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EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF STIX & CO, INC.
Plan identification number 502

EMPLOYEE HEALTH PLAN OF STIX & CO, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

STIX & CO, INC. has sponsored the creation of one or more 401k plans.

Company Name:STIX & CO, INC.
Employer identification number (EIN):202862405
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF STIX & CO, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022019-05-01
5022018-05-01
5022017-05-01CARLA CRIBB
5022016-05-01CARLA CRIBB
5022015-05-01CARLA CRIBB
5022014-05-01CARLA CRIBB
5022013-05-01ZODY CRIBB
5022012-05-01ZODY CRIBB
5022011-05-01ZODY CRIBB

Plan Statistics for EMPLOYEE HEALTH PLAN OF STIX & CO, INC.

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF STIX & CO, INC.

Measure Date Value
2019: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2019 401k membership
Total participants, beginning-of-year2019-05-0113
Total number of active participants reported on line 7a of the Form 55002019-05-016
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-016
2018: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2018 401k membership
Total participants, beginning-of-year2018-05-0118
Total number of active participants reported on line 7a of the Form 55002018-05-0113
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-0113
2017: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2017 401k membership
Total participants, beginning-of-year2017-05-0114
Total number of active participants reported on line 7a of the Form 55002017-05-0119
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-0119
2016: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2016 401k membership
Total participants, beginning-of-year2016-05-017
Total number of active participants reported on line 7a of the Form 55002016-05-014
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-014
2015: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2015 401k membership
Total participants, beginning-of-year2015-05-017
Total number of active participants reported on line 7a of the Form 55002015-05-017
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-017
2014: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2014 401k membership
Total participants, beginning-of-year2014-05-019
Total number of active participants reported on line 7a of the Form 55002014-05-017
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-017
2013: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2013 401k membership
Total participants, beginning-of-year2013-05-0110
Total number of active participants reported on line 7a of the Form 55002013-05-019
Number of retired or separated participants receiving benefits2013-05-010
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-019
2012: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2012 401k membership
Total participants, beginning-of-year2012-05-018
Total number of active participants reported on line 7a of the Form 55002012-05-0110
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-0110
2011: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2011 401k membership
Total participants, beginning-of-year2011-05-018
Total number of active participants reported on line 7a of the Form 55002011-05-018
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-018

Financial Data on EMPLOYEE HEALTH PLAN OF STIX & CO, INC.

Measure Date Value
2020 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2020 401k financial data
Total plan liabilities at beginning of year2020-04-30$0
Total income from all sources2020-04-30$46,937
Expenses. Total of all expenses incurred2020-04-30$46,937
Benefits paid (including direct rollovers)2020-04-30$22,527
Total plan assets at end of year2020-04-30$0
Total plan assets at beginning of year2020-04-30$0
Value of fidelity bond covering the plan2020-04-30$10,000
Expenses. Other expenses not covered elsewhere2020-04-30$24,410
Net income (gross income less expenses)2020-04-30$0
Net plan assets at end of year (total assets less liabilities)2020-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$0
Total contributions received or receivable from employer(s)2020-04-30$46,937
2018 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2018 401k financial data
Total plan liabilities at end of year2018-04-30$0
Total plan liabilities at beginning of year2018-04-30$0
Total income from all sources2018-04-30$100,393
Expenses. Total of all expenses incurred2018-04-30$100,393
Benefits paid (including direct rollovers)2018-04-30$47,457
Total plan assets at end of year2018-04-30$0
Total plan assets at beginning of year2018-04-30$0
Value of fidelity bond covering the plan2018-04-30$10,000
Expenses. Other expenses not covered elsewhere2018-04-30$52,936
Net income (gross income less expenses)2018-04-30$0
Net plan assets at end of year (total assets less liabilities)2018-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$0
Total contributions received or receivable from employer(s)2018-04-30$100,393
2017 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2017 401k financial data
Total plan liabilities at end of year2017-04-30$0
Total plan liabilities at beginning of year2017-04-30$0
Total income from all sources2017-04-30$74,209
Expenses. Total of all expenses incurred2017-04-30$74,209
Benefits paid (including direct rollovers)2017-04-30$26,773
Total plan assets at end of year2017-04-30$0
Total plan assets at beginning of year2017-04-30$0
Value of fidelity bond covering the plan2017-04-30$10,000
Expenses. Other expenses not covered elsewhere2017-04-30$47,436
Net income (gross income less expenses)2017-04-30$0
Net plan assets at end of year (total assets less liabilities)2017-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$0
Total contributions received or receivable from employer(s)2017-04-30$74,209
2016 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$695
Total income from all sources2016-04-30$84,726
Expenses. Total of all expenses incurred2016-04-30$84,726
Benefits paid (including direct rollovers)2016-04-30$39,691
Total plan assets at end of year2016-04-30$0
Total plan assets at beginning of year2016-04-30$695
Value of fidelity bond covering the plan2016-04-30$10,000
Expenses. Other expenses not covered elsewhere2016-04-30$45,035
Net income (gross income less expenses)2016-04-30$0
Net plan assets at end of year (total assets less liabilities)2016-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2016-04-30$0
Total contributions received or receivable from employer(s)2016-04-30$84,726
2015 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2015 401k financial data
Total plan liabilities at end of year2015-04-30$695
Total plan liabilities at beginning of year2015-04-30$2,047
Total income from all sources2015-04-30$102,774
Expenses. Total of all expenses incurred2015-04-30$102,774
Benefits paid (including direct rollovers)2015-04-30$48,123
Total plan assets at end of year2015-04-30$695
Total plan assets at beginning of year2015-04-30$2,047
Value of fidelity bond covering the plan2015-04-30$25,000
Expenses. Other expenses not covered elsewhere2015-04-30$54,651
Net income (gross income less expenses)2015-04-30$0
Net plan assets at end of year (total assets less liabilities)2015-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$0
Total contributions received or receivable from employer(s)2015-04-30$102,774
2014 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2014 401k financial data
Total plan liabilities at end of year2014-04-30$2,047
Total plan liabilities at beginning of year2014-04-30$1,081
Total income from all sources2014-04-30$100,943
Expenses. Total of all expenses incurred2014-04-30$100,943
Benefits paid (including direct rollovers)2014-04-30$43,686
Total plan assets at end of year2014-04-30$2,047
Total plan assets at beginning of year2014-04-30$1,081
Value of fidelity bond covering the plan2014-04-30$25,000
Expenses. Other expenses not covered elsewhere2014-04-30$57,257
Net income (gross income less expenses)2014-04-30$0
Net plan assets at end of year (total assets less liabilities)2014-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2014-04-30$0
Total contributions received or receivable from employer(s)2014-04-30$100,943
2013 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2013 401k financial data
Total plan liabilities at end of year2013-04-30$1,081
Total plan liabilities at beginning of year2013-04-30$2,635
Total income from all sources2013-04-30$73,683
Expenses. Total of all expenses incurred2013-04-30$73,683
Benefits paid (including direct rollovers)2013-04-30$35,293
Total plan assets at end of year2013-04-30$1,081
Total plan assets at beginning of year2013-04-30$2,635
Expenses. Other expenses not covered elsewhere2013-04-30$38,390
Net income (gross income less expenses)2013-04-30$0
Net plan assets at end of year (total assets less liabilities)2013-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2013-04-30$0
Total contributions received or receivable from employer(s)2013-04-30$73,683
2012 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2012 401k financial data
Total plan liabilities at end of year2012-04-30$2,635
Total plan liabilities at beginning of year2012-04-30$1,284
Total income from all sources2012-04-30$63,549
Expenses. Total of all expenses incurred2012-04-30$63,549
Benefits paid (including direct rollovers)2012-04-30$29,695
Total plan assets at end of year2012-04-30$2,635
Total plan assets at beginning of year2012-04-30$1,284
Expenses. Other expenses not covered elsewhere2012-04-30$33,854
Net income (gross income less expenses)2012-04-30$0
Net plan assets at end of year (total assets less liabilities)2012-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$0
Total contributions received or receivable from employer(s)2012-04-30$63,549
2011 : EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2011 401k financial data
Total plan liabilities at end of year2011-04-30$1,284
Total plan liabilities at beginning of year2011-04-30$0
Total income from all sources2011-04-30$64,377
Expenses. Total of all expenses incurred2011-04-30$64,377
Benefits paid (including direct rollovers)2011-04-30$32,836
Total plan assets at end of year2011-04-30$1,284
Total plan assets at beginning of year2011-04-30$0
Expenses. Other expenses not covered elsewhere2011-04-30$31,541
Net income (gross income less expenses)2011-04-30$0
Net plan assets at end of year (total assets less liabilities)2011-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2011-04-30$0
Total contributions received or receivable from employer(s)2011-04-30$64,377

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF STIX & CO, INC.

2019: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2016: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – TrustYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement - TrustYes
2015: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement - TrustYes
2014: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2013: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: EMPLOYEE HEALTH PLAN OF STIX & CO, INC. 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered7
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $20,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered17
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $29,034
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered30
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $43,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered11
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $35,909
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered13
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $43,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered16
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $42,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered17
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $26,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered14
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $23,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14180 NFA 0197
Policy instance 1
Insurance contract or identification number14180 NFA 0197
Number of Individuals Covered11
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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