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EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC
Plan identification number 501

EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC Benefits

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

401k Sponsoring company profile

LANCASTER SUBWAY, INC has sponsored the creation of one or more 401k plans.

Company Name:LANCASTER SUBWAY, INC
Employer identification number (EIN):561731360
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01
5012021-05-01
5012020-05-01
5012020-05-01
5012019-05-01
5012018-05-01
5012017-05-01KENNETH LANCASTER
5012016-05-01KENNETH LANCASTER
5012015-10-01KENNETH LANCASTER

Plan Statistics for EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2022 401k membership
Total participants, beginning-of-year2022-05-013
Total number of active participants reported on line 7a of the Form 55002022-05-013
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-013
2021: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2021 401k membership
Total participants, beginning-of-year2021-05-016
Total number of active participants reported on line 7a of the Form 55002021-05-014
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-014
2020: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2020 401k membership
Total participants, beginning-of-year2020-05-0110
Total number of active participants reported on line 7a of the Form 55002020-05-016
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-016
2019: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2019 401k membership
Total participants, beginning-of-year2019-05-018
Total number of active participants reported on line 7a of the Form 55002019-05-019
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 participants2019-05-019
2018: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2018 401k membership
Total participants, beginning-of-year2018-05-0113
Total number of active participants reported on line 7a of the Form 55002018-05-0111
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 participants2018-05-0111
2017: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2017 401k membership
Total participants, beginning-of-year2017-05-0117
Total number of active participants reported on line 7a of the Form 55002017-05-0115
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 participants2017-05-0115
2016: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2016 401k membership
Total participants, beginning-of-year2016-05-0117
Total number of active participants reported on line 7a of the Form 55002016-05-0116
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 participants2016-05-0116
2015: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2015 401k membership
Total participants, beginning-of-year2015-10-0116
Total number of active participants reported on line 7a of the Form 55002015-10-0113
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 participants2015-10-0113

Financial Data on EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2023 401k financial data
Total income from all sources2023-04-30$21,129
Expenses. Total of all expenses incurred2023-04-30$21,129
Benefits paid (including direct rollovers)2023-04-30$9,872
Value of fidelity bond covering the plan2023-04-30$2,000
Expenses. Other expenses not covered elsewhere2023-04-30$11,257
Net income (gross income less expenses)2023-04-30$0
Net plan assets at end of year (total assets less liabilities)2023-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$0
Total contributions received or receivable from employer(s)2023-04-30$21,129
2022 : EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2022 401k financial data
Total income from all sources2022-04-30$28,038
Expenses. Total of all expenses incurred2022-04-30$28,038
Benefits paid (including direct rollovers)2022-04-30$13,113
Value of fidelity bond covering the plan2022-04-30$1,000
Expenses. Other expenses not covered elsewhere2022-04-30$14,925
Net income (gross income less expenses)2022-04-30$0
Net plan assets at end of year (total assets less liabilities)2022-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$0
Total contributions received or receivable from employer(s)2022-04-30$28,038
2021 : EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$32,331
Expenses. Total of all expenses incurred2021-04-30$32,331
Benefits paid (including direct rollovers)2021-04-30$14,756
Total plan assets at beginning of year2021-04-30$0
Value of fidelity bond covering the plan2021-04-30$5,000
Expenses. Other expenses not covered elsewhere2021-04-30$17,575
Net income (gross income less expenses)2021-04-30$0
Net plan assets at end of year (total assets less liabilities)2021-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$0
Total contributions received or receivable from employer(s)2021-04-30$32,331
2020 : EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 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$32,013
Expenses. Total of all expenses incurred2020-04-30$32,013
Benefits paid (including direct rollovers)2020-04-30$13,884
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$5,000
Expenses. Other expenses not covered elsewhere2020-04-30$18,129
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$32,013
2018 : EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 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$39,146
Expenses. Total of all expenses incurred2018-04-30$39,146
Benefits paid (including direct rollovers)2018-04-30$16,251
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$5,000
Expenses. Other expenses not covered elsewhere2018-04-30$22,895
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$39,146
2017 : EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 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$44,253
Expenses. Total of all expenses incurred2017-04-30$46,208
Benefits paid (including direct rollovers)2017-04-30$20,591
Total plan assets at end of year2017-04-30$0
Total plan assets at beginning of year2017-04-30$1,955
Value of fidelity bond covering the plan2017-04-30$5,000
Expenses. Other expenses not covered elsewhere2017-04-30$25,617
Net income (gross income less expenses)2017-04-30$-1,955
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$1,955
Total contributions received or receivable from employer(s)2017-04-30$44,253
2016 : EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$0
Total income from all sources2016-04-30$23,638
Expenses. Total of all expenses incurred2016-04-30$21,683
Benefits paid (including direct rollovers)2016-04-30$7,851
Total plan assets at end of year2016-04-30$1,955
Total plan assets at beginning of year2016-04-30$0
Value of fidelity bond covering the plan2016-04-30$5,000
Expenses. Other expenses not covered elsewhere2016-04-30$13,832
Net income (gross income less expenses)2016-04-30$1,955
Net plan assets at end of year (total assets less liabilities)2016-04-30$1,955
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$23,638

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC

2022: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedYes
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC 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 LANCASTER SUBWAY, INC 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 LANCASTER SUBWAY, INC 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 LANCASTER SUBWAY, INC 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 LANCASTER SUBWAY, INC 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01First time form 5500 has been submittedYes
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)Yes
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number31044 NFA 0596
Policy instance 1
Insurance contract or identification number31044 NFA 0596
Number of Individuals Covered4
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
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 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 $9,000
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 number31044 NFA 0596
Policy instance 1
Insurance contract or identification number31044 NFA 0596
Number of Individuals Covered5
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
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 $11,867
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 number31044 NFA 0596
Policy instance 1
Insurance contract or identification number31044 NFA 0596
Number of Individuals Covered7
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
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 $13,440
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 number31044 NFA 0596
Policy instance 1
Insurance contract or identification number31044 NFA 0596
Number of Individuals Covered10
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 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 $13,286
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 number31044 NFA 0596
Policy instance 1
Insurance contract or identification number31044 NFA 0596
Number of Individuals Covered14
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 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 $16,219
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 number31044 NFA 0596
Policy instance 1
Insurance contract or identification number31044 NFA 0596
Number of Individuals Covered19
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 $15,813
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 number31044 NFA 0676
Policy instance 1
Insurance contract or identification number31044 NFA 0676
Number of Individuals Covered17
Insurance policy start date2015-10-01
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 $9,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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