SHEET METAL WORKERS LOCAL 46 HEALTH FUND BOARD OF TRUSTEES has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SHEET METAL WORKERS LOCAL 46 HEALTH FUND
| Measure | Date | Value |
|---|
| 2022 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-06-30 | $-553,042 |
| Total unrealized appreciation/depreciation of assets | 2022-06-30 | $-553,042 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $489,681 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $759,697 |
| Total income from all sources (including contributions) | 2022-06-30 | $7,339,477 |
| Total loss/gain on sale of assets | 2022-06-30 | $226,618 |
| Total of all expenses incurred | 2022-06-30 | $6,502,367 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-06-30 | $5,588,185 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-06-30 | $7,629,817 |
| Value of total assets at end of year | 2022-06-30 | $9,329,106 |
| Value of total assets at beginning of year | 2022-06-30 | $8,762,012 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-06-30 | $914,182 |
| Total interest from all sources | 2022-06-30 | $66,667 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-06-30 | $61,784 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-06-30 | $46,663 |
| Administrative expenses professional fees incurred | 2022-06-30 | $167,940 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2022-06-30 | $0 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2022-06-30 | $16,063 |
| Was this plan covered by a fidelity bond | 2022-06-30 | Yes |
| Value of fidelity bond cover | 2022-06-30 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-06-30 | No |
| Contributions received from participants | 2022-06-30 | $861,452 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-06-30 | $101,988 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-06-30 | $166,993 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-06-30 | $106,030 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-06-30 | $408,181 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-06-30 | $694,400 |
| Other income not declared elsewhere | 2022-06-30 | $191,388 |
| Administrative expenses (other) incurred | 2022-06-30 | $379,141 |
| Liabilities. Value of operating payables at end of year | 2022-06-30 | $81,500 |
| Liabilities. Value of operating payables at beginning of year | 2022-06-30 | $65,297 |
| Total non interest bearing cash at end of year | 2022-06-30 | $817,973 |
| Total non interest bearing cash at beginning of year | 2022-06-30 | $802,075 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Value of net income/loss | 2022-06-30 | $837,110 |
| Value of net assets at end of year (total assets less liabilities) | 2022-06-30 | $8,839,425 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-06-30 | $8,002,315 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-06-30 | No |
| Investment advisory and management fees | 2022-06-30 | $48,764 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-06-30 | $1,458,333 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-06-30 | $1,749,806 |
| Interest earned on other investments | 2022-06-30 | $17,143 |
| Income. Interest from US Government securities | 2022-06-30 | $15,257 |
| Income. Interest from corporate debt instruments | 2022-06-30 | $34,252 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-06-30 | $2,117,250 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-06-30 | $638,747 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-06-30 | $638,747 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-06-30 | $15 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-06-30 | $1,048,064 |
| Asset value of US Government securities at end of year | 2022-06-30 | $1,470,961 |
| Asset value of US Government securities at beginning of year | 2022-06-30 | $1,346,086 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-06-30 | $-283,755 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-06-30 | No |
| Contributions received in cash from employer | 2022-06-30 | $6,768,365 |
| Employer contributions (assets) at end of year | 2022-06-30 | $617,286 |
| Employer contributions (assets) at beginning of year | 2022-06-30 | $542,452 |
| Income. Dividends from preferred stock | 2022-06-30 | $83 |
| Income. Dividends from common stock | 2022-06-30 | $15,038 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-06-30 | $4,438,133 |
| Asset. Corporate debt instrument debt (other) at end of year | 2022-06-30 | $1,318,796 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2022-06-30 | $1,558,216 |
| Contract administrator fees | 2022-06-30 | $318,337 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-06-30 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2022-06-30 | $1,337,753 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2022-06-30 | $1,981,220 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2022-06-30 | $23,761 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2022-06-30 | $21,317 |
| Did the plan have assets held for investment | 2022-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-06-30 | No |
| Aggregate proceeds on sale of assets | 2022-06-30 | $3,162,704 |
| Aggregate carrying amount (costs) on sale of assets | 2022-06-30 | $2,936,086 |
| Opinion of an independent qualified public accountant for this plan | 2022-06-30 | Unqualified |
| Accountancy firm name | 2022-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2022-06-30 | 161131146 |
| 2021 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-06-30 | $-2,184,169 |
| Total unrealized appreciation/depreciation of assets | 2021-06-30 | $-2,184,169 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $759,697 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $588,411 |
| Total income from all sources (including contributions) | 2021-06-30 | $7,880,823 |
| Total loss/gain on sale of assets | 2021-06-30 | $2,654,181 |
| Total of all expenses incurred | 2021-06-30 | $7,762,865 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-06-30 | $6,842,686 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-06-30 | $7,016,393 |
| Value of total assets at end of year | 2021-06-30 | $8,762,012 |
| Value of total assets at beginning of year | 2021-06-30 | $8,472,768 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-06-30 | $920,179 |
| Total interest from all sources | 2021-06-30 | $52,099 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-06-30 | $161,487 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-06-30 | $141,313 |
| Administrative expenses professional fees incurred | 2021-06-30 | $176,250 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2021-06-30 | $16,063 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2021-06-30 | $34,903 |
| Was this plan covered by a fidelity bond | 2021-06-30 | Yes |
| Value of fidelity bond cover | 2021-06-30 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-06-30 | No |
| Contributions received from participants | 2021-06-30 | $851,129 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-06-30 | $104,312 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-06-30 | $106,030 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-06-30 | $215,825 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-06-30 | $694,400 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-06-30 | $433,000 |
| Other income not declared elsewhere | 2021-06-30 | $150,844 |
| Administrative expenses (other) incurred | 2021-06-30 | $423,875 |
| Liabilities. Value of operating payables at end of year | 2021-06-30 | $65,297 |
| Liabilities. Value of operating payables at beginning of year | 2021-06-30 | $155,411 |
| Total non interest bearing cash at end of year | 2021-06-30 | $802,075 |
| Total non interest bearing cash at beginning of year | 2021-06-30 | $817,407 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Value of net income/loss | 2021-06-30 | $117,958 |
| Value of net assets at end of year (total assets less liabilities) | 2021-06-30 | $8,002,315 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-06-30 | $7,884,357 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-06-30 | No |
| Investment advisory and management fees | 2021-06-30 | $46,943 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-06-30 | $1,749,806 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-06-30 | $1,641,257 |
| Interest earned on other investments | 2021-06-30 | $13,631 |
| Income. Interest from US Government securities | 2021-06-30 | $17,911 |
| Income. Interest from corporate debt instruments | 2021-06-30 | $20,539 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-06-30 | $638,747 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-06-30 | $1,901,516 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-06-30 | $1,901,516 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-06-30 | $18 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-06-30 | $1,091,474 |
| Asset value of US Government securities at end of year | 2021-06-30 | $1,346,086 |
| Asset value of US Government securities at beginning of year | 2021-06-30 | $1,236,084 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-06-30 | $29,988 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-06-30 | No |
| Contributions received in cash from employer | 2021-06-30 | $6,165,264 |
| Employer contributions (assets) at end of year | 2021-06-30 | $542,452 |
| Employer contributions (assets) at beginning of year | 2021-06-30 | $542,447 |
| Income. Dividends from preferred stock | 2021-06-30 | $1,836 |
| Income. Dividends from common stock | 2021-06-30 | $18,338 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-06-30 | $5,646,900 |
| Asset. Corporate debt instrument debt (other) at end of year | 2021-06-30 | $1,558,216 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2021-06-30 | $709,829 |
| Contract administrator fees | 2021-06-30 | $273,111 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2021-06-30 | $1,981,220 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2021-06-30 | $1,367,131 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2021-06-30 | $21,317 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2021-06-30 | $6,369 |
| Did the plan have assets held for investment | 2021-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-06-30 | No |
| Aggregate proceeds on sale of assets | 2021-06-30 | $4,149,382 |
| Aggregate carrying amount (costs) on sale of assets | 2021-06-30 | $1,495,201 |
| Opinion of an independent qualified public accountant for this plan | 2021-06-30 | Unqualified |
| Accountancy firm name | 2021-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2021-06-30 | 161131146 |
| 2020 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-06-30 | $652,904 |
| Total unrealized appreciation/depreciation of assets | 2020-06-30 | $652,904 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $588,411 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $358,335 |
| Total income from all sources (including contributions) | 2020-06-30 | $7,785,931 |
| Total loss/gain on sale of assets | 2020-06-30 | $84,253 |
| Total of all expenses incurred | 2020-06-30 | $6,427,767 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $5,552,137 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $7,222,286 |
| Value of total assets at end of year | 2020-06-30 | $8,472,768 |
| Value of total assets at beginning of year | 2020-06-30 | $6,884,528 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-06-30 | $875,630 |
| Total interest from all sources | 2020-06-30 | $56,500 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-06-30 | $78,049 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-06-30 | $56,579 |
| Administrative expenses professional fees incurred | 2020-06-30 | $176,690 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2020-06-30 | $34,903 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2020-06-30 | $192,559 |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Contributions received from participants | 2020-06-30 | $831,965 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-06-30 | $114,588 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-06-30 | $215,825 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-06-30 | $194,713 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-06-30 | $433,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-06-30 | $161,500 |
| Other income not declared elsewhere | 2020-06-30 | $178,657 |
| Administrative expenses (other) incurred | 2020-06-30 | $414,244 |
| Liabilities. Value of operating payables at end of year | 2020-06-30 | $155,411 |
| Liabilities. Value of operating payables at beginning of year | 2020-06-30 | $196,835 |
| Total non interest bearing cash at end of year | 2020-06-30 | $817,407 |
| Total non interest bearing cash at beginning of year | 2020-06-30 | $767,241 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $1,358,164 |
| Value of net assets at end of year (total assets less liabilities) | 2020-06-30 | $7,884,357 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-06-30 | $6,526,193 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Investment advisory and management fees | 2020-06-30 | $44,470 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-06-30 | $1,641,257 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-06-30 | $1,213,447 |
| Income. Interest from loans (other than to participants) | 2020-06-30 | $1,127 |
| Interest earned on other investments | 2020-06-30 | $28,368 |
| Income. Interest from US Government securities | 2020-06-30 | $875 |
| Income. Interest from corporate debt instruments | 2020-06-30 | $26,130 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-06-30 | $1,901,516 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-06-30 | $1,825,230 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-06-30 | $1,825,230 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-06-30 | $1,078,799 |
| Asset value of US Government securities at end of year | 2020-06-30 | $1,236,084 |
| Asset value of US Government securities at beginning of year | 2020-06-30 | $1,148,933 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-06-30 | $-486,718 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $6,390,321 |
| Employer contributions (assets) at end of year | 2020-06-30 | $542,447 |
| Employer contributions (assets) at beginning of year | 2020-06-30 | $548,428 |
| Income. Dividends from preferred stock | 2020-06-30 | $9,925 |
| Income. Dividends from common stock | 2020-06-30 | $11,545 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-06-30 | $4,358,750 |
| Asset. Corporate debt instrument debt (other) at end of year | 2020-06-30 | $709,829 |
| Contract administrator fees | 2020-06-30 | $240,226 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2020-06-30 | $1,367,131 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2020-06-30 | $993,977 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2020-06-30 | $6,369 |
| Did the plan have assets held for investment | 2020-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| Aggregate proceeds on sale of assets | 2020-06-30 | $6,542,432 |
| Aggregate carrying amount (costs) on sale of assets | 2020-06-30 | $6,458,179 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-06-30 | Unqualified |
| Accountancy firm name | 2020-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2020-06-30 | 161131146 |
| 2019 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-06-30 | $197,108 |
| Total unrealized appreciation/depreciation of assets | 2019-06-30 | $197,108 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $358,335 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $1,111,812 |
| Total income from all sources (including contributions) | 2019-06-30 | $7,545,706 |
| Total loss/gain on sale of assets | 2019-06-30 | $34,946 |
| Total of all expenses incurred | 2019-06-30 | $5,521,825 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $4,734,743 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $7,075,228 |
| Value of total assets at end of year | 2019-06-30 | $6,884,528 |
| Value of total assets at beginning of year | 2019-06-30 | $5,614,124 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-06-30 | $787,082 |
| Total interest from all sources | 2019-06-30 | $28,679 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-06-30 | $85,222 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-06-30 | $63,024 |
| Administrative expenses professional fees incurred | 2019-06-30 | $213,783 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2019-06-30 | $192,559 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2019-06-30 | $155,536 |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2019-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Contributions received from participants | 2019-06-30 | $844,281 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-06-30 | $99,959 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-06-30 | $194,713 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-06-30 | $138,435 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-06-30 | $161,500 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-06-30 | $603,800 |
| Other income not declared elsewhere | 2019-06-30 | $135,031 |
| Administrative expenses (other) incurred | 2019-06-30 | $325,280 |
| Liabilities. Value of operating payables at end of year | 2019-06-30 | $196,835 |
| Liabilities. Value of operating payables at beginning of year | 2019-06-30 | $508,012 |
| Total non interest bearing cash at end of year | 2019-06-30 | $767,241 |
| Total non interest bearing cash at beginning of year | 2019-06-30 | $1,280,529 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $2,023,881 |
| Value of net assets at end of year (total assets less liabilities) | 2019-06-30 | $6,526,193 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-06-30 | $4,502,312 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Investment advisory and management fees | 2019-06-30 | $22,041 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-06-30 | $1,213,447 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-06-30 | $1,082,388 |
| Income. Interest from US Government securities | 2019-06-30 | $28,679 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-06-30 | $1,825,230 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-06-30 | $291,418 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-06-30 | $291,418 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-06-30 | $1,146,592 |
| Asset value of US Government securities at end of year | 2019-06-30 | $1,148,933 |
| Asset value of US Government securities at beginning of year | 2019-06-30 | $1,195,915 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-06-30 | $-10,508 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $6,230,947 |
| Employer contributions (assets) at end of year | 2019-06-30 | $548,428 |
| Employer contributions (assets) at beginning of year | 2019-06-30 | $526,255 |
| Income. Dividends from preferred stock | 2019-06-30 | $11,892 |
| Income. Dividends from common stock | 2019-06-30 | $10,306 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-06-30 | $3,488,192 |
| Contract administrator fees | 2019-06-30 | $225,978 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2019-06-30 | $993,977 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2019-06-30 | $943,648 |
| Did the plan have assets held for investment | 2019-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| Aggregate proceeds on sale of assets | 2019-06-30 | $3,766,241 |
| Aggregate carrying amount (costs) on sale of assets | 2019-06-30 | $3,731,295 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-06-30 | Unqualified |
| Accountancy firm name | 2019-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2019-06-30 | 161131146 |
| 2018 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-06-30 | $-25,974 |
| Total unrealized appreciation/depreciation of assets | 2018-06-30 | $-25,974 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $1,111,812 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $1,556,067 |
| Total income from all sources (including contributions) | 2018-06-30 | $6,545,546 |
| Total loss/gain on sale of assets | 2018-06-30 | $105,676 |
| Total of all expenses incurred | 2018-06-30 | $5,651,414 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-06-30 | $4,924,219 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-06-30 | $6,264,077 |
| Value of total assets at end of year | 2018-06-30 | $5,614,124 |
| Value of total assets at beginning of year | 2018-06-30 | $5,164,247 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-06-30 | $727,195 |
| Total interest from all sources | 2018-06-30 | $24,743 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-06-30 | $53,224 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-06-30 | $31,931 |
| Administrative expenses professional fees incurred | 2018-06-30 | $233,337 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2018-06-30 | $155,536 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2018-06-30 | $99,271 |
| Was this plan covered by a fidelity bond | 2018-06-30 | Yes |
| Value of fidelity bond cover | 2018-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2018-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-06-30 | No |
| Contributions received from participants | 2018-06-30 | $880,143 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-06-30 | $80,261 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-06-30 | $138,435 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-06-30 | $79,498 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-06-30 | $603,800 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-06-30 | $910,200 |
| Other income not declared elsewhere | 2018-06-30 | $131,876 |
| Administrative expenses (other) incurred | 2018-06-30 | $249,051 |
| Liabilities. Value of operating payables at end of year | 2018-06-30 | $508,012 |
| Liabilities. Value of operating payables at beginning of year | 2018-06-30 | $645,867 |
| Total non interest bearing cash at end of year | 2018-06-30 | $1,280,529 |
| Total non interest bearing cash at beginning of year | 2018-06-30 | $1,323,367 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Value of net income/loss | 2018-06-30 | $894,132 |
| Value of net assets at end of year (total assets less liabilities) | 2018-06-30 | $4,502,312 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-06-30 | $3,608,180 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-06-30 | No |
| Investment advisory and management fees | 2018-06-30 | $23,594 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-06-30 | $1,082,388 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-06-30 | $1,151,048 |
| Income. Interest from US Government securities | 2018-06-30 | $24,743 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-06-30 | $291,418 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-06-30 | $103,200 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-06-30 | $103,200 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-06-30 | $1,231,734 |
| Asset value of US Government securities at end of year | 2018-06-30 | $1,195,915 |
| Asset value of US Government securities at beginning of year | 2018-06-30 | $1,097,505 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-06-30 | $-8,076 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-06-30 | No |
| Contributions received in cash from employer | 2018-06-30 | $5,383,934 |
| Employer contributions (assets) at end of year | 2018-06-30 | $526,255 |
| Employer contributions (assets) at beginning of year | 2018-06-30 | $432,197 |
| Income. Dividends from preferred stock | 2018-06-30 | $11,108 |
| Income. Dividends from common stock | 2018-06-30 | $10,185 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-06-30 | $3,612,224 |
| Contract administrator fees | 2018-06-30 | $221,213 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2018-06-30 | $943,648 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2018-06-30 | $877,248 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2018-06-30 | $913 |
| Did the plan have assets held for investment | 2018-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-06-30 | No |
| Aggregate proceeds on sale of assets | 2018-06-30 | $6,468,730 |
| Aggregate carrying amount (costs) on sale of assets | 2018-06-30 | $6,363,054 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-06-30 | Unqualified |
| Accountancy firm name | 2018-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2018-06-30 | 161131146 |
| 2017 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-06-30 | $4,667 |
| Total unrealized appreciation/depreciation of assets | 2017-06-30 | $4,667 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $1,556,067 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $1,607,059 |
| Total income from all sources (including contributions) | 2017-06-30 | $5,922,050 |
| Total loss/gain on sale of assets | 2017-06-30 | $146,499 |
| Total of all expenses incurred | 2017-06-30 | $7,293,640 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-06-30 | $6,382,503 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-06-30 | $5,645,333 |
| Value of total assets at end of year | 2017-06-30 | $5,164,247 |
| Value of total assets at beginning of year | 2017-06-30 | $6,586,829 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-06-30 | $911,137 |
| Total interest from all sources | 2017-06-30 | $24,588 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-06-30 | $65,191 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-06-30 | $43,639 |
| Administrative expenses professional fees incurred | 2017-06-30 | $320,380 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2017-06-30 | $99,271 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2017-06-30 | $73 |
| Was this plan covered by a fidelity bond | 2017-06-30 | Yes |
| Value of fidelity bond cover | 2017-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2017-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-06-30 | No |
| Contributions received from participants | 2017-06-30 | $841,921 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-06-30 | $135,421 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-06-30 | $79,498 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-06-30 | $6,858 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-06-30 | $910,200 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-06-30 | $1,087,500 |
| Administrative expenses (other) incurred | 2017-06-30 | $266,764 |
| Liabilities. Value of operating payables at end of year | 2017-06-30 | $645,867 |
| Liabilities. Value of operating payables at beginning of year | 2017-06-30 | $519,559 |
| Total non interest bearing cash at end of year | 2017-06-30 | $1,323,367 |
| Total non interest bearing cash at beginning of year | 2017-06-30 | $1,174,356 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Value of net income/loss | 2017-06-30 | $-1,371,590 |
| Value of net assets at end of year (total assets less liabilities) | 2017-06-30 | $3,608,180 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-06-30 | $4,979,770 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-06-30 | No |
| Investment advisory and management fees | 2017-06-30 | $21,303 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-06-30 | $1,151,048 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-06-30 | $1,813,274 |
| Income. Interest from US Government securities | 2017-06-30 | $20,419 |
| Income. Interest from corporate debt instruments | 2017-06-30 | $4,169 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-06-30 | $103,200 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-06-30 | $173,915 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-06-30 | $173,915 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-06-30 | $1,116,501 |
| Asset value of US Government securities at end of year | 2017-06-30 | $1,097,505 |
| Asset value of US Government securities at beginning of year | 2017-06-30 | $1,181,877 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-06-30 | $35,772 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-06-30 | No |
| Contributions received in cash from employer | 2017-06-30 | $4,803,412 |
| Employer contributions (assets) at end of year | 2017-06-30 | $432,197 |
| Employer contributions (assets) at beginning of year | 2017-06-30 | $471,171 |
| Income. Dividends from preferred stock | 2017-06-30 | $3,614 |
| Income. Dividends from common stock | 2017-06-30 | $17,938 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-06-30 | $5,130,581 |
| Asset. Corporate debt instrument preferred debt at end of year | 2017-06-30 | $0 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2017-06-30 | $313,225 |
| Contract administrator fees | 2017-06-30 | $302,690 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2017-06-30 | $877,248 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2017-06-30 | $1,450,350 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2017-06-30 | $913 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2017-06-30 | $1,730 |
| Did the plan have assets held for investment | 2017-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-06-30 | No |
| Aggregate proceeds on sale of assets | 2017-06-30 | $12,817,405 |
| Aggregate carrying amount (costs) on sale of assets | 2017-06-30 | $12,670,906 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-06-30 | Unqualified |
| Accountancy firm name | 2017-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2017-06-30 | 161131146 |
| 2016 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-06-30 | $-199,851 |
| Total unrealized appreciation/depreciation of assets | 2016-06-30 | $-199,851 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $1,607,059 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $1,068,707 |
| Total income from all sources (including contributions) | 2016-06-30 | $5,602,169 |
| Total loss/gain on sale of assets | 2016-06-30 | $15,116 |
| Total of all expenses incurred | 2016-06-30 | $7,851,288 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-06-30 | $7,138,750 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-06-30 | $5,545,896 |
| Value of total assets at end of year | 2016-06-30 | $6,586,829 |
| Value of total assets at beginning of year | 2016-06-30 | $8,297,596 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-06-30 | $712,538 |
| Total interest from all sources | 2016-06-30 | $37,350 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-06-30 | $96,050 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-06-30 | $75,545 |
| Administrative expenses professional fees incurred | 2016-06-30 | $259,216 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2016-06-30 | $73 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2016-06-30 | $91,000 |
| Was this plan covered by a fidelity bond | 2016-06-30 | Yes |
| Value of fidelity bond cover | 2016-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2016-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-06-30 | No |
| Contributions received from participants | 2016-06-30 | $773,843 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-06-30 | $175,637 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-06-30 | $6,858 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-06-30 | $11,229 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-06-30 | $1,087,500 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-06-30 | $824,900 |
| Administrative expenses (other) incurred | 2016-06-30 | $280,097 |
| Liabilities. Value of operating payables at end of year | 2016-06-30 | $519,559 |
| Liabilities. Value of operating payables at beginning of year | 2016-06-30 | $243,807 |
| Total non interest bearing cash at end of year | 2016-06-30 | $1,174,356 |
| Total non interest bearing cash at beginning of year | 2016-06-30 | $705,618 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Value of net income/loss | 2016-06-30 | $-2,249,119 |
| Value of net assets at end of year (total assets less liabilities) | 2016-06-30 | $4,979,770 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-06-30 | $7,228,889 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-06-30 | No |
| Investment advisory and management fees | 2016-06-30 | $38,295 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-06-30 | $1,813,274 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-06-30 | $2,996,949 |
| Income. Interest from US Government securities | 2016-06-30 | $28,011 |
| Income. Interest from corporate debt instruments | 2016-06-30 | $9,339 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-06-30 | $173,915 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-06-30 | $239,394 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-06-30 | $239,394 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-06-30 | $1,040,019 |
| Asset value of US Government securities at end of year | 2016-06-30 | $1,181,877 |
| Asset value of US Government securities at beginning of year | 2016-06-30 | $1,600,278 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-06-30 | $107,608 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-06-30 | No |
| Contributions received in cash from employer | 2016-06-30 | $4,772,053 |
| Employer contributions (assets) at end of year | 2016-06-30 | $471,171 |
| Employer contributions (assets) at beginning of year | 2016-06-30 | $472,900 |
| Income. Dividends from preferred stock | 2016-06-30 | $294 |
| Income. Dividends from common stock | 2016-06-30 | $20,211 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-06-30 | $5,923,094 |
| Asset. Corporate debt instrument preferred debt at end of year | 2016-06-30 | $313,225 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2016-06-30 | $367,900 |
| Contract administrator fees | 2016-06-30 | $134,930 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-06-30 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2016-06-30 | $1,450,350 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2016-06-30 | $1,808,159 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2016-06-30 | $1,730 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2016-06-30 | $4,169 |
| Did the plan have assets held for investment | 2016-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-06-30 | No |
| Aggregate proceeds on sale of assets | 2016-06-30 | $6,088,425 |
| Aggregate carrying amount (costs) on sale of assets | 2016-06-30 | $6,073,309 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-06-30 | Unqualified |
| Accountancy firm name | 2016-06-30 | BONADIO & CO. LLP |
| Accountancy firm EIN | 2016-06-30 | 161131146 |
| 2015 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-06-30 | $-394,134 |
| Total unrealized appreciation/depreciation of assets | 2015-06-30 | $-394,134 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $1,068,707 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $1,130,856 |
| Total income from all sources (including contributions) | 2015-06-30 | $4,773,782 |
| Total loss/gain on sale of assets | 2015-06-30 | $342,488 |
| Total of all expenses incurred | 2015-06-30 | $6,011,853 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-06-30 | $5,427,650 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-06-30 | $4,788,100 |
| Value of total assets at end of year | 2015-06-30 | $8,297,596 |
| Value of total assets at beginning of year | 2015-06-30 | $9,597,816 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-06-30 | $584,203 |
| Total interest from all sources | 2015-06-30 | $44,213 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-06-30 | $132,470 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-06-30 | $100,791 |
| Administrative expenses professional fees incurred | 2015-06-30 | $70,054 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2015-06-30 | $91,000 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2015-06-30 | $108,776 |
| Was this plan covered by a fidelity bond | 2015-06-30 | Yes |
| Value of fidelity bond cover | 2015-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2015-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-06-30 | No |
| Contributions received from participants | 2015-06-30 | $651,790 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2015-06-30 | $324,670 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-06-30 | $11,229 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-06-30 | $11,191 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-06-30 | $824,900 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-06-30 | $751,300 |
| Administrative expenses (other) incurred | 2015-06-30 | $341,483 |
| Liabilities. Value of operating payables at end of year | 2015-06-30 | $243,807 |
| Liabilities. Value of operating payables at beginning of year | 2015-06-30 | $379,556 |
| Total non interest bearing cash at end of year | 2015-06-30 | $705,618 |
| Total non interest bearing cash at beginning of year | 2015-06-30 | $947,228 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Value of net income/loss | 2015-06-30 | $-1,238,071 |
| Value of net assets at end of year (total assets less liabilities) | 2015-06-30 | $7,228,889 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-06-30 | $8,466,960 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-06-30 | No |
| Investment advisory and management fees | 2015-06-30 | $43,363 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-06-30 | $2,996,949 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-06-30 | $3,313,486 |
| Income. Interest from US Government securities | 2015-06-30 | $29,413 |
| Income. Interest from corporate debt instruments | 2015-06-30 | $14,800 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-06-30 | $239,394 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-06-30 | $493,972 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-06-30 | $493,972 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-06-30 | $850,353 |
| Asset value of US Government securities at end of year | 2015-06-30 | $1,600,278 |
| Asset value of US Government securities at beginning of year | 2015-06-30 | $957,128 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-06-30 | $-139,355 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-06-30 | No |
| Contributions received in cash from employer | 2015-06-30 | $4,136,310 |
| Employer contributions (assets) at end of year | 2015-06-30 | $472,900 |
| Employer contributions (assets) at beginning of year | 2015-06-30 | $455,780 |
| Income. Dividends from preferred stock | 2015-06-30 | $1,462 |
| Income. Dividends from common stock | 2015-06-30 | $30,217 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-06-30 | $4,252,627 |
| Asset. Corporate debt instrument preferred debt at end of year | 2015-06-30 | $367,900 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2015-06-30 | $668,440 |
| Contract administrator fees | 2015-06-30 | $129,303 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2015-06-30 | $1,808,159 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2015-06-30 | $2,634,187 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2015-06-30 | $4,169 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-06-30 | $7,628 |
| Did the plan have assets held for investment | 2015-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-06-30 | No |
| Aggregate proceeds on sale of assets | 2015-06-30 | $10,406,871 |
| Aggregate carrying amount (costs) on sale of assets | 2015-06-30 | $10,064,383 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-06-30 | Unqualified |
| Accountancy firm name | 2015-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2015-06-30 | 161131146 |
| 2014 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-06-30 | $573,189 |
| Total unrealized appreciation/depreciation of assets | 2014-06-30 | $573,189 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $1,130,856 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $1,129,430 |
| Total income from all sources (including contributions) | 2014-06-30 | $6,092,356 |
| Total loss/gain on sale of assets | 2014-06-30 | $365,407 |
| Total of all expenses incurred | 2014-06-30 | $5,456,208 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-06-30 | $4,854,053 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-06-30 | $4,940,167 |
| Value of total assets at end of year | 2014-06-30 | $9,597,816 |
| Value of total assets at beginning of year | 2014-06-30 | $8,960,242 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-06-30 | $602,155 |
| Total interest from all sources | 2014-06-30 | $54,087 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-06-30 | $114,091 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-06-30 | $80,254 |
| Administrative expenses professional fees incurred | 2014-06-30 | $55,249 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2014-06-30 | $108,776 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2014-06-30 | $167,944 |
| Was this plan covered by a fidelity bond | 2014-06-30 | Yes |
| Value of fidelity bond cover | 2014-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2014-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-06-30 | No |
| Contributions received from participants | 2014-06-30 | $532,196 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-06-30 | $295,158 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-06-30 | $11,191 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-06-30 | $69,431 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-06-30 | $751,300 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-06-30 | $808,500 |
| Administrative expenses (other) incurred | 2014-06-30 | $345,943 |
| Liabilities. Value of operating payables at end of year | 2014-06-30 | $379,556 |
| Liabilities. Value of operating payables at beginning of year | 2014-06-30 | $320,930 |
| Total non interest bearing cash at end of year | 2014-06-30 | $947,228 |
| Total non interest bearing cash at beginning of year | 2014-06-30 | $965,095 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Value of net income/loss | 2014-06-30 | $636,148 |
| Value of net assets at end of year (total assets less liabilities) | 2014-06-30 | $8,466,960 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-06-30 | $7,830,812 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-06-30 | No |
| Investment advisory and management fees | 2014-06-30 | $41,325 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-06-30 | $3,313,486 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-06-30 | $3,065,796 |
| Income. Interest from US Government securities | 2014-06-30 | $31,638 |
| Income. Interest from corporate debt instruments | 2014-06-30 | $22,449 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-06-30 | $493,972 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-06-30 | $590,413 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-06-30 | $590,413 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-06-30 | $775,025 |
| Asset value of US Government securities at end of year | 2014-06-30 | $957,128 |
| Asset value of US Government securities at beginning of year | 2014-06-30 | $998,016 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-06-30 | $45,415 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-06-30 | No |
| Contributions received in cash from employer | 2014-06-30 | $4,407,971 |
| Employer contributions (assets) at end of year | 2014-06-30 | $455,780 |
| Employer contributions (assets) at beginning of year | 2014-06-30 | $487,406 |
| Income. Dividends from preferred stock | 2014-06-30 | $2,071 |
| Income. Dividends from common stock | 2014-06-30 | $31,766 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-06-30 | $3,783,870 |
| Asset. Corporate debt instrument preferred debt at end of year | 2014-06-30 | $668,440 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2014-06-30 | $487,623 |
| Contract administrator fees | 2014-06-30 | $159,638 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2014-06-30 | $2,634,187 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2014-06-30 | $2,072,580 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2014-06-30 | $7,628 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2014-06-30 | $55,938 |
| Did the plan have assets held for investment | 2014-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-06-30 | No |
| Aggregate proceeds on sale of assets | 2014-06-30 | $9,712,090 |
| Aggregate carrying amount (costs) on sale of assets | 2014-06-30 | $9,346,683 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-06-30 | Unqualified |
| Accountancy firm name | 2014-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2014-06-30 | 161131146 |
| 2013 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-06-30 | $327,598 |
| Total unrealized appreciation/depreciation of assets | 2013-06-30 | $327,598 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $1,129,430 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $1,048,272 |
| Total income from all sources (including contributions) | 2013-06-30 | $5,527,546 |
| Total loss/gain on sale of assets | 2013-06-30 | $177,862 |
| Total of all expenses incurred | 2013-06-30 | $5,536,024 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-06-30 | $4,929,046 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-06-30 | $4,824,103 |
| Value of total assets at end of year | 2013-06-30 | $8,960,242 |
| Value of total assets at beginning of year | 2013-06-30 | $8,887,562 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-06-30 | $606,978 |
| Total interest from all sources | 2013-06-30 | $76,025 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-06-30 | $99,687 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-06-30 | $57,236 |
| Administrative expenses professional fees incurred | 2013-06-30 | $85,302 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2013-06-30 | $167,944 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2013-06-30 | $229,047 |
| Was this plan covered by a fidelity bond | 2013-06-30 | Yes |
| Value of fidelity bond cover | 2013-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2013-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-06-30 | No |
| Contributions received from participants | 2013-06-30 | $504,120 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-06-30 | $258,436 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-06-30 | $69,431 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-06-30 | $75,413 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-06-30 | $808,500 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-06-30 | $725,700 |
| Administrative expenses (other) incurred | 2013-06-30 | $321,765 |
| Liabilities. Value of operating payables at end of year | 2013-06-30 | $320,930 |
| Liabilities. Value of operating payables at beginning of year | 2013-06-30 | $322,572 |
| Total non interest bearing cash at end of year | 2013-06-30 | $965,095 |
| Total non interest bearing cash at beginning of year | 2013-06-30 | $873,316 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Value of net income/loss | 2013-06-30 | $-8,478 |
| Value of net assets at end of year (total assets less liabilities) | 2013-06-30 | $7,830,812 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-06-30 | $7,839,290 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-06-30 | No |
| Investment advisory and management fees | 2013-06-30 | $41,875 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-06-30 | $3,065,796 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-06-30 | $1,603,075 |
| Income. Interest from US Government securities | 2013-06-30 | $62,396 |
| Income. Interest from corporate debt instruments | 2013-06-30 | $13,628 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-06-30 | $590,413 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-06-30 | $564,135 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-06-30 | $564,135 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-06-30 | $1 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-06-30 | $798,758 |
| Asset value of US Government securities at end of year | 2013-06-30 | $998,016 |
| Asset value of US Government securities at beginning of year | 2013-06-30 | $2,421,163 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-06-30 | $22,271 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-06-30 | No |
| Contributions received in cash from employer | 2013-06-30 | $4,319,983 |
| Employer contributions (assets) at end of year | 2013-06-30 | $487,406 |
| Employer contributions (assets) at beginning of year | 2013-06-30 | $528,773 |
| Income. Dividends from preferred stock | 2013-06-30 | $1,624 |
| Income. Dividends from common stock | 2013-06-30 | $40,827 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-06-30 | $3,871,852 |
| Asset. Corporate debt instrument preferred debt at end of year | 2013-06-30 | $487,623 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2013-06-30 | $264,249 |
| Contract administrator fees | 2013-06-30 | $158,036 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2013-06-30 | $2,072,580 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2013-06-30 | $2,316,650 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2013-06-30 | $55,938 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2013-06-30 | $11,741 |
| Did the plan have assets held for investment | 2013-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-06-30 | No |
| Aggregate proceeds on sale of assets | 2013-06-30 | $4,778,794 |
| Aggregate carrying amount (costs) on sale of assets | 2013-06-30 | $4,600,932 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-06-30 | Unqualified |
| Accountancy firm name | 2013-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2013-06-30 | 161131146 |
| 2012 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-06-30 | $284,640 |
| Total unrealized appreciation/depreciation of assets | 2012-06-30 | $284,640 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $1,048,272 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $835,645 |
| Total income from all sources (including contributions) | 2012-06-30 | $5,211,048 |
| Total loss/gain on sale of assets | 2012-06-30 | $-298,005 |
| Total of all expenses incurred | 2012-06-30 | $5,478,360 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-06-30 | $4,868,883 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-06-30 | $5,109,522 |
| Value of total assets at end of year | 2012-06-30 | $8,887,562 |
| Value of total assets at beginning of year | 2012-06-30 | $8,942,247 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-06-30 | $609,477 |
| Total interest from all sources | 2012-06-30 | $70,249 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-06-30 | $45,616 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-06-30 | $15,138 |
| Administrative expenses professional fees incurred | 2012-06-30 | $222,425 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2012-06-30 | $229,047 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2012-06-30 | $0 |
| Was this plan covered by a fidelity bond | 2012-06-30 | Yes |
| Value of fidelity bond cover | 2012-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-06-30 | No |
| Contributions received from participants | 2012-06-30 | $497,784 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-06-30 | $240,254 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-06-30 | $75,413 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-06-30 | $45,528 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-06-30 | $725,700 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-06-30 | $599,800 |
| Administrative expenses (other) incurred | 2012-06-30 | $180,535 |
| Liabilities. Value of operating payables at end of year | 2012-06-30 | $322,572 |
| Liabilities. Value of operating payables at beginning of year | 2012-06-30 | $235,845 |
| Total non interest bearing cash at end of year | 2012-06-30 | $873,316 |
| Total non interest bearing cash at beginning of year | 2012-06-30 | $1,430,999 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Value of net income/loss | 2012-06-30 | $-267,312 |
| Value of net assets at end of year (total assets less liabilities) | 2012-06-30 | $7,839,290 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-06-30 | $8,106,602 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-06-30 | No |
| Investment advisory and management fees | 2012-06-30 | $33,590 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-06-30 | $1,603,075 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-06-30 | $667,600 |
| Income. Interest from US Government securities | 2012-06-30 | $49,803 |
| Income. Interest from corporate debt instruments | 2012-06-30 | $20,231 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-06-30 | $564,135 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-06-30 | $950,414 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-06-30 | $950,414 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-06-30 | $215 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-06-30 | $867,955 |
| Asset value of US Government securities at end of year | 2012-06-30 | $2,421,163 |
| Asset value of US Government securities at beginning of year | 2012-06-30 | $1,618,974 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-06-30 | $-974 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-06-30 | No |
| Contributions received in cash from employer | 2012-06-30 | $4,611,738 |
| Employer contributions (assets) at end of year | 2012-06-30 | $528,773 |
| Employer contributions (assets) at beginning of year | 2012-06-30 | $555,639 |
| Income. Dividends from preferred stock | 2012-06-30 | $154 |
| Income. Dividends from common stock | 2012-06-30 | $30,324 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-06-30 | $3,760,674 |
| Asset. Corporate debt instrument preferred debt at end of year | 2012-06-30 | $264,249 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2012-06-30 | $1,332,759 |
| Contract administrator fees | 2012-06-30 | $172,927 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-06-30 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2012-06-30 | $2,316,650 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2012-06-30 | $2,317,937 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2012-06-30 | $11,741 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-06-30 | $22,397 |
| Did the plan have assets held for investment | 2012-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-06-30 | No |
| Aggregate proceeds on sale of assets | 2012-06-30 | $3,254,116 |
| Aggregate carrying amount (costs) on sale of assets | 2012-06-30 | $3,552,121 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-06-30 | Unqualified |
| Accountancy firm name | 2012-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2012-06-30 | 161131146 |
| 2011 : SHEET METAL WORKERS LOCAL 46 HEALTH FUND 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-06-30 | $358,116 |
| Total unrealized appreciation/depreciation of assets | 2011-06-30 | $358,116 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $835,645 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $892,705 |
| Total income from all sources (including contributions) | 2011-06-30 | $5,658,866 |
| Total loss/gain on sale of assets | 2011-06-30 | $157,566 |
| Total of all expenses incurred | 2011-06-30 | $4,641,510 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-06-30 | $4,032,309 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-06-30 | $4,890,135 |
| Value of total assets at end of year | 2011-06-30 | $8,942,247 |
| Value of total assets at beginning of year | 2011-06-30 | $7,981,951 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-06-30 | $609,201 |
| Total interest from all sources | 2011-06-30 | $86,778 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-06-30 | $36,020 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-06-30 | $6,284 |
| Administrative expenses professional fees incurred | 2011-06-30 | $205,598 |
| Was this plan covered by a fidelity bond | 2011-06-30 | Yes |
| Value of fidelity bond cover | 2011-06-30 | $4,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-06-30 | No |
| Contributions received from participants | 2011-06-30 | $527,067 |
| Assets. Other investments not covered elsewhere at end of year | 2011-06-30 | $1,052,070 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-06-30 | $406,337 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-06-30 | $221,935 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-06-30 | $45,528 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-06-30 | $46,530 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-06-30 | $599,800 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-06-30 | $634,200 |
| Administrative expenses (other) incurred | 2011-06-30 | $201,955 |
| Liabilities. Value of operating payables at end of year | 2011-06-30 | $235,845 |
| Liabilities. Value of operating payables at beginning of year | 2011-06-30 | $258,505 |
| Total non interest bearing cash at end of year | 2011-06-30 | $1,430,999 |
| Total non interest bearing cash at beginning of year | 2011-06-30 | $1,475,389 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Value of net income/loss | 2011-06-30 | $1,017,356 |
| Value of net assets at end of year (total assets less liabilities) | 2011-06-30 | $8,106,602 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-06-30 | $7,089,246 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-06-30 | No |
| Investment advisory and management fees | 2011-06-30 | $29,883 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-06-30 | $667,600 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-06-30 | $505,371 |
| Income. Interest from US Government securities | 2011-06-30 | $38,856 |
| Income. Interest from corporate debt instruments | 2011-06-30 | $44,503 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-06-30 | $950,414 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-06-30 | $1,966,849 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-06-30 | $1,966,849 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-06-30 | $3,419 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-06-30 | $802,337 |
| Asset value of US Government securities at end of year | 2011-06-30 | $566,904 |
| Asset value of US Government securities at beginning of year | 2011-06-30 | $661,965 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-06-30 | $130,251 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-06-30 | No |
| Contributions received in cash from employer | 2011-06-30 | $4,363,068 |
| Employer contributions (assets) at end of year | 2011-06-30 | $555,639 |
| Employer contributions (assets) at beginning of year | 2011-06-30 | $443,692 |
| Income. Dividends from common stock | 2011-06-30 | $29,736 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-06-30 | $3,008,037 |
| Asset. Corporate debt instrument preferred debt at end of year | 2011-06-30 | $1,332,759 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2011-06-30 | $785,981 |
| Contract administrator fees | 2011-06-30 | $171,765 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-06-30 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2011-06-30 | $2,317,937 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2011-06-30 | $1,641,689 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2011-06-30 | $22,397 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-06-30 | $48,148 |
| Did the plan have assets held for investment | 2011-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-06-30 | No |
| Aggregate proceeds on sale of assets | 2011-06-30 | $1,801,827 |
| Aggregate carrying amount (costs) on sale of assets | 2011-06-30 | $1,644,261 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-06-30 | Unqualified |
| Accountancy firm name | 2011-06-30 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2011-06-30 | 161131146 |
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3340/C4603 |
| Policy instance | 1 |
| Insurance contract or identification number | G3340/C4603 | | Number of Individuals Covered | 255 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,305 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $38,502 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,305 | | Insurance broker organization code? | 3 |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 2 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 975 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $89,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SMW-RET |
| Policy instance | 3 |
| Insurance contract or identification number | SMW-RET | | Number of Individuals Covered | 105 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,018 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00113190 |
| Policy instance | 4 |
| Insurance contract or identification number | 00113190 | | Number of Individuals Covered | 358 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $138,121 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00501203 |
| Policy instance | 5 |
| Insurance contract or identification number | 00501203 | | Number of Individuals Covered | 139 | | 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 $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $422,372 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00501202 |
| Policy instance | 6 |
| Insurance contract or identification number | 00501202 | | Number of Individuals Covered | 3 | | 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 $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $52,264 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00510386 |
| Policy instance | 7 |
| Insurance contract or identification number | 00510386 | | Number of Individuals Covered | 3 | | 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 $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,128 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00500282 |
| Policy instance | 8 |
| Insurance contract or identification number | 00500282 | | Number of Individuals Covered | 1 | | 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 $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,687 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 8054796 |
| Policy instance | 1 |
| Insurance contract or identification number | 8054796 | | Number of Individuals Covered | 410 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2020-12-31 | | 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 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $12,968 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SMW-RET |
| Policy instance | 3 |
| Insurance contract or identification number | SMW-RET | | Number of Individuals Covered | 88 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00007537 |
| Policy instance | 5 |
| Insurance contract or identification number | 00007537 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $343,419 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00113190 |
| Policy instance | 4 |
| Insurance contract or identification number | 00113190 | | Number of Individuals Covered | 356 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $135,102 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00501203 |
| Policy instance | 6 |
| Insurance contract or identification number | 00501203 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $28,234 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00501202 |
| Policy instance | 7 |
| Insurance contract or identification number | 00501202 | | Number of Individuals Covered | 133 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $539,887 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 2 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 997 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $91,848 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00500282 |
| Policy instance | 9 |
| Insurance contract or identification number | 00500282 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $10,144 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00510386 |
| Policy instance | 8 |
| Insurance contract or identification number | 00510386 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $7,879 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00510386 |
| Policy instance | 8 |
| Insurance contract or identification number | 00510386 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $-361 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,879 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | -361 | | Insurance broker organization code? | 3 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00007537 |
| Policy instance | 5 |
| Insurance contract or identification number | 00007537 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $340,314 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SMW-RET |
| Policy instance | 3 |
| Insurance contract or identification number | SMW-RET | | Number of Individuals Covered | 92 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,839 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 2 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 1058 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $86,633 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 100308 |
| Policy instance | 1 |
| Insurance contract or identification number | 100308 | | Number of Individuals Covered | 386 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $2,545 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $17,908 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,545 | | Insurance broker organization code? | 3 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00501202 |
| Policy instance | 7 |
| Insurance contract or identification number | 00501202 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $549,960 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00113190 |
| Policy instance | 4 |
| Insurance contract or identification number | 00113190 | | Number of Individuals Covered | 390 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $139,682 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00501203 |
| Policy instance | 6 |
| Insurance contract or identification number | 00501203 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $25,018 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SMW-RET |
| Policy instance | 3 |
| Insurance contract or identification number | SMW-RET | | Number of Individuals Covered | 94 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,692 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 100308 |
| Policy instance | 1 |
| Insurance contract or identification number | 100308 | | Number of Individuals Covered | 392 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,617 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $28,847 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,617 | | Insurance broker organization code? | 3 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00007537 |
| Policy instance | 5 |
| Insurance contract or identification number | 00007537 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $321,239 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 2 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 988 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $88,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00510386 |
| Policy instance | 8 |
| Insurance contract or identification number | 00510386 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $361 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,228 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $361 | | Insurance broker organization code? | 3 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00501203 |
| Policy instance | 7 |
| Insurance contract or identification number | 00501203 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $33,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00501202 |
| Policy instance | 6 |
| Insurance contract or identification number | 00501202 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $180 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $536,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $180 | | Insurance broker organization code? | 3 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00113190 |
| Policy instance | 4 |
| Insurance contract or identification number | 00113190 | | Number of Individuals Covered | 361 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $25,244 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $163,289 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,244 |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 2 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 1057 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,383 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 100308 |
| Policy instance | 1 |
| Insurance contract or identification number | 100308 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $3,588 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $28,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00113190 |
| Policy instance | 8 |
| Insurance contract or identification number | 00113190 | | Number of Individuals Covered | 377 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $25,116 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $167,439 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SMW-RET |
| Policy instance | 3 |
| Insurance contract or identification number | SMW-RET | | Number of Individuals Covered | 90 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,094 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00113190 |
| Policy instance | 4 |
| Insurance contract or identification number | 00113190 | | Number of Individuals Covered | 363 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $186,235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193503 |
| Policy instance | 5 |
| Insurance contract or identification number | 16193503 | | Number of Individuals Covered | 354 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193543 |
| Policy instance | 7 |
| Insurance contract or identification number | 16193543 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193504 |
| Policy instance | 6 |
| Insurance contract or identification number | 16193504 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 ) |
| Policy contract number | EXL-30266 |
| Policy instance | 8 |
| Insurance contract or identification number | EXL-30266 | | Number of Individuals Covered | 364 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $12,575 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EXCESS LOSS | | Welfare Benefit Premiums Paid to Carrier | USD $83,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,575 | | Insurance broker name | |
|
| HEALTH ECONOMICS GROUP, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 5 |
| Number of Individuals Covered | 491 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | 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 $333,568 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020003 |
| Policy instance | 4 |
| Insurance contract or identification number | 005012020003 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | 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 $230,423 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020002 |
| Policy instance | 3 |
| Insurance contract or identification number | 005012020002 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | 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 $264,639 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020001 |
| Policy instance | 2 |
| Insurance contract or identification number | 005012020001 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | 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 $5,379 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0100308 |
| Policy instance | 1 |
| Insurance contract or identification number | 0100308 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $3,643 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $29,185 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,643 | | Insurance broker name | DENNIS KIRBY |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SMW-RET |
| Policy instance | 7 |
| Insurance contract or identification number | SMW-RET | | Number of Individuals Covered | 83 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,096 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 6 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 1069 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,136 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020001 |
| Policy instance | 2 |
| Insurance contract or identification number | 005012020001 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,252 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 100308 |
| Policy instance | 1 |
| Insurance contract or identification number | 100308 | | Number of Individuals Covered | 388 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $3,730 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $30,758 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,730 | | Insurance broker name | DENNIS KIRBY |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020002 |
| Policy instance | 3 |
| Insurance contract or identification number | 005012020002 | | Number of Individuals Covered | 101 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $173,477 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020003 |
| Policy instance | 4 |
| Insurance contract or identification number | 005012020003 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $187,148 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ECONOMICS GROUP, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 5 |
| Number of Individuals Covered | 479 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $320,727 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ENVISION RX (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | LOCAL46 |
| Policy instance | 6 |
| Insurance contract or identification number | LOCAL46 | | Number of Individuals Covered | 1084 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $16,150 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 ) |
| Policy contract number | EXL-30266 |
| Policy instance | 7 |
| Insurance contract or identification number | EXL-30266 | | Number of Individuals Covered | 370 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $12,379 | | 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 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,523 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,379 | | Insurance broker name | PATRICIA HUERTA |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 8 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 1141 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $77,180 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020002 |
| Policy instance | 5 |
| Insurance contract or identification number | 005012020002 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $169,257 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020001 |
| Policy instance | 4 |
| Insurance contract or identification number | 005012020001 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $3,891 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193502 |
| Policy instance | 3 |
| Insurance contract or identification number | 16193502 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,612 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ECONOMICS GROUP, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 504 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $12,088 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $315,745 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 100308 |
| Policy instance | 12 |
| Insurance contract or identification number | 100308 | | Number of Individuals Covered | 408 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $3,856 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $32,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,856 | | Amount paid for insurance broker fees | 0 | | Insurance broker name | DENNIS KIRBY |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005012020003 |
| Policy instance | 6 |
| Insurance contract or identification number | 005012020003 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $94,681 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GL1002-2013R2 |
| Policy instance | 7 |
| Insurance contract or identification number | GL1002-2013R2 | | Number of Individuals Covered | 417 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $13,090 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $87,264 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,090 | | Insurance broker name | EBS-RMSCO, INC. |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 000075370001 |
| Policy instance | 8 |
| Insurance contract or identification number | 000075370001 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $134,641 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ENVISION RX (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | LOCAL46 |
| Policy instance | 11 |
| Insurance contract or identification number | LOCAL46 | | Number of Individuals Covered | 1168 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,265 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $14,947 | | 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 | 1265 | | Insurance broker organization code? | 3 | | Insurance broker name | ENVISION PHARMACEUTICAL SERVICES, I |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 000075370002 |
| Policy instance | 9 |
| Insurance contract or identification number | 000075370002 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 10 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 1566 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,149 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $92,191 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4149 | | Insurance broker name | HM LIFE INSURANCE COMPANY |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 005002820001 |
| Policy instance | 13 |
| Insurance contract or identification number | 005002820001 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,354 | | 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 | | Insurance broker name | |
|
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 7087500001 |
| Policy instance | 1 |
| Insurance contract or identification number | 7087500001 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $2,555 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,355 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,555 | | Insurance broker name | ERIC LINALTA |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | DE16R001 |
| Policy instance | 2 |
| Insurance contract or identification number | DE16R001 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,634 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ECONOMICS GROUP, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 4 |
| Number of Individuals Covered | 507 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $323,674 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GLI002-2013R2 |
| Policy instance | 5 |
| Insurance contract or identification number | GLI002-2013R2 | | Number of Individuals Covered | 417 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $6,631 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $44,204 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,631 | | Insurance broker name | EBS-RMSCO, INC. |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193502 |
| Policy instance | 6 |
| Insurance contract or identification number | 16193502 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,258 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193652 |
| Policy instance | 7 |
| Insurance contract or identification number | 16193652 | | Number of Individuals Covered | 97 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $167,441 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193004 |
| Policy instance | 9 |
| Insurance contract or identification number | 16193004 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,289 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193651 |
| Policy instance | 8 |
| Insurance contract or identification number | 16193651 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $177,563 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 511651601 |
| Policy instance | 10 |
| Insurance contract or identification number | 511651601 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,301 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193654 |
| Policy instance | 11 |
| Insurance contract or identification number | 16193654 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,395 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GLI003-2012 |
| Policy instance | 12 |
| Insurance contract or identification number | GLI003-2012 | | Number of Individuals Covered | 427 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $6,559 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $43,727 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,559 | | Insurance broker name | EBS-RMSCO, INC. |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 100308 |
| Policy instance | 1 |
| Insurance contract or identification number | 100308 | | Number of Individuals Covered | 420 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,882 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $32,370 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,882 | | Insurance broker name | DENNIS KIRBY |
|
| HEALTH ECONOMICS GROUP, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 16 |
| Number of Individuals Covered | 414 | | Insurance policy start date | 2012-07-03 | | Insurance policy end date | 2013-04-23 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $87,338 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | SWW-001 |
| Policy instance | 15 |
| Insurance contract or identification number | SWW-001 | | Number of Individuals Covered | 1111 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,232 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1232 | | Insurance broker name | HM LIFE INSURANCE COMPANY |
|
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 7087500001 |
| Policy instance | 3 |
| Insurance contract or identification number | 7087500001 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $2,817 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $71,654 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,817 | | Insurance broker name | ERIC LINALTA |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 000075370002 |
| Policy instance | 14 |
| Insurance contract or identification number | 000075370002 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,184 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 000075370001 |
| Policy instance | 13 |
| Insurance contract or identification number | 000075370001 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $152,712 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | DE16R001 |
| Policy instance | 2 |
| Insurance contract or identification number | DE16R001 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,384 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 000075370001 |
| Policy instance | 12 |
| Insurance contract or identification number | 000075370001 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $71,575 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 000075370002 |
| Policy instance | 13 |
| Insurance contract or identification number | 000075370002 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,939 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193654 |
| Policy instance | 11 |
| Insurance contract or identification number | 16193654 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,026 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193005 |
| Policy instance | 10 |
| Insurance contract or identification number | 16193005 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,323 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193004 |
| Policy instance | 9 |
| Insurance contract or identification number | 16193004 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,825 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193651 |
| Policy instance | 8 |
| Insurance contract or identification number | 16193651 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $160,488 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 100308 |
| Policy instance | 1 |
| Insurance contract or identification number | 100308 | | Number of Individuals Covered | 422 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,842 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $32,136 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193502 |
| Policy instance | 6 |
| Insurance contract or identification number | 16193502 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,874 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GER10001 |
| Policy instance | 5 |
| Insurance contract or identification number | GER10001 | | Number of Individuals Covered | 428 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $14,019 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $93,461 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ECONOMICS GROUP, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 4 |
| Number of Individuals Covered | 502 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $282,825 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 7087500001 |
| Policy instance | 3 |
| Insurance contract or identification number | 7087500001 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $2,431 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $67,176 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193652 |
| Policy instance | 7 |
| Insurance contract or identification number | 16193652 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $139,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 100308 |
| Policy instance | 1 |
| Insurance contract or identification number | 100308 | | Number of Individuals Covered | 420 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $4,004 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $35,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193005 |
| Policy instance | 10 |
| Insurance contract or identification number | 16193005 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,881 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193004 |
| Policy instance | 9 |
| Insurance contract or identification number | 16193004 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $246,704 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193651 |
| Policy instance | 8 |
| Insurance contract or identification number | 16193651 | | Number of Individuals Covered | 76 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $192,505 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193652 |
| Policy instance | 7 |
| Insurance contract or identification number | 16193652 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $121,263 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193502 |
| Policy instance | 6 |
| Insurance contract or identification number | 16193502 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,213 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | GER10001 |
| Policy instance | 5 |
| Insurance contract or identification number | GER10001 | | Number of Individuals Covered | 426 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $14,298 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $95,320 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ECONOMICS GROUP, INC. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 4 |
| Number of Individuals Covered | 402 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $206,152 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 7087500001 |
| Policy instance | 3 |
| Insurance contract or identification number | 7087500001 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,207 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | DE16R001 |
| Policy instance | 2 |
| Insurance contract or identification number | DE16R001 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 16193654 |
| Policy instance | 11 |
| Insurance contract or identification number | 16193654 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,431 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
