GOODWILL INDUSTRIES OF CENTRAL IOWA has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GOODWILL INDUSTRIES OF CENTRAL IOWA
| Measure | Date | Value |
|---|
| 2014 : GOODWILL INDUSTRIES OF CENTRAL IOWA 2014 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2014-02-28 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-02-28 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-02-28 | $0 |
| Total income from all sources (including contributions) | 2014-02-28 | $0 |
| Total loss/gain on sale of assets | 2014-02-28 | $0 |
| Total of all expenses incurred | 2014-02-28 | $0 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-02-28 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-02-28 | $0 |
| Value of total assets at end of year | 2014-02-28 | $0 |
| Value of total assets at beginning of year | 2014-02-28 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-02-28 | $0 |
| Total interest from all sources | 2014-02-28 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-02-28 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-02-28 | No |
| Was this plan covered by a fidelity bond | 2014-02-28 | No |
| If this is an individual account plan, was there a blackout period | 2014-02-28 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-02-28 | No |
| Total non interest bearing cash at end of year | 2014-02-28 | $0 |
| Total non interest bearing cash at beginning of year | 2014-02-28 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-02-28 | No |
| Value of net income/loss | 2014-02-28 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2014-02-28 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-02-28 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-02-28 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-02-28 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-02-28 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-02-28 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-02-28 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-02-28 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-02-28 | No |
| Did the plan have assets held for investment | 2014-02-28 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-02-28 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-02-28 | No |
| 2013 : GOODWILL INDUSTRIES OF CENTRAL IOWA 2013 401k financial data |
|---|
| Total income from all sources (including contributions) | 2013-02-28 | $0 |
| Total of all expenses incurred | 2013-02-28 | $0 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-02-28 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-02-28 | $0 |
| Value of total assets at end of year | 2013-02-28 | $0 |
| Value of total assets at beginning of year | 2013-02-28 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-02-28 | No |
| Was this plan covered by a fidelity bond | 2013-02-28 | No |
| If this is an individual account plan, was there a blackout period | 2013-02-28 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-02-28 | No |
| Total non interest bearing cash at end of year | 2013-02-28 | $0 |
| Total non interest bearing cash at beginning of year | 2013-02-28 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-02-28 | No |
| Value of net income/loss | 2013-02-28 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2013-02-28 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-02-28 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-02-28 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-02-28 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-02-28 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-02-28 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-02-28 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-02-28 | No |
| Contributions received in cash from employer | 2013-02-28 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-02-28 | $0 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-02-28 | No |
| Did the plan have assets held for investment | 2013-02-28 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-02-28 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-02-28 | No |
| 2012 : GOODWILL INDUSTRIES OF CENTRAL IOWA 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of real estate assets | 2012-02-29 | $0 |
| Total unrealized appreciation/depreciation of assets | 2012-02-29 | $0 |
| Total transfer of assets to this plan | 2012-02-29 | $0 |
| Total transfer of assets from this plan | 2012-02-29 | $0 |
| Total income from all sources (including contributions) | 2012-02-29 | $0 |
| Total loss/gain on sale of assets | 2012-02-29 | $0 |
| Total of all expenses incurred | 2012-02-29 | $0 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-02-29 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-02-29 | $0 |
| Value of total assets at end of year | 2012-02-29 | $0 |
| Value of total assets at beginning of year | 2012-02-29 | $0 |
| Total income from rents | 2012-02-29 | $0 |
| Total interest from all sources | 2012-02-29 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-02-29 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-02-29 | No |
| Was this plan covered by a fidelity bond | 2012-02-29 | No |
| If this is an individual account plan, was there a blackout period | 2012-02-29 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-02-29 | No |
| Other income not declared elsewhere | 2012-02-29 | $0 |
| Total non interest bearing cash at end of year | 2012-02-29 | $0 |
| Total non interest bearing cash at beginning of year | 2012-02-29 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-02-29 | No |
| Value of net income/loss | 2012-02-29 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2012-02-29 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-02-29 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-02-29 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-02-29 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-02-29 | No |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-02-29 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-02-29 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-02-29 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-02-29 | No |
| Contributions received in cash from employer | 2012-02-29 | $0 |
| Income. Dividends from preferred stock | 2012-02-29 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-02-29 | $0 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-02-29 | No |
| Did the plan have assets held for investment | 2012-02-29 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-02-29 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-02-29 | No |
| Aggregate proceeds on sale of assets | 2012-02-29 | $0 |
| 2011 : GOODWILL INDUSTRIES OF CENTRAL IOWA 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of real estate assets | 2011-02-28 | $0 |
| Total unrealized appreciation/depreciation of assets | 2011-02-28 | $0 |
| Total transfer of assets to this plan | 2011-02-28 | $0 |
| Total transfer of assets from this plan | 2011-02-28 | $0 |
| Total income from all sources (including contributions) | 2011-02-28 | $0 |
| Total loss/gain on sale of assets | 2011-02-28 | $0 |
| Total of all expenses incurred | 2011-02-28 | $0 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-02-28 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-02-28 | $0 |
| Value of total assets at end of year | 2011-02-28 | $0 |
| Value of total assets at beginning of year | 2011-02-28 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-02-28 | $0 |
| Total income from rents | 2011-02-28 | $0 |
| Total interest from all sources | 2011-02-28 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-02-28 | $0 |
| Administrative expenses professional fees incurred | 2011-02-28 | $0 |
| Was this plan covered by a fidelity bond | 2011-02-28 | No |
| If this is an individual account plan, was there a blackout period | 2011-02-28 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-02-28 | No |
| Other income not declared elsewhere | 2011-02-28 | $0 |
| Total non interest bearing cash at end of year | 2011-02-28 | $0 |
| Total non interest bearing cash at beginning of year | 2011-02-28 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-02-28 | No |
| Value of net income/loss | 2011-02-28 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2011-02-28 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-02-28 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-02-28 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-02-28 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-02-28 | No |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-02-28 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-02-28 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-02-28 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-02-28 | No |
| Contributions received in cash from employer | 2011-02-28 | $0 |
| Income. Dividends from preferred stock | 2011-02-28 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-02-28 | $0 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-02-28 | No |
| Did the plan have assets held for investment | 2011-02-28 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-02-28 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-02-28 | No |
| Aggregate proceeds on sale of assets | 2011-02-28 | $0 |
| 2023: GOODWILL INDUSTRIES OF CENTRAL IOWA 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GOODWILL INDUSTRIES OF CENTRAL IOWA 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GOODWILL INDUSTRIES OF CENTRAL IOWA 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GOODWILL INDUSTRIES OF CENTRAL IOWA 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GOODWILL INDUSTRIES OF CENTRAL IOWA 2018 form 5500 responses |
|---|
| 2018-03-01 | Type of plan entity | Single employer plan |
| 2018-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-03-01 | Plan funding arrangement – Insurance | Yes |
| 2018-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GOODWILL INDUSTRIES OF CENTRAL IOWA 2017 form 5500 responses |
|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GOODWILL INDUSTRIES OF CENTRAL IOWA 2016 form 5500 responses |
|---|
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GOODWILL INDUSTRIES OF CENTRAL IOWA 2015 form 5500 responses |
|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GOODWILL INDUSTRIES OF CENTRAL IOWA 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GOODWILL INDUSTRIES OF CENTRAL IOWA 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Submission has been amended | No |
| 2013-03-01 | This submission is the final filing | No |
| 2013-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-03-01 | Plan is a collectively bargained plan | No |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GOODWILL INDUSTRIES OF CENTRAL IOWA 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Submission has been amended | No |
| 2012-03-01 | This submission is the final filing | No |
| 2012-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-03-01 | Plan is a collectively bargained plan | No |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GOODWILL INDUSTRIES OF CENTRAL IOWA 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Submission has been amended | No |
| 2011-03-01 | This submission is the final filing | No |
| 2011-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-03-01 | Plan is a collectively bargained plan | No |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: GOODWILL INDUSTRIES OF CENTRAL IOWA 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 2010-03-01 | Submission has been amended | No |
| 2010-03-01 | This submission is the final filing | No |
| 2010-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-03-01 | Plan is a collectively bargained plan | No |
| 2010-03-01 | Plan funding arrangement – Insurance | Yes |
| 2010-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GOODWILL INDUSTRIES OF CENTRAL IOWA 2009 form 5500 responses |
|---|
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | Submission has been amended | No |
| 2009-03-01 | This submission is the final filing | No |
| 2009-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-03-01 | Plan is a collectively bargained plan | No |
| 2009-03-01 | Plan funding arrangement – Insurance | Yes |
| 2009-03-01 | Plan benefit arrangement – Insurance | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | CI-0000058025 |
| Policy instance | 9 |
| Insurance contract or identification number | CI-0000058025 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $1,892 | | Total amount of fees paid to insurance company | USD $201 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,606 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 136-420238 |
| Policy instance | 1 |
| Insurance contract or identification number | 136-420238 | | Number of Individuals Covered | 294 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $3,222 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 60790-433 |
| Policy instance | 2 |
| Insurance contract or identification number | 60790-433 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,354 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,209 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | A96 |
| Policy instance | 3 |
| Insurance contract or identification number | A96 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Health Insurance Welfare Benefit | Yes | | 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 number | ACC-0000058026 |
| Policy instance | 4 |
| Insurance contract or identification number | ACC-0000058026 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $1,240 | | Total amount of fees paid to insurance company | USD $139 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,103 | | 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 number | 000010267940 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010267940 | | Number of Individuals Covered | 216 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $1,643 | | Total amount of fees paid to insurance company | USD $448 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,429 | | 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 number | 40000100 26923 |
| Policy instance | 6 |
| Insurance contract or identification number | 40000100 26923 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $1,260 | | Total amount of fees paid to insurance company | USD $367 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,600 | | 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 number | 000010267941 |
| Policy instance | 7 |
| Insurance contract or identification number | 000010267941 | | Number of Individuals Covered | 216 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $3,396 | | Total amount of fees paid to insurance company | USD $944 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,955 | | 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 number | 000010267942 |
| Policy instance | 8 |
| Insurance contract or identification number | 000010267942 | | Number of Individuals Covered | 216 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $6,717 | | Total amount of fees paid to insurance company | USD $1,828 | | Unemployment Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $67,172 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 136-420238 |
| Policy instance | 1 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 60790-433 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151134 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 123992 |
| Policy instance | 4 |
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | A96 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G165121 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VG 187461 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VCI 801532 |
| Policy instance | 8 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAI 826693 |
| Policy instance | 9 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 136-420238 |
| Policy instance | 1 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 60790-433 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151134 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 123992 |
| Policy instance | 4 |
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | A96 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VG 187461 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G165121 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VCI 801532 |
| Policy instance | 8 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAI 826693 |
| Policy instance | 9 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VCI 801532 |
| Policy instance | 8 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 136-420238 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAI 826693 |
| Policy instance | 9 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VG 187461 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G165121 |
| Policy instance | 6 |
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | A96 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 123992 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151134 |
| Policy instance | 3 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 60790-433 |
| Policy instance | 2 |
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 00017551 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 136-420238 |
| Policy instance | 2 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 60790-433 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151134 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 123992 |
| Policy instance | 5 |
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | 00017551 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G165121 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151134 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 123992 |
| Policy instance | 5 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 60790-433 |
| Policy instance | 3 |
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 00017551 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 136-420238 |
| Policy instance | 2 |
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | 00017551 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G165121 |
| Policy instance | 7 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | N12905 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 123992 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151134 |
| Policy instance | 3 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 60790-433 |
| Policy instance | 2 |
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 00017551 |
| Policy instance | 1 |
| WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
| Policy contract number | 00017551 |
| Policy instance | 5 |
