-31 | $0 |
| Noncash contributions received | 2013-12-31 | $0 |
| Net income (gross income less expenses) | 2013-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
| Value of corrective distributions | 2013-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $0 |
| 2012 : FRANK & CAMILLE'S INTERNATIONAL INC 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total plan liabilities at end of year | 2012-12-31 | $0 |
| Total plan liabilities at beginning of year | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $0 |
| Total plan assets at end of year | 2012-12-31 | $0 |
| Total plan assets at beginning of year | 2012-12-31 | $0 |
| Value of fidelity bond covering the plan | 2012-12-31 | $300,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $0 |
| Other income received | 2012-12-31 | $0 |
| Noncash contributions received | 2012-12-31 | $0 |
| Net income (gross income less expenses) | 2012-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
| Value of corrective distributions | 2012-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $0 |
| 2011 : FRANK & CAMILLE'S INTERNATIONAL INC 2011 401k financial data |
|---|
| Total plan liabilities at end of year | 2011-12-31 | $0 |
| Total plan liabilities at beginning of year | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $0 |
| Total plan assets at end of year | 2011-12-31 | $0 |
| Total plan assets at beginning of year | 2011-12-31 | $0 |
| Value of fidelity bond covering the plan | 2011-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $0 |
| Other income received | 2011-12-31 | $0 |
| Noncash contributions received | 2011-12-31 | $0 |
| Net income (gross income less expenses) | 2011-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $0 |
| 2010 : FRANK & CAMILLE'S INTERNATIONAL INC 2010 401k financial data |
|---|
| Transfers to/from the plan | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $0 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $0 |
| Total plan assets at end of year | 2010-12-31 | $0 |
| Total plan assets at beginning of year | 2010-12-31 | $0 |
| Value of fidelity bond covering the plan | 2010-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $0 |
| Noncash contributions received | 2010-12-31 | $0 |
| Net income (gross income less expenses) | 2010-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $0 |
| 2018: FRANK & CAMILLE'S INTERNATIONAL INC 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: FRANK & CAMILLE'S INTERNATIONAL INC 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: FRANK & CAMILLE'S INTERNATIONAL INC 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FRANK & CAMILLE'S INTERNATIONAL INC 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: FRANK & CAMILLE'S INTERNATIONAL INC 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: FRANK & CAMILLE'S INTERNATIONAL INC 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: FRANK & CAMILLE'S INTERNATIONAL INC 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: FRANK & CAMILLE'S INTERNATIONAL INC 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: FRANK & CAMILLE'S INTERNATIONAL INC 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FRANK & CAMILLE'S INTERNATIONAL INC 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 00474734 |
| Policy instance | 2 |
| Insurance contract or identification number | 00474734 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | FC19101 |
| Policy instance | 1 |
| Insurance contract or identification number | FC19101 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 00474734 |
| Policy instance | 2 |
| Insurance contract or identification number | 00474734 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2016-12-01 | | Insurance policy end date | 2017-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | FC19101 |
| Policy instance | 1 |
| Insurance contract or identification number | FC19101 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2016-12-01 | | Insurance policy end date | 2017-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | FC19101 |
| Policy instance | 2 |
| Insurance contract or identification number | FC19101 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 00474734 |
| Policy instance | 1 |
| Insurance contract or identification number | 00474734 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 00474734 |
| Policy instance | 2 |
| Insurance contract or identification number | 00474734 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | FC19101 |
| Policy instance | 1 |
| Insurance contract or identification number | FC19101 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 00474734 |
| Policy instance | 2 |
| Insurance contract or identification number | 00474734 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | FC19101 |
| Policy instance | 1 |
| Insurance contract or identification number | FC19101 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 00474734 |
| Policy instance | 3 |
| Insurance contract or identification number | 00474734 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | FC19101 |
| Policy instance | 2 |
| Insurance contract or identification number | FC19101 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | INTERCITY AGENCY |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 524329 |
| Policy instance | 1 |
| Insurance contract or identification number | 524329 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | MY BENEFIT ADVISORS LLC |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 524329 |
| Policy instance | 1 |
| Insurance contract or identification number | 524329 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| EMPIRE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 524329 |
| Policy instance | 1 |
| Insurance contract or identification number | 524329 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2009-06-01 | | Insurance policy end date | 2010-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | MY BENEFIT ADVISORS LLC |
|
