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TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 401k Plan overview

Plan NameTAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC.
Plan identification number 001

TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.

401k Sponsoring company profile

STOKES-REYNOLDS MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:STOKES-REYNOLDS MEMORIAL HOSPITAL
Employer identification number (EIN):561793620
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012012-01-01PAMELA P. TILLMAN
0012011-01-01PAM TILLMAN
0012010-01-01PAM TILLMAN
0012009-01-01CAROL MAINE
0012007-01-01CAROL MAINE

Plan Statistics for TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC.

401k plan membership statisitcs for TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC.

Measure Date Value
2012: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-01276
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-010
Number of participants with account balances2012-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-01276
Total number of active participants reported on line 7a of the Form 55002011-01-014
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-01272
Total of all active and inactive participants2011-01-01276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01276
Number of participants with account balances2011-01-01276
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2010 401k membership
Total participants, beginning-of-year2010-01-01426
Total number of active participants reported on line 7a of the Form 55002010-01-01258
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-01168
Total of all active and inactive participants2010-01-01426
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01426
Number of participants with account balances2010-01-01344
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-01215
Total number of active participants reported on line 7a of the Form 55002009-01-01200
Number of retired or separated participants receiving benefits2009-01-017
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01207
Number of participants with account balances2009-01-01207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-015

Financial Data on TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC.

Measure Date Value
2012 : TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-05-14$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-05-14$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-05-14$0
Total income from all sources (including contributions)2012-05-14$125,665
Total loss/gain on sale of assets2012-05-14$0
Total of all expenses incurred2012-05-14$6,314,686
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-05-14$6,307,485
Expenses. Certain deemed distributions of participant loans2012-05-14$-55
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-05-14$7,372
Value of total assets at end of year2012-05-14$0
Value of total assets at beginning of year2012-05-14$6,189,021
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-05-14$7,256
Total interest from all sources2012-05-14$69,125
Total dividends received (eg from common stock, registered investment company shares)2012-05-14$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-05-14Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2012-05-14$0
Was this plan covered by a fidelity bond2012-05-14Yes
Value of fidelity bond cover2012-05-14$500,000
If this is an individual account plan, was there a blackout period2012-05-14No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-05-14$0
Were there any nonexempt tranactions with any party-in-interest2012-05-14No
Participant contributions at end of year2012-05-14$0
Participant contributions at beginning of year2012-05-14$103,841
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-14No
Value of net income/loss2012-05-14$-6,189,021
Value of net assets at end of year (total assets less liabilities)2012-05-14$0
Value of net assets at beginning of year (total assets less liabilities)2012-05-14$6,189,021
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-05-14No
Were any loans by the plan or fixed income obligations due to the plan in default2012-05-14No
Were any leases to which the plan was party in default or uncollectible2012-05-14No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-05-14$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-05-14$1,531,819
Interest on participant loans2012-05-14$1,433
Interest earned on other investments2012-05-14$67,692
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-05-14$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-05-14$4,553,361
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-05-14$49,168
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-05-14No
Was there a failure to transmit to the plan any participant contributions2012-05-14No
Has the plan failed to provide any benefit when due under the plan2012-05-14No
Contributions received in cash from employer2012-05-14$7,372
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-05-14$6,307,485
Contract administrator fees2012-05-14$7,256
Did the plan have assets held for investment2012-05-14Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-14No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-05-14Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-05-14Yes
Opinion of an independent qualified public accountant for this plan2012-05-14Disclaimer
Accountancy firm name2012-05-14MARTIN STARNES AND ASSOC
Accountancy firm EIN2012-05-14561761202
2011 : TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$373,400
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$2,032,416
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,988,885
Expenses. Certain deemed distributions of participant loans2011-12-31$27,048
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$215,082
Value of total assets at end of year2011-12-31$6,189,021
Value of total assets at beginning of year2011-12-31$7,848,037
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$16,483
Total interest from all sources2011-12-31$210,060
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$235
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2011-12-31$0
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$235
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$157,440
Participant contributions at end of year2011-12-31$103,841
Participant contributions at beginning of year2011-12-31$152,605
Administrative expenses (other) incurred2011-12-31$14,338
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-1,659,016
Value of net assets at end of year (total assets less liabilities)2011-12-31$6,189,021
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$7,848,037
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,531,819
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$2,248,086
Interest on participant loans2011-12-31$5,831
Interest earned on other investments2011-12-31$204,229
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$4,553,361
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$5,447,346
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-51,977
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$57,642
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,988,885
Contract administrator fees2011-12-31$2,145
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MARTIN STARNES AND ASSOC
Accountancy firm EIN2011-12-31561761202
2010 : TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$986,426
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$494,527
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$404,372
Expenses. Certain deemed distributions of participant loans2010-12-31$84,032
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$465,223
Value of total assets at end of year2010-12-31$7,848,037
Value of total assets at beginning of year2010-12-31$7,356,138
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$6,123
Total interest from all sources2010-12-31$213,536
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$206
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$206
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$293,367
Participant contributions at end of year2010-12-31$152,605
Participant contributions at beginning of year2010-12-31$209,079
Administrative expenses (other) incurred2010-12-31$3,160
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$491,899
Value of net assets at end of year (total assets less liabilities)2010-12-31$7,848,037
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$7,356,138
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$2,248,086
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$1,987,888
Interest on participant loans2010-12-31$5,849
Interest earned on other investments2010-12-31$207,687
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$5,447,346
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$5,159,171
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$307,461
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$171,856
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$404,372
Contract administrator fees2010-12-31$2,963
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31MARTIN STARNES AND ASSOC
Accountancy firm EIN2010-12-31561761202
2009 : TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC.

2012: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingYes
2012-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes
2007: TAX DEFERRED SAVINGS PLAN OF STOKES-REYNOLDS MEMORIAL HOSPITAL, INC. 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number49097
Policy instance 1
Insurance contract or identification number49097
Number of Individuals Covered0
Insurance policy start date2012-01-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $368
Total amount of fees paid to insurance companyUSD $0
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $345
Insurance broker organization code?3
Insurance broker nameSCHULTZ, MICHAEL J
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number49097
Policy instance 1
Insurance contract or identification number49097
Number of Individuals Covered273
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,270
Total amount of fees paid to insurance companyUSD $0
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number49097
Policy instance 1
Insurance contract or identification number49097
Number of Individuals Covered346
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $6,062
Total amount of fees paid to insurance companyUSD $0
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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