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CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 401k Plan overview

Plan NameCIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM
Plan identification number 501

CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM Benefits

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

401k Sponsoring company profile

CIRCLE CITY ELECTRIC, INC. has sponsored the creation of one or more 401k plans.

Company Name:CIRCLE CITY ELECTRIC, INC.
Employer identification number (EIN):330151202
NAIC Classification:238210
NAIC Description:Electrical Contractors and Other Wiring Installation Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01JENNY JOHNSON2022-10-06
5012020-01-01JENNY JOHNSON2021-04-27
5012019-01-01JENNY JOHNSON2020-02-26
5012018-01-01JENNY JOHNSON2019-07-24
5012017-01-01
5012017-01-01
5012016-01-01JENNY JOHNSON
5012015-01-01MIKE OWINGS
5012014-01-01JENNY JOHNSON
5012013-01-01JENNY JOHNSON
5012012-01-01JENNY JOHNSON
5012011-01-01JENNY JOHNSON
5012010-01-01JENNY JOHNSON
5012009-09-01JENNY JOHNSON
5012009-09-01JENNY JOHNSON JENNY JOHNSON2010-10-12

Plan Statistics for CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM

401k plan membership statisitcs for CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM

Measure Date Value
2021: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2021 401k membership
Total participants, beginning-of-year2021-01-012
Total number of active participants reported on line 7a of the Form 55002021-01-010
Total of all active and inactive participants2021-01-010
2020: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2020 401k membership
Total participants, beginning-of-year2020-01-012
Total number of active participants reported on line 7a of the Form 55002020-01-012
Total of all active and inactive participants2020-01-012
2019: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2019 401k membership
Total participants, beginning-of-year2019-01-012
Total number of active participants reported on line 7a of the Form 55002019-01-012
Total of all active and inactive participants2019-01-012
2018: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2018 401k membership
Total participants, beginning-of-year2018-01-012
Total number of active participants reported on line 7a of the Form 55002018-01-012
Total of all active and inactive participants2018-01-012
2017: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2017 401k membership
Total participants, beginning-of-year2017-01-012
Total number of active participants reported on line 7a of the Form 55002017-01-012
Total of all active and inactive participants2017-01-012
2016: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2016 401k membership
Total participants, beginning-of-year2016-01-013
Total number of active participants reported on line 7a of the Form 55002016-01-012
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-012
2015: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2015 401k membership
Total participants, beginning-of-year2015-01-0116
Total number of active participants reported on line 7a of the Form 55002015-01-013
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-013
2014: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2014 401k membership
Total participants, beginning-of-year2014-01-0116
Total number of active participants reported on line 7a of the Form 55002014-01-0116
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0116
2013: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2013 401k membership
Total participants, beginning-of-year2013-01-0116
Total number of active participants reported on line 7a of the Form 55002013-01-0116
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0116
2012: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2012 401k membership
Total participants, beginning-of-year2012-01-0116
Total number of active participants reported on line 7a of the Form 55002012-01-0116
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0116
2011: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2011 401k membership
Total participants, beginning-of-year2011-01-014
Total number of active participants reported on line 7a of the Form 55002011-01-0116
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0116
2010: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2010 401k membership
Total participants, beginning-of-year2010-01-0113
Total number of active participants reported on line 7a of the Form 55002010-01-017
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-017
2009: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2009 401k membership
Total participants, beginning-of-year2009-09-0116
Total number of active participants reported on line 7a of the Form 55002009-09-0112
Number of retired or separated participants receiving benefits2009-09-010
Number of other retired or separated participants entitled to future benefits2009-09-011
Total of all active and inactive participants2009-09-0113

Financial Data on CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM

Measure Date Value
2021 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2021 401k financial data
Total income from all sources2021-12-31$0
Expenses. Total of all expenses incurred2021-12-31$364
Benefits paid (including direct rollovers)2021-12-31$54
Total plan assets at end of year2021-12-31$0
Total plan assets at beginning of year2021-12-31$364
Net income (gross income less expenses)2021-12-31$-364
Net plan assets at end of year (total assets less liabilities)2021-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$364
Total contributions received or receivable from employer(s)2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$310
2020 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2020 401k financial data
Total income from all sources2020-12-31$0
Expenses. Total of all expenses incurred2020-12-31$424
Benefits paid (including direct rollovers)2020-12-31$310
Total plan assets at end of year2020-12-31$364
Total plan assets at beginning of year2020-12-31$788
Net income (gross income less expenses)2020-12-31$-424
Net plan assets at end of year (total assets less liabilities)2020-12-31$364
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$788
Total contributions received or receivable from employer(s)2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$114
2019 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2019 401k financial data
Total income from all sources2019-12-31$0
Expenses. Total of all expenses incurred2019-12-31$964
Benefits paid (including direct rollovers)2019-12-31$834
Total plan assets at end of year2019-12-31$788
Total plan assets at beginning of year2019-12-31$1,752
Net income (gross income less expenses)2019-12-31$-964
Net plan assets at end of year (total assets less liabilities)2019-12-31$788
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,752
Total contributions received or receivable from employer(s)2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$130
2018 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2018 401k financial data
Total income from all sources2018-12-31$0
Expenses. Total of all expenses incurred2018-12-31$400
Benefits paid (including direct rollovers)2018-12-31$246
Total plan assets at end of year2018-12-31$1,752
Total plan assets at beginning of year2018-12-31$2,152
Net income (gross income less expenses)2018-12-31$-400
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,752
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$2,152
Total contributions received or receivable from employer(s)2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$154
2017 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2017 401k financial data
Total income from all sources2017-12-31$0
Expenses. Total of all expenses incurred2017-12-31$636
Benefits paid (including direct rollovers)2017-12-31$458
Total plan assets at end of year2017-12-31$2,152
Total plan assets at beginning of year2017-12-31$2,788
Net income (gross income less expenses)2017-12-31$-636
Net plan assets at end of year (total assets less liabilities)2017-12-31$2,152
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,788
Total contributions received or receivable from employer(s)2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$178
2016 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2016 401k financial data
Total income from all sources2016-12-31$0
Expenses. Total of all expenses incurred2016-12-31$583
Benefits paid (including direct rollovers)2016-12-31$406
Total plan assets at end of year2016-12-31$2,788
Total plan assets at beginning of year2016-12-31$3,371
Net income (gross income less expenses)2016-12-31$-583
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,788
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,371
Total contributions received or receivable from employer(s)2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$177
2015 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2015 401k financial data
Total income from all sources2015-12-31$0
Expenses. Total of all expenses incurred2015-12-31$344
Benefits paid (including direct rollovers)2015-12-31$105
Total plan assets at end of year2015-12-31$3,371
Total plan assets at beginning of year2015-12-31$3,715
Net income (gross income less expenses)2015-12-31$-344
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,371
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,715
Total contributions received or receivable from employer(s)2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$239
2014 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2014 401k financial data
Total income from all sources2014-12-31$0
Expenses. Total of all expenses incurred2014-12-31$888
Benefits paid (including direct rollovers)2014-12-31$635
Total plan assets at end of year2014-12-31$3,715
Total plan assets at beginning of year2014-12-31$4,603
Value of fidelity bond covering the plan2014-12-31$150,000
Net income (gross income less expenses)2014-12-31$-888
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,715
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$4,603
Total contributions received or receivable from employer(s)2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$253
2013 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2013 401k financial data
Total income from all sources2013-12-31$0
Expenses. Total of all expenses incurred2013-12-31$1,573
Benefits paid (including direct rollovers)2013-12-31$1,247
Total plan assets at end of year2013-12-31$4,603
Total plan assets at beginning of year2013-12-31$6,176
Value of fidelity bond covering the plan2013-12-31$150,000
Net income (gross income less expenses)2013-12-31$-1,573
Net plan assets at end of year (total assets less liabilities)2013-12-31$4,603
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$6,176
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$326
2012 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2012 401k financial data
Total income from all sources2012-12-31$0
Expenses. Total of all expenses incurred2012-12-31$4,717
Benefits paid (including direct rollovers)2012-12-31$4,476
Total plan assets at end of year2012-12-31$6,176
Total plan assets at beginning of year2012-12-31$10,893
Value of fidelity bond covering the plan2012-12-31$150,000
Net income (gross income less expenses)2012-12-31$-4,717
Net plan assets at end of year (total assets less liabilities)2012-12-31$6,176
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$10,893
Total contributions received or receivable from employer(s)2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$241
2011 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2011 401k financial data
Total income from all sources2011-12-31$5,017
Expenses. Total of all expenses incurred2011-12-31$14,607
Benefits paid (including direct rollovers)2011-12-31$14,344
Total plan assets at end of year2011-12-31$10,893
Total plan assets at beginning of year2011-12-31$20,483
Value of fidelity bond covering the plan2011-12-31$150,000
Net income (gross income less expenses)2011-12-31$-9,590
Net plan assets at end of year (total assets less liabilities)2011-12-31$10,893
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$20,483
Total contributions received or receivable from employer(s)2011-12-31$5,017
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$263
2010 : CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2010 401k financial data
Total income from all sources2010-12-31$69,124
Expenses. Total of all expenses incurred2010-12-31$96,550
Benefits paid (including direct rollovers)2010-12-31$91,513
Total plan assets at end of year2010-12-31$20,483
Total plan assets at beginning of year2010-12-31$47,909
Net income (gross income less expenses)2010-12-31$-27,426
Net plan assets at end of year (total assets less liabilities)2010-12-31$20,483
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$47,909
Total contributions received or receivable from employer(s)2010-12-31$69,124
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$5,037

Form 5500 Responses for CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM

2021: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: CIRCLE CITY ELECTRIC INC HEALTH & WELFARE PROGRAM 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01First time form 5500 has been submittedYes
2009-09-01Submission has been amendedYes
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan funding arrangement – TrustYes
2009-09-01Plan benefit arrangement – InsuranceYes
2009-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number230477/03J2016
Policy instance 1
Insurance contract or identification number230477/03J2016
Number of Individuals Covered4
Insurance policy start date2011-01-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $688
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $6,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number100-5330-00
Policy instance 2
Insurance contract or identification number100-5330-00
Number of Individuals Covered4
Insurance policy start date2011-01-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $102
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number230477/03J2016
Policy instance 1
Insurance contract or identification number230477/03J2016
Number of Individuals Covered4
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,227
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $66,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,227
Insurance broker organization code?3
Insurance broker nameBENECO
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number100-5330-00
Policy instance 2
Insurance contract or identification number100-5330-00
Number of Individuals Covered4
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,526
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $10,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,526
Insurance broker organization code?3
Insurance broker nameBENECO

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