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COMMUNITY CARE SERVICES 403(B) PLAN 401k Plan overview

Plan NameCOMMUNITY CARE SERVICES 403(B) PLAN
Plan identification number 001

COMMUNITY CARE SERVICES 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

COMMUNITY CARE SERVICES has sponsored the creation of one or more 401k plans.

Company Name:COMMUNITY CARE SERVICES
Employer identification number (EIN):382601865
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about COMMUNITY CARE SERVICES

Jurisdiction of Incorporation: Michigan Secretary of State
Incorporation Date: 0000-00-00
Company Identification Number: 710583
Legal Registered Office Address: W OUTER DR LINCOLN PARK 48146


United States of America (USA)
26184

More information about COMMUNITY CARE SERVICES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY CARE SERVICES 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012020-01-01
0012019-01-01SUSAN KOZAK2020-10-12
0012019-01-01SUSAN KOZAK2021-03-25
0012018-01-01SUSAN KOZAK2019-10-10
0012018-01-01SUSAN KOZAK2021-03-25
0012017-01-01SUSAN KOZAK2018-10-12
0012017-01-01SUSAN KOZAK2021-04-08
0012017-01-01SUSAN KOZAK2021-03-25
0012016-01-01SUSAN KOZAK2017-10-11
0012016-01-01SUSAN KOZAK2021-04-08
0012016-01-01SUSAN KOZAK2021-03-25
0012015-01-01SUSAN KOZAK2016-08-31
0012014-01-01SUSAN KOZAK2016-08-31
0012014-01-01SUSAN KOZAK2015-10-15
0012013-01-01SUSAN KOZAK2014-09-23
0012012-01-01SUSAN KOZAK2014-01-09
0012011-01-01SUSAN KOZAK2014-01-09
0012010-01-01SUSAN KOZAK2014-01-09

Plan Statistics for COMMUNITY CARE SERVICES 403(B) PLAN

401k plan membership statisitcs for COMMUNITY CARE SERVICES 403(B) PLAN

Measure Date Value
2020: COMMUNITY CARE SERVICES 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01157
Total number of active participants reported on line 7a of the Form 55002020-01-01101
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0147
Total of all active and inactive participants2020-01-01148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01148
Number of participants with account balances2020-01-01148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010

Financial Data on COMMUNITY CARE SERVICES 403(B) PLAN

Measure Date Value
2021 : COMMUNITY CARE SERVICES 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$811,407
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$450,005
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$442,009
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$421,847
Value of total assets at end of year2021-12-31$3,319,145
Value of total assets at beginning of year2021-12-31$2,957,743
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$7,996
Total interest from all sources2021-12-31$1,738
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$250,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$197,249
Participant contributions at end of year2021-12-31$43,368
Participant contributions at beginning of year2021-12-31$56,371
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$361,402
Value of net assets at end of year (total assets less liabilities)2021-12-31$3,319,145
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,957,743
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$7,996
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$3,275,777
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$2,811,055
Interest on participant loans2021-12-31$1,738
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$90,317
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$387,822
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$224,598
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$442,009
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
2020 : COMMUNITY CARE SERVICES 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$788,777
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$319,211
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$312,799
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$418,213
Value of total assets at end of year2020-12-31$2,957,743
Value of total assets at beginning of year2020-12-31$2,488,177
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$6,412
Total interest from all sources2020-12-31$7,066
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$250,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$188,127
Participant contributions at end of year2020-12-31$56,371
Participant contributions at beginning of year2020-12-31$16,811
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$469,566
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,957,743
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,488,177
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$6,412
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$2,811,055
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$2,381,359
Interest on participant loans2020-12-31$7,066
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$90,317
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$90,007
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$363,498
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$230,086
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$312,799
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No

Form 5500 Responses for COMMUNITY CARE SERVICES 403(B) PLAN

2020: COMMUNITY CARE SERVICES 403(B) PLAN 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 – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR08591
Policy instance 1
Insurance contract or identification numberCR08591
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-07-25
Total amount of commissions paid to insurance brokerUSD $581
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $581
Insurance broker organization code?4
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract numberVARIOUS
Policy instance 2
Insurance contract or identification numberVARIOUS
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-07-25
Total amount of commissions paid to insurance brokerUSD $239
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $239
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 3
Insurance contract or identification number613953
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-07-25
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR08591
Policy instance 1
Insurance contract or identification numberCR08591
Number of Individuals Covered15
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $499
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $499
Insurance broker organization code?4
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract numberVARIOUS
Policy instance 2
Insurance contract or identification numberVARIOUS
Number of Individuals Covered4
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $26
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 3
Insurance contract or identification number613953
Number of Individuals Covered91
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR08591
Policy instance 1
Insurance contract or identification numberCR08591
Number of Individuals Covered16
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $506
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract numberVARIOUS
Policy instance 2
Insurance contract or identification numberVARIOUS
Number of Individuals Covered4
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $28
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 3
Insurance contract or identification number613953
Number of Individuals Covered95
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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