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INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 401k Plan overview

Plan NameINVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN
Plan identification number 505

INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN Benefits

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

401k Sponsoring company profile

INVESTORS TITLE COMPANY AND AFFILIATES has sponsored the creation of one or more 401k plans.

Company Name:INVESTORS TITLE COMPANY AND AFFILIATES
Employer identification number (EIN):561110199
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052021-10-01
5052020-10-01
5052019-10-01
5052018-10-01
5052017-10-01
5052016-10-01MITCHELL WARD
5052015-10-01MITCHELL WARD
5052014-10-01MITCHELL WARD

Plan Statistics for INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN

401k plan membership statisitcs for INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN

Measure Date Value
2021: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01584
Total number of active participants reported on line 7a of the Form 55002021-10-01736
Number of retired or separated participants receiving benefits2021-10-0110
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01746
2020: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01416
Total number of active participants reported on line 7a of the Form 55002020-10-01547
Number of retired or separated participants receiving benefits2020-10-0112
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01559
2019: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01386
Total number of active participants reported on line 7a of the Form 55002019-10-01406
Number of retired or separated participants receiving benefits2019-10-015
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01411
2018: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01362
Total number of active participants reported on line 7a of the Form 55002018-10-01380
Number of retired or separated participants receiving benefits2018-10-016
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01386
2017: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01343
Total number of active participants reported on line 7a of the Form 55002017-10-01359
Number of retired or separated participants receiving benefits2017-10-013
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01362
2016: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01336
Total number of active participants reported on line 7a of the Form 55002016-10-01339
Number of retired or separated participants receiving benefits2016-10-014
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01343
2015: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01318
Total number of active participants reported on line 7a of the Form 55002015-10-01332
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01332
2014: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01307
Total number of active participants reported on line 7a of the Form 55002014-10-01307
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01307

Financial Data on INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN

Measure Date Value
2022 : INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$1,474,902
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$1,081,235
Total income from all sources (including contributions)2022-09-30$9,299,906
Total loss/gain on sale of assets2022-09-30$0
Total of all expenses incurred2022-09-30$9,238,829
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$9,209,681
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$9,299,906
Value of total assets at end of year2022-09-30$1,822,031
Value of total assets at beginning of year2022-09-30$1,367,287
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$29,148
Total interest from all sources2022-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2022-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Was this plan covered by a fidelity bond2022-09-30Yes
Value of fidelity bond cover2022-09-30$2,000,000
If this is an individual account plan, was there a blackout period2022-09-30No
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$1,313,319
Income. Received or receivable in cash from other sources (including rollovers)2022-09-30$141
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-09-30$627,027
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-09-30$9,908
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-09-30$92,603
Liabilities. Value of operating payables at end of year2022-09-30$330,592
Liabilities. Value of operating payables at beginning of year2022-09-30$11,329
Total non interest bearing cash at end of year2022-09-30$1,551,758
Total non interest bearing cash at beginning of year2022-09-30$1,236,488
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$61,077
Value of net assets at end of year (total assets less liabilities)2022-09-30$347,129
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$286,052
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2022-09-30$1,258,385
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30No
Was there a failure to transmit to the plan any participant contributions2022-09-30No
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$7,986,446
Employer contributions (assets) at end of year2022-09-30$260,365
Employer contributions (assets) at beginning of year2022-09-30$38,196
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$7,324,269
Contract administrator fees2022-09-30$29,148
Liabilities. Value of benefit claims payable at end of year2022-09-30$1,144,310
Liabilities. Value of benefit claims payable at beginning of year2022-09-30$1,069,906
Did the plan have assets held for investment2022-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30No
Opinion of an independent qualified public accountant for this plan2022-09-30Unqualified
Accountancy firm name2022-09-30BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN2022-09-30540504608
2021 : INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$1,081,235
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$362,756
Total income from all sources (including contributions)2021-09-30$5,977,309
Total loss/gain on sale of assets2021-09-30$0
Total of all expenses incurred2021-09-30$7,471,105
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-09-30$7,443,529
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-09-30$5,977,309
Value of total assets at end of year2021-09-30$1,367,287
Value of total assets at beginning of year2021-09-30$2,142,604
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-09-30$27,576
Total interest from all sources2021-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2021-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-09-30No
Was this plan covered by a fidelity bond2021-09-30Yes
Value of fidelity bond cover2021-09-30$2,000,000
If this is an individual account plan, was there a blackout period2021-09-30No
Were there any nonexempt tranactions with any party-in-interest2021-09-30No
Contributions received from participants2021-09-30$1,093,255
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-09-30$500,087
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-09-30$92,603
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-09-30$936
Liabilities. Value of operating payables at end of year2021-09-30$11,329
Liabilities. Value of operating payables at beginning of year2021-09-30$270
Total non interest bearing cash at end of year2021-09-30$1,236,488
Total non interest bearing cash at beginning of year2021-09-30$2,077,890
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Value of net income/loss2021-09-30$-1,493,796
Value of net assets at end of year (total assets less liabilities)2021-09-30$286,052
Value of net assets at beginning of year (total assets less liabilities)2021-09-30$1,779,848
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-09-30No
Were any leases to which the plan was party in default or uncollectible2021-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2021-09-30$1,016,048
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-09-30No
Was there a failure to transmit to the plan any participant contributions2021-09-30No
Has the plan failed to provide any benefit when due under the plan2021-09-30No
Contributions received in cash from employer2021-09-30$4,884,054
Employer contributions (assets) at end of year2021-09-30$38,196
Employer contributions (assets) at beginning of year2021-09-30$63,778
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-09-30$5,927,394
Contract administrator fees2021-09-30$27,576
Liabilities. Value of benefit claims payable at end of year2021-09-30$1,069,906
Liabilities. Value of benefit claims payable at beginning of year2021-09-30$362,486
Did the plan have assets held for investment2021-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-09-30No
Opinion of an independent qualified public accountant for this plan2021-09-30Unqualified
Accountancy firm name2021-09-30BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN2021-09-30540504608
2020 : INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$362,756
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$324,482
Total income from all sources (including contributions)2020-09-30$4,897,205
Total loss/gain on sale of assets2020-09-30$0
Total of all expenses incurred2020-09-30$4,842,678
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-09-30$4,758,350
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-09-30$4,897,205
Value of total assets at end of year2020-09-30$2,142,604
Value of total assets at beginning of year2020-09-30$2,049,803
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-09-30$84,328
Total interest from all sources2020-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2020-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-09-30No
Was this plan covered by a fidelity bond2020-09-30Yes
Value of fidelity bond cover2020-09-30$2,000,000
If this is an individual account plan, was there a blackout period2020-09-30No
Were there any nonexempt tranactions with any party-in-interest2020-09-30No
Contributions received from participants2020-09-30$870,944
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-09-30$394,216
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-09-30$936
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-09-30$936
Liabilities. Value of operating payables at end of year2020-09-30$270
Liabilities. Value of operating payables at beginning of year2020-09-30$98,680
Total non interest bearing cash at end of year2020-09-30$2,077,890
Total non interest bearing cash at beginning of year2020-09-30$1,913,817
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Value of net income/loss2020-09-30$54,527
Value of net assets at end of year (total assets less liabilities)2020-09-30$1,779,848
Value of net assets at beginning of year (total assets less liabilities)2020-09-30$1,725,321
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-09-30No
Were any leases to which the plan was party in default or uncollectible2020-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2020-09-30$766,681
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-09-30No
Was there a failure to transmit to the plan any participant contributions2020-09-30No
Has the plan failed to provide any benefit when due under the plan2020-09-30No
Contributions received in cash from employer2020-09-30$4,026,261
Employer contributions (assets) at end of year2020-09-30$63,778
Employer contributions (assets) at beginning of year2020-09-30$135,050
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-09-30$3,597,453
Contract administrator fees2020-09-30$84,328
Liabilities. Value of benefit claims payable at end of year2020-09-30$362,486
Liabilities. Value of benefit claims payable at beginning of year2020-09-30$225,802
Did the plan have assets held for investment2020-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-09-30No
Opinion of an independent qualified public accountant for this plan2020-09-30Unqualified
Accountancy firm name2020-09-30BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN2020-09-30540504608
2019 : INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$324,482
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$588,213
Total income from all sources (including contributions)2019-09-30$4,654,983
Total loss/gain on sale of assets2019-09-30$0
Total of all expenses incurred2019-09-30$3,560,464
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-09-30$3,536,048
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-09-30$4,654,983
Value of total assets at end of year2019-09-30$2,049,803
Value of total assets at beginning of year2019-09-30$1,219,015
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-09-30$24,416
Total interest from all sources2019-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2019-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-09-30No
Was this plan covered by a fidelity bond2019-09-30Yes
Value of fidelity bond cover2019-09-30$2,000,000
If this is an individual account plan, was there a blackout period2019-09-30No
Were there any nonexempt tranactions with any party-in-interest2019-09-30No
Contributions received from participants2019-09-30$781,498
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-09-30$377,923
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-09-30$936
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-09-30$942
Liabilities. Value of operating payables at end of year2019-09-30$98,680
Liabilities. Value of operating payables at beginning of year2019-09-30$0
Total non interest bearing cash at end of year2019-09-30$1,913,817
Total non interest bearing cash at beginning of year2019-09-30$1,067,121
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Value of net income/loss2019-09-30$1,094,519
Value of net assets at end of year (total assets less liabilities)2019-09-30$1,725,321
Value of net assets at beginning of year (total assets less liabilities)2019-09-30$630,802
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-09-30No
Were any leases to which the plan was party in default or uncollectible2019-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2019-09-30$755,570
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-09-30No
Was there a failure to transmit to the plan any participant contributions2019-09-30No
Has the plan failed to provide any benefit when due under the plan2019-09-30No
Contributions received in cash from employer2019-09-30$3,873,485
Employer contributions (assets) at end of year2019-09-30$135,050
Employer contributions (assets) at beginning of year2019-09-30$150,952
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-09-30$2,402,555
Contract administrator fees2019-09-30$24,416
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-09-30No
Liabilities. Value of benefit claims payable at end of year2019-09-30$225,802
Liabilities. Value of benefit claims payable at beginning of year2019-09-30$588,213
Did the plan have assets held for investment2019-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-09-30No
Opinion of an independent qualified public accountant for this plan2019-09-30Unqualified
Accountancy firm name2019-09-30BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN2019-09-30540504608
2018 : INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$588,213
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$957,146
Total income from all sources (including contributions)2018-09-30$4,373,082
Total loss/gain on sale of assets2018-09-30$0
Total of all expenses incurred2018-09-30$4,253,122
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-09-30$4,229,168
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-09-30$4,373,082
Value of total assets at end of year2018-09-30$1,219,015
Value of total assets at beginning of year2018-09-30$1,467,988
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-09-30$23,954
Total interest from all sources2018-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2018-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-09-30No
Was this plan covered by a fidelity bond2018-09-30Yes
Value of fidelity bond cover2018-09-30$2,000,000
If this is an individual account plan, was there a blackout period2018-09-30No
Were there any nonexempt tranactions with any party-in-interest2018-09-30No
Contributions received from participants2018-09-30$715,985
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-09-30$400,997
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-09-30$942
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-09-30$878
Liabilities. Value of operating payables at end of year2018-09-30$0
Liabilities. Value of operating payables at beginning of year2018-09-30$438,445
Total non interest bearing cash at end of year2018-09-30$1,067,121
Total non interest bearing cash at beginning of year2018-09-30$1,335,963
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Value of net income/loss2018-09-30$119,960
Value of net assets at end of year (total assets less liabilities)2018-09-30$630,802
Value of net assets at beginning of year (total assets less liabilities)2018-09-30$510,842
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-09-30No
Were any leases to which the plan was party in default or uncollectible2018-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2018-09-30$694,462
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-09-30No
Was there a failure to transmit to the plan any participant contributions2018-09-30No
Has the plan failed to provide any benefit when due under the plan2018-09-30No
Contributions received in cash from employer2018-09-30$3,657,097
Employer contributions (assets) at end of year2018-09-30$150,952
Employer contributions (assets) at beginning of year2018-09-30$131,147
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-09-30$3,133,709
Contract administrator fees2018-09-30$23,954
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-09-30No
Liabilities. Value of benefit claims payable at end of year2018-09-30$588,213
Liabilities. Value of benefit claims payable at beginning of year2018-09-30$518,701
Did the plan have assets held for investment2018-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-09-30No
Opinion of an independent qualified public accountant for this plan2018-09-30Unqualified
Accountancy firm name2018-09-30BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN2018-09-30540504608
2017 : INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$957,146
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$357,699
Total income from all sources (including contributions)2017-09-30$4,232,349
Total loss/gain on sale of assets2017-09-30$0
Total of all expenses incurred2017-09-30$4,200,178
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-09-30$4,169,521
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-09-30$4,232,349
Value of total assets at end of year2017-09-30$1,467,988
Value of total assets at beginning of year2017-09-30$836,370
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-09-30$30,657
Total interest from all sources2017-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2017-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-09-30No
Was this plan covered by a fidelity bond2017-09-30Yes
Value of fidelity bond cover2017-09-30$2,000,000
If this is an individual account plan, was there a blackout period2017-09-30No
Were there any nonexempt tranactions with any party-in-interest2017-09-30No
Contributions received from participants2017-09-30$719,285
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-09-30$351,167
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-09-30$878
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-09-30$548,867
Liabilities. Value of operating payables at end of year2017-09-30$438,445
Liabilities. Value of operating payables at beginning of year2017-09-30$0
Total non interest bearing cash at end of year2017-09-30$1,335,963
Total non interest bearing cash at beginning of year2017-09-30$105,041
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Value of net income/loss2017-09-30$32,171
Value of net assets at end of year (total assets less liabilities)2017-09-30$510,842
Value of net assets at beginning of year (total assets less liabilities)2017-09-30$478,671
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-09-30No
Were any leases to which the plan was party in default or uncollectible2017-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2017-09-30$614,226
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-09-30No
Was there a failure to transmit to the plan any participant contributions2017-09-30No
Has the plan failed to provide any benefit when due under the plan2017-09-30No
Contributions received in cash from employer2017-09-30$3,513,064
Employer contributions (assets) at end of year2017-09-30$131,147
Employer contributions (assets) at beginning of year2017-09-30$182,462
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-09-30$3,204,128
Contract administrator fees2017-09-30$30,657
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-09-30No
Liabilities. Value of benefit claims payable at end of year2017-09-30$518,701
Liabilities. Value of benefit claims payable at beginning of year2017-09-30$357,699
Did the plan have assets held for investment2017-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-09-30No
Opinion of an independent qualified public accountant for this plan2017-09-30Unqualified
Accountancy firm name2017-09-30BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN2017-09-30540504608
2016 : INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$357,699
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$183,351
Total income from all sources (including contributions)2016-09-30$3,503,338
Total loss/gain on sale of assets2016-09-30$0
Total of all expenses incurred2016-09-30$3,700,618
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-09-30$3,672,013
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-09-30$3,503,338
Value of total assets at end of year2016-09-30$836,370
Value of total assets at beginning of year2016-09-30$859,302
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-09-30$28,605
Total interest from all sources2016-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2016-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-09-30No
Was this plan covered by a fidelity bond2016-09-30Yes
Value of fidelity bond cover2016-09-30$2,000,000
If this is an individual account plan, was there a blackout period2016-09-30No
Were there any nonexempt tranactions with any party-in-interest2016-09-30No
Contributions received from participants2016-09-30$636,125
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-09-30$327,623
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-09-30$548,867
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-09-30$1,154
Liabilities. Value of operating payables at end of year2016-09-30$0
Liabilities. Value of operating payables at beginning of year2016-09-30$238
Total non interest bearing cash at end of year2016-09-30$105,041
Total non interest bearing cash at beginning of year2016-09-30$659,191
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Value of net income/loss2016-09-30$-197,280
Value of net assets at end of year (total assets less liabilities)2016-09-30$478,671
Value of net assets at beginning of year (total assets less liabilities)2016-09-30$675,951
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-09-30No
Were any leases to which the plan was party in default or uncollectible2016-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2016-09-30$513,421
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-09-30No
Was there a failure to transmit to the plan any participant contributions2016-09-30No
Has the plan failed to provide any benefit when due under the plan2016-09-30No
Contributions received in cash from employer2016-09-30$2,867,213
Employer contributions (assets) at end of year2016-09-30$182,462
Employer contributions (assets) at beginning of year2016-09-30$198,957
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-09-30$2,830,969
Contract administrator fees2016-09-30$28,605
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-09-30No
Liabilities. Value of benefit claims payable at end of year2016-09-30$357,699
Liabilities. Value of benefit claims payable at beginning of year2016-09-30$183,113
Did the plan have assets held for investment2016-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-09-30No
Opinion of an independent qualified public accountant for this plan2016-09-30Unqualified
Accountancy firm name2016-09-30BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN2016-09-30540504608
2015 : INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$183,351
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$0
Total income from all sources (including contributions)2015-09-30$3,500,932
Total loss/gain on sale of assets2015-09-30$0
Total of all expenses incurred2015-09-30$2,824,981
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-09-30$2,812,643
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-09-30$3,500,932
Value of total assets at end of year2015-09-30$859,302
Value of total assets at beginning of year2015-09-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-09-30$12,338
Total interest from all sources2015-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2015-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-09-30No
Was this plan covered by a fidelity bond2015-09-30Yes
Value of fidelity bond cover2015-09-30$2,000,000
Were there any nonexempt tranactions with any party-in-interest2015-09-30No
Contributions received from participants2015-09-30$594,699
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-09-30$293,907
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-09-30$1,154
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-09-30$0
Liabilities. Value of operating payables at end of year2015-09-30$238
Liabilities. Value of operating payables at beginning of year2015-09-30$0
Total non interest bearing cash at end of year2015-09-30$659,191
Total non interest bearing cash at beginning of year2015-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Value of net income/loss2015-09-30$675,951
Value of net assets at end of year (total assets less liabilities)2015-09-30$675,951
Value of net assets at beginning of year (total assets less liabilities)2015-09-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-09-30No
Were any leases to which the plan was party in default or uncollectible2015-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2015-09-30$430,254
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-09-30No
Was there a failure to transmit to the plan any participant contributions2015-09-30No
Has the plan failed to provide any benefit when due under the plan2015-09-30No
Contributions received in cash from employer2015-09-30$2,906,233
Employer contributions (assets) at end of year2015-09-30$198,957
Employer contributions (assets) at beginning of year2015-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-09-30$2,088,482
Contract administrator fees2015-09-30$12,338
Liabilities. Value of benefit claims payable at end of year2015-09-30$183,113
Liabilities. Value of benefit claims payable at beginning of year2015-09-30$0
Did the plan have assets held for investment2015-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-09-30No
Opinion of an independent qualified public accountant for this plan2015-09-30Unqualified
Accountancy firm name2015-09-30BROWN, EDWARDS & COMPANY LLP
Accountancy firm EIN2015-09-30540504608

Form 5500 Responses for INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN

2021: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2021 form 5500 responses
2021-10-01Type of plan entityMulitple employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes
2020: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2020 form 5500 responses
2020-10-01Type of plan entityMulitple employer plan
2020-10-01Submission has been amendedNo
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planNo
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2019 form 5500 responses
2019-10-01Type of plan entityMulitple employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2018 form 5500 responses
2018-10-01Type of plan entityMulitple employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2017 form 5500 responses
2017-10-01Type of plan entityMulitple employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2016 form 5500 responses
2016-10-01Type of plan entityMulitple employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2015 form 5500 responses
2015-10-01Type of plan entityMulitple employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: INVESTORS TITLE COMPANY AND AFFILIATES GROUP BENEFITS TRUST GROUP MEDICAL INSURANCE PLAN 2014 form 5500 responses
2014-10-01Type of plan entityMulitple employer plan
2014-10-01First time form 5500 has been submittedYes
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335123
Policy instance 1
Insurance contract or identification number3335123
Number of Individuals Covered1227
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $21,144
Total amount of fees paid to insurance companyUSD $8,940
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 BenefitYes
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 $2,080,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $21,144
Amount paid for insurance broker fees8940
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT FEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335123
Policy instance 1
Insurance contract or identification number3335123
Number of Individuals Covered987
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $16,874
Total amount of fees paid to insurance companyUSD $843
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 BenefitYes
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 $1,678,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $16,874
Amount paid for insurance broker fees843
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT FEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335123
Policy instance 1
Insurance contract or identification number3335123
Number of Individuals Covered749
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $12,951
Total amount of fees paid to insurance companyUSD $7,234
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 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 $1,266,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,951
Insurance broker organization code?3
Amount paid for insurance broker fees7234
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT FEES
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335123
Policy instance 1
Insurance contract or identification number3335123
Number of Individuals Covered714
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $12,928
Total amount of fees paid to insurance companyUSD $665
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 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 $1,265,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,928
Amount paid for insurance broker fees665
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT FEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335123
Policy instance 1
Insurance contract or identification number3335123
Number of Individuals Covered672
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $12,371
Total amount of fees paid to insurance companyUSD $2,674
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 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 $1,200,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335123
Policy instance 1
Insurance contract or identification number3335123
Number of Individuals Covered560
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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