PPG INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.
Additional information about PPG INDUSTRIES, INC.
Submission information for form 5500 for 401k plan GROUP BENEFITS PLAN- OAK CREEK, WI
| Measure | Date | Value |
|---|
| 2021: GROUP BENEFITS PLAN- OAK CREEK, WI 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-12-31 | 306 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-31 | 289 |
| Number of retired or separated participants receiving benefits | 2021-12-31 | 34 |
| Total of all active and inactive participants | 2021-12-31 | 323 |
| Total participants | 2021-12-31 | 323 |
| 2020: GROUP BENEFITS PLAN- OAK CREEK, WI 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-31 | 298 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-31 | 284 |
| Number of retired or separated participants receiving benefits | 2020-12-31 | 22 |
| Total of all active and inactive participants | 2020-12-31 | 306 |
| Total participants | 2020-12-31 | 306 |
| 2019: GROUP BENEFITS PLAN- OAK CREEK, WI 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-31 | 278 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-31 | 298 |
| Total of all active and inactive participants | 2019-12-31 | 298 |
| Total participants | 2019-12-31 | 298 |
| 2018: GROUP BENEFITS PLAN- OAK CREEK, WI 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-31 | 318 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-31 | 274 |
| Number of retired or separated participants receiving benefits | 2018-12-31 | 4 |
| Total of all active and inactive participants | 2018-12-31 | 278 |
| Total participants | 2018-12-31 | 278 |
| 2017: GROUP BENEFITS PLAN- OAK CREEK, WI 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-31 | 235 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-31 | 314 |
| Number of retired or separated participants receiving benefits | 2017-12-31 | 4 |
| Total of all active and inactive participants | 2017-12-31 | 318 |
| Total participants | 2017-12-31 | 318 |
| 2016: GROUP BENEFITS PLAN- OAK CREEK, WI 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-12-31 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-31 | 231 |
| Number of retired or separated participants receiving benefits | 2016-12-31 | 4 |
| Total of all active and inactive participants | 2016-12-31 | 235 |
| Total participants | 2016-12-31 | 235 |
| 2015: GROUP BENEFITS PLAN- OAK CREEK, WI 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-12-31 | 285 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-31 | 217 |
| Number of retired or separated participants receiving benefits | 2015-12-31 | 5 |
| Total of all active and inactive participants | 2015-12-31 | 222 |
| Total participants | 2015-12-31 | 0 |
| 2014: GROUP BENEFITS PLAN- OAK CREEK, WI 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-31 | 319 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-31 | 280 |
| Number of retired or separated participants receiving benefits | 2014-12-31 | 5 |
| Total of all active and inactive participants | 2014-12-31 | 285 |
| Total participants | 2014-12-31 | 0 |
| 2013: GROUP BENEFITS PLAN- OAK CREEK, WI 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-12-31 | 298 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-12-31 | 226 |
| Number of retired or separated participants receiving benefits | 2013-12-31 | 93 |
| Total of all active and inactive participants | 2013-12-31 | 319 |
| Total participants | 2013-12-31 | 0 |
| 2012: GROUP BENEFITS PLAN- OAK CREEK, WI 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-12-31 | 316 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-12-31 | 210 |
| Number of retired or separated participants receiving benefits | 2012-12-31 | 88 |
| Total of all active and inactive participants | 2012-12-31 | 298 |
| Total participants | 2012-12-31 | 0 |
| 2011: GROUP BENEFITS PLAN- OAK CREEK, WI 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-12-31 | 258 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-12-31 | 234 |
| Number of retired or separated participants receiving benefits | 2011-12-31 | 82 |
| Total of all active and inactive participants | 2011-12-31 | 316 |
| Total participants | 2011-12-31 | 316 |
| 2010: GROUP BENEFITS PLAN- OAK CREEK, WI 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-12-31 | 255 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-12-31 | 214 |
| Number of retired or separated participants receiving benefits | 2010-12-31 | 44 |
| Total of all active and inactive participants | 2010-12-31 | 258 |
| Total participants | 2010-12-31 | 258 |
| 2009: GROUP BENEFITS PLAN- OAK CREEK, WI 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-12-31 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-12-31 | 214 |
| Number of retired or separated participants receiving benefits | 2009-12-31 | 41 |
| Total of all active and inactive participants | 2009-12-31 | 255 |
| Total participants | 2009-12-31 | 255 |
| 2021: GROUP BENEFITS PLAN- OAK CREEK, WI 2021 form 5500 responses |
|---|
| 2021-12-31 | Type of plan entity | Single employer plan |
| 2021-12-31 | Plan is a collectively bargained plan | Yes |
| 2021-12-31 | Plan funding arrangement – Insurance | Yes |
| 2021-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2021-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: GROUP BENEFITS PLAN- OAK CREEK, WI 2020 form 5500 responses |
|---|
| 2020-12-31 | Type of plan entity | Single employer plan |
| 2020-12-31 | Plan is a collectively bargained plan | Yes |
| 2020-12-31 | Plan funding arrangement – Insurance | Yes |
| 2020-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2020-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: GROUP BENEFITS PLAN- OAK CREEK, WI 2019 form 5500 responses |
|---|
| 2019-12-31 | Type of plan entity | Single employer plan |
| 2019-12-31 | Plan is a collectively bargained plan | Yes |
| 2019-12-31 | Plan funding arrangement – Insurance | Yes |
| 2019-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2019-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: GROUP BENEFITS PLAN- OAK CREEK, WI 2018 form 5500 responses |
|---|
| 2018-12-31 | Type of plan entity | Single employer plan |
| 2018-12-31 | Plan is a collectively bargained plan | Yes |
| 2018-12-31 | Plan funding arrangement – Insurance | Yes |
| 2018-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2018-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: GROUP BENEFITS PLAN- OAK CREEK, WI 2017 form 5500 responses |
|---|
| 2017-12-31 | Type of plan entity | Single employer plan |
| 2017-12-31 | Plan is a collectively bargained plan | Yes |
| 2017-12-31 | Plan funding arrangement – Insurance | Yes |
| 2017-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2017-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: GROUP BENEFITS PLAN- OAK CREEK, WI 2016 form 5500 responses |
|---|
| 2016-12-31 | Type of plan entity | Single employer plan |
| 2016-12-31 | Plan is a collectively bargained plan | Yes |
| 2016-12-31 | Plan funding arrangement – Insurance | Yes |
| 2016-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2016-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: GROUP BENEFITS PLAN- OAK CREEK, WI 2015 form 5500 responses |
|---|
| 2015-12-31 | Type of plan entity | Single employer plan |
| 2015-12-31 | Plan is a collectively bargained plan | Yes |
| 2015-12-31 | Plan funding arrangement – Insurance | Yes |
| 2015-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2015-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: GROUP BENEFITS PLAN- OAK CREEK, WI 2014 form 5500 responses |
|---|
| 2014-12-31 | Type of plan entity | Single employer plan |
| 2014-12-31 | Plan is a collectively bargained plan | Yes |
| 2014-12-31 | Plan funding arrangement – Insurance | Yes |
| 2014-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2014-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: GROUP BENEFITS PLAN- OAK CREEK, WI 2013 form 5500 responses |
|---|
| 2013-12-31 | Type of plan entity | Single employer plan |
| 2013-12-31 | Plan is a collectively bargained plan | Yes |
| 2013-12-31 | Plan funding arrangement – Insurance | Yes |
| 2013-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2013-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: GROUP BENEFITS PLAN- OAK CREEK, WI 2012 form 5500 responses |
|---|
| 2012-12-31 | Type of plan entity | Single employer plan |
| 2012-12-31 | Plan is a collectively bargained plan | Yes |
| 2012-12-31 | Plan funding arrangement – Insurance | Yes |
| 2012-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2012-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: GROUP BENEFITS PLAN- OAK CREEK, WI 2011 form 5500 responses |
|---|
| 2011-12-31 | Type of plan entity | Single employer plan |
| 2011-12-31 | Plan is a collectively bargained plan | Yes |
| 2011-12-31 | Plan funding arrangement – Insurance | Yes |
| 2011-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2011-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: GROUP BENEFITS PLAN- OAK CREEK, WI 2010 form 5500 responses |
|---|
| 2010-12-31 | Type of plan entity | Single employer plan |
| 2010-12-31 | Plan is a collectively bargained plan | Yes |
| 2010-12-31 | Plan funding arrangement – Insurance | Yes |
| 2010-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2010-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: GROUP BENEFITS PLAN- OAK CREEK, WI 2009 form 5500 responses |
|---|
| 2009-12-31 | Type of plan entity | Single employer plan |
| 2009-12-31 | This submission is the final filing | No |
| 2009-12-31 | Plan is a collectively bargained plan | Yes |
| 2009-12-31 | Plan funding arrangement – Insurance | Yes |
| 2009-12-31 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2009-12-31 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: GROUP BENEFITS PLAN- OAK CREEK, WI 2008 form 5500 responses |
|---|
| 2008-12-31 | Type of plan entity | Single employer plan |
| 2008-12-31 | Submission has been amended | No |
| 2008-12-31 | This submission is the final filing | No |
| 2008-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-12-31 | Plan is a collectively bargained plan | No |
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | N/A |
| Policy instance | 8 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 289 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $9,017 | | 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 | CH#800129 |
| Policy instance | 1 |
| Insurance contract or identification number | CH#800129 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,127 | | 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 | GTA101506 |
| Policy instance | 2 |
| Insurance contract or identification number | GTA101506 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EMERGENCY SQUAD AD&D | | 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 | 681077 |
| Policy instance | 3 |
| Insurance contract or identification number | 681077 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | HOURLY BASIC LTD | | Welfare Benefit Premiums Paid to Carrier | USD $11,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | VARIOUS |
| Policy instance | 4 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 200 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 6036796 |
| Policy instance | 5 |
| Insurance contract or identification number | 6036796 | | Number of Individuals Covered | 335 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,328 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0229100 |
| Policy instance | 6 |
| Insurance contract or identification number | 0229100 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | BASIC CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $3,409 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0214387 |
| Policy instance | 7 |
| Insurance contract or identification number | 0214387 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | SEAT BELT AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,164 | | 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 | CH#800129 |
| Policy instance | 1 |
| Insurance contract or identification number | CH#800129 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,471 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINENTAL CASUALTY COMPANY (National Association of Insurance Commissioners NAIC id number: 20443 ) |
| Policy contract number | ETB 200939 |
| Policy instance | 2 |
| Insurance contract or identification number | ETB 200939 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D FIRE SQUAD CNR | | Welfare Benefit Premiums Paid to Carrier | USD $360 | | 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 | 378050 |
| Policy instance | 3 |
| Insurance contract or identification number | 378050 | | Number of Individuals Covered | 219 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | HOURLY BASIC LTD | | Welfare Benefit Premiums Paid to Carrier | USD $20,461 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | VARIOUS |
| Policy instance | 4 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 137 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 6036796 |
| Policy instance | 5 |
| Insurance contract or identification number | 6036796 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,346 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0229100 |
| Policy instance | 6 |
| Insurance contract or identification number | 0229100 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | BASIC CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $4,388 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0214387 |
| Policy instance | 7 |
| Insurance contract or identification number | 0214387 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | SEAT BELT AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,952 | | 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 | 697331 |
| Policy instance | 8 |
| Insurance contract or identification number | 697331 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | LEAVE MANAGEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $7,772 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 6036796 |
| Policy instance | 6 |
| Insurance contract or identification number | 6036796 | | Number of Individuals Covered | 265 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 45087 |
| Policy instance | 5 |
| Insurance contract or identification number | 45087 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | 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 | 378050 |
| Policy instance | 4 |
| Insurance contract or identification number | 378050 | | Number of Individuals Covered | 207 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Other welfare benefits provided | HOURLY BASIC LTD | | Welfare Benefit Premiums Paid to Carrier | USD $17,685 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINENTAL CASUALTY COMPANY (National Association of Insurance Commissioners NAIC id number: 20443 ) |
| Policy contract number | ETB 200939 |
| Policy instance | 3 |
| Insurance contract or identification number | ETB 200939 | | Number of Individuals Covered | 298 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D FIRE SQUAD CNR | | Welfare Benefit Premiums Paid to Carrier | USD $385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINENTAL CASUALTY COMPANY (National Association of Insurance Commissioners NAIC id number: 20443 ) |
| Policy contract number | 00-ADD-S06751 |
| Policy instance | 2 |
| Insurance contract or identification number | 00-ADD-S06751 | | Number of Individuals Covered | 298 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SEAT BELT AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $223 | | 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 | CH#800129 |
| Policy instance | 1 |
| Insurance contract or identification number | CH#800129 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,169 | | 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 | CH#800129 |
| Policy instance | 1 |
| Insurance contract or identification number | CH#800129 | | Number of Individuals Covered | 118 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,636 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | 060303370 |
| Policy instance | 2 |
| Insurance contract or identification number | 060303370 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,936 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINENTAL CASUALTY COMPANY (National Association of Insurance Commissioners NAIC id number: 20443 ) |
| Policy contract number | 00-ADD-S06751 |
| Policy instance | 3 |
| Insurance contract or identification number | 00-ADD-S06751 | | Number of Individuals Covered | 274 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SEAT BELT AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $215 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINENTAL CASUALTY COMPANY (National Association of Insurance Commissioners NAIC id number: 20443 ) |
| Policy contract number | ETB 200939 |
| Policy instance | 4 |
| Insurance contract or identification number | ETB 200939 | | Number of Individuals Covered | 274 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D FIRE SQUAD CNR | | Welfare Benefit Premiums Paid to Carrier | USD $331 | | 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 | 378050 |
| Policy instance | 5 |
| Insurance contract or identification number | 378050 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Other welfare benefits provided | HOURLY BASIC LTD | | Welfare Benefit Premiums Paid to Carrier | USD $18,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 45087 |
| Policy instance | 6 |
| Insurance contract or identification number | 45087 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 6036796 |
| Policy instance | 7 |
| Insurance contract or identification number | 6036796 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,143 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | 060303370 |
| Policy instance | 2 |
| Insurance contract or identification number | 060303370 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,284 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| CONTINENTAL CASUALTY COMPANY (National Association of Insurance Commissioners NAIC id number: 20443 ) |
| Policy contract number | 00-ADD-S06751 |
| Policy instance | 3 |
| Insurance contract or identification number | 00-ADD-S06751 | | Number of Individuals Covered | 314 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SEAT BELT AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| CONTINENTAL CASUALTY COMPANY (National Association of Insurance Commissioners NAIC id number: 20443 ) |
| Policy contract number | ETB 200939 |
| Policy instance | 4 |
| Insurance contract or identification number | ETB 200939 | | Number of Individuals Covered | 314 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D FIRE SQUAD CNR | | Welfare Benefit Premiums Paid to Carrier | USD $327 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 378050 |
| Policy instance | 5 |
| Insurance contract or identification number | 378050 | | Number of Individuals Covered | 181 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Other welfare benefits provided | HOURLY BASIC LTD | | Welfare Benefit Premiums Paid to Carrier | USD $20,418 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 45087 |
| Policy instance | 6 |
| Insurance contract or identification number | 45087 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 6036796 |
| Policy instance | 7 |
| Insurance contract or identification number | 6036796 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,278 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | CH#800129 |
| Policy instance | 1 |
| Insurance contract or identification number | CH#800129 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,946 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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