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EMPLOYEE HEALTH PLAN OF EAU-D 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF EAU-D
Plan identification number 502

EMPLOYEE HEALTH PLAN OF EAU-D Benefits

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

401k Sponsoring company profile

EAU-D, INC. has sponsored the creation of one or more 401k plans.

Company Name:EAU-D, INC.
Employer identification number (EIN):391554756
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF EAU-D

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

Plan Statistics for EMPLOYEE HEALTH PLAN OF EAU-D

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF EAU-D

Measure Date Value
2019: EMPLOYEE HEALTH PLAN OF EAU-D 2019 401k membership
Total participants, beginning-of-year2019-05-017
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 EAU-D 2018 401k membership
Total participants, beginning-of-year2018-05-0111
Total number of active participants reported on line 7a of the Form 55002018-05-017
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 participants2018-05-017
2017: EMPLOYEE HEALTH PLAN OF EAU-D 2017 401k membership
Total participants, beginning-of-year2017-05-018
Total number of active participants reported on line 7a of the Form 55002017-05-019
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 participants2017-05-019
2016: EMPLOYEE HEALTH PLAN OF EAU-D 2016 401k membership
Total participants, beginning-of-year2016-05-019
Total number of active participants reported on line 7a of the Form 55002016-05-017
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 participants2016-05-017
2015: EMPLOYEE HEALTH PLAN OF EAU-D 2015 401k membership
Total participants, beginning-of-year2015-05-014
Total number of active participants reported on line 7a of the Form 55002015-05-013
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 participants2015-05-013
2014: EMPLOYEE HEALTH PLAN OF EAU-D 2014 401k membership
Total participants, beginning-of-year2014-05-0110
Total number of active participants reported on line 7a of the Form 55002014-05-016
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 participants2014-05-016
2013: EMPLOYEE HEALTH PLAN OF EAU-D 2013 401k membership
Total participants, beginning-of-year2013-05-0120
Total number of active participants reported on line 7a of the Form 55002013-05-0110
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 participants2013-05-0110
2012: EMPLOYEE HEALTH PLAN OF EAU-D 2012 401k membership
Total participants, beginning-of-year2012-05-0120
Total number of active participants reported on line 7a of the Form 55002012-05-0120
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 participants2012-05-0120
2011: EMPLOYEE HEALTH PLAN OF EAU-D 2011 401k membership
Total participants, beginning-of-year2011-05-0127
Total number of active participants reported on line 7a of the Form 55002011-05-0120
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 participants2011-05-0120

Financial Data on EMPLOYEE HEALTH PLAN OF EAU-D

Measure Date Value
2020 : EMPLOYEE HEALTH PLAN OF EAU-D 2020 401k financial data
Total plan liabilities at end of year2020-04-30$0
Total plan liabilities at beginning of year2020-04-30$0
Total income from all sources2020-04-30$19,065
Expenses. Total of all expenses incurred2020-04-30$19,065
Benefits paid (including direct rollovers)2020-04-30$8,928
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$10,137
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$19,065
2018 : EMPLOYEE HEALTH PLAN OF EAU-D 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$75,788
Expenses. Total of all expenses incurred2018-04-30$75,788
Benefits paid (including direct rollovers)2018-04-30$35,173
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$40,615
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$75,788
2017 : EMPLOYEE HEALTH PLAN OF EAU-D 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$66,029
Expenses. Total of all expenses incurred2017-04-30$66,029
Benefits paid (including direct rollovers)2017-04-30$26,807
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$39,222
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$66,029
2016 : EMPLOYEE HEALTH PLAN OF EAU-D 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$1,036
Total income from all sources2016-04-30$54,005
Expenses. Total of all expenses incurred2016-04-30$54,005
Benefits paid (including direct rollovers)2016-04-30$24,239
Total plan assets at end of year2016-04-30$0
Total plan assets at beginning of year2016-04-30$1,036
Value of fidelity bond covering the plan2016-04-30$10,000
Expenses. Other expenses not covered elsewhere2016-04-30$29,766
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$54,005
2015 : EMPLOYEE HEALTH PLAN OF EAU-D 2015 401k financial data
Total plan liabilities at end of year2015-04-30$1,036
Total plan liabilities at beginning of year2015-04-30$2,516
Total income from all sources2015-04-30$61,688
Expenses. Total of all expenses incurred2015-04-30$61,688
Benefits paid (including direct rollovers)2015-04-30$27,948
Total plan assets at end of year2015-04-30$1,036
Total plan assets at beginning of year2015-04-30$2,516
Value of fidelity bond covering the plan2015-04-30$10,000
Expenses. Other expenses not covered elsewhere2015-04-30$33,740
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$61,688
2014 : EMPLOYEE HEALTH PLAN OF EAU-D 2014 401k financial data
Total plan liabilities at end of year2014-04-30$2,516
Total plan liabilities at beginning of year2014-04-30$1,577
Total income from all sources2014-04-30$103,049
Expenses. Total of all expenses incurred2014-04-30$103,049
Benefits paid (including direct rollovers)2014-04-30$44,303
Total plan assets at end of year2014-04-30$2,516
Total plan assets at beginning of year2014-04-30$1,577
Value of fidelity bond covering the plan2014-04-30$25,000
Expenses. Other expenses not covered elsewhere2014-04-30$58,746
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$103,049
2013 : EMPLOYEE HEALTH PLAN OF EAU-D 2013 401k financial data
Total plan liabilities at end of year2013-04-30$1,577
Total plan liabilities at beginning of year2013-04-30$4,971
Total income from all sources2013-04-30$110,345
Expenses. Total of all expenses incurred2013-04-30$110,345
Benefits paid (including direct rollovers)2013-04-30$54,257
Total plan assets at end of year2013-04-30$1,577
Total plan assets at beginning of year2013-04-30$4,971
Expenses. Other expenses not covered elsewhere2013-04-30$56,088
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$110,345
2012 : EMPLOYEE HEALTH PLAN OF EAU-D 2012 401k financial data
Total plan liabilities at end of year2012-04-30$4,971
Total plan liabilities at beginning of year2012-04-30$1,693
Total income from all sources2012-04-30$89,377
Expenses. Total of all expenses incurred2012-04-30$113,980
Benefits paid (including direct rollovers)2012-04-30$68,034
Total plan assets at end of year2012-04-30$4,971
Total plan assets at beginning of year2012-04-30$26,296
Expenses. Other expenses not covered elsewhere2012-04-30$45,946
Net income (gross income less expenses)2012-04-30$-24,603
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$24,603
Total contributions received or receivable from employer(s)2012-04-30$89,377
2011 : EMPLOYEE HEALTH PLAN OF EAU-D 2011 401k financial data
Total plan liabilities at end of year2011-04-30$1,693
Total plan liabilities at beginning of year2011-04-30$0
Total income from all sources2011-04-30$113,534
Expenses. Total of all expenses incurred2011-04-30$88,931
Benefits paid (including direct rollovers)2011-04-30$35,589
Total plan assets at end of year2011-04-30$26,296
Total plan assets at beginning of year2011-04-30$0
Expenses. Other expenses not covered elsewhere2011-04-30$53,342
Net income (gross income less expenses)2011-04-30$24,603
Net plan assets at end of year (total assets less liabilities)2011-04-30$24,603
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$113,534

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF EAU-D

2019: EMPLOYEE HEALTH PLAN OF EAU-D 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 EAU-D 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 EAU-D 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 EAU-D 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 EAU-D 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 EAU-D 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 EAU-D 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 EAU-D 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 EAU-D 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 number12141NFA0056
Policy instance 1
Insurance contract or identification number12141NFA0056
Number of Individuals Covered9
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 $8,582
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 number12141NFA0056
Policy instance 1
Insurance contract or identification number12141NFA0056
Number of Individuals Covered10
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 $33,749
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 number12141 NFA 0056
Policy instance 1
Insurance contract or identification number12141 NFA 0056
Number of Individuals Covered16
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 $33,191
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 number12141 NFA 0056
Policy instance 1
Insurance contract or identification number12141 NFA 0056
Number of Individuals Covered9
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 $22,884
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 number12141 NFA 0056
Policy instance 1
Insurance contract or identification number12141 NFA 0056
Number of Individuals Covered11
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 $26,500
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 number12141 NFA 0056
Policy instance 1
Insurance contract or identification number12141 NFA 0056
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 $43,313
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 number12141 NFA 0056
Policy instance 1
Insurance contract or identification number12141 NFA 0056
Number of Individuals Covered28
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 $38,590
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 number12141 NFA 0056
Policy instance 1
Insurance contract or identification number12141 NFA 0056
Number of Individuals Covered29
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 $32,448
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 number12141 NFA 0056
Policy instance 1
Insurance contract or identification number12141 NFA 0056
Number of Individuals Covered34
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 $43,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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