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NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan NameNFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN
Plan identification number 511

NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

PANTHERS FOOTBALL, LLC has sponsored the creation of one or more 401k plans.

Company Name:PANTHERS FOOTBALL, LLC
Employer identification number (EIN):562174519
NAIC Classification:711210
NAIC Description: Spectator Sports

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112019-04-01
5112018-04-01

Plan Statistics for NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

401k plan membership statisitcs for NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

Measure Date Value
2019: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01202
Total number of active participants reported on line 7a of the Form 55002019-04-01222
Number of retired or separated participants receiving benefits2019-04-0116
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01238
2018: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01198
Total number of active participants reported on line 7a of the Form 55002018-04-01194
Number of retired or separated participants receiving benefits2018-04-0113
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01207

Financial Data on NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

Measure Date Value
2020 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$74,951
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$0
Total income from all sources (including contributions)2020-03-31$4,837,371
Total loss/gain on sale of assets2020-03-31$0
Total of all expenses incurred2020-03-31$4,760,499
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-03-31$4,648,456
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-03-31$4,836,674
Value of total assets at end of year2020-03-31$153,863
Value of total assets at beginning of year2020-03-31$2,040
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-03-31$112,043
Total interest from all sources2020-03-31$697
Total dividends received (eg from common stock, registered investment company shares)2020-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-03-31No
Was this plan covered by a fidelity bond2020-03-31Yes
Value of fidelity bond cover2020-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-03-31No
Contributions received from participants2020-03-31$1,002,683
Administrative expenses (other) incurred2020-03-31$112,043
Liabilities. Value of operating payables at end of year2020-03-31$74,951
Liabilities. Value of operating payables at beginning of year2020-03-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Value of net income/loss2020-03-31$76,872
Value of net assets at end of year (total assets less liabilities)2020-03-31$78,912
Value of net assets at beginning of year (total assets less liabilities)2020-03-31$2,040
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-03-31No
Were any leases to which the plan was party in default or uncollectible2020-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-03-31$78,912
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-03-31$2,040
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-03-31$697
Expenses. Payments to insurance carriers foe the provision of benefits2020-03-31$654,633
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-03-31Yes
Was there a failure to transmit to the plan any participant contributions2020-03-31No
Has the plan failed to provide any benefit when due under the plan2020-03-31No
Contributions received in cash from employer2020-03-31$3,833,991
Employer contributions (assets) at end of year2020-03-31$74,951
Employer contributions (assets) at beginning of year2020-03-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-03-31$3,993,823
Did the plan have assets held for investment2020-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-03-31No
Opinion of an independent qualified public accountant for this plan2020-03-31Unqualified
Accountancy firm name2020-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2020-03-31521854049
2019 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$54,610
Total income from all sources (including contributions)2019-03-31$4,205,113
Total loss/gain on sale of assets2019-03-31$0
Total of all expenses incurred2019-03-31$4,203,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-03-31$4,101,519
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-03-31$4,204,532
Value of total assets at end of year2019-03-31$2,040
Value of total assets at beginning of year2019-03-31$54,874
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-03-31$101,818
Total interest from all sources2019-03-31$581
Total dividends received (eg from common stock, registered investment company shares)2019-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-03-31No
Was this plan covered by a fidelity bond2019-03-31Yes
Value of fidelity bond cover2019-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2019-03-31No
Contributions received from participants2019-03-31$1,108,961
Administrative expenses (other) incurred2019-03-31$101,818
Liabilities. Value of operating payables at end of year2019-03-31$0
Liabilities. Value of operating payables at beginning of year2019-03-31$54,610
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Value of net income/loss2019-03-31$1,776
Value of net assets at end of year (total assets less liabilities)2019-03-31$2,040
Value of net assets at beginning of year (total assets less liabilities)2019-03-31$264
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-03-31No
Were any leases to which the plan was party in default or uncollectible2019-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-03-31$2,040
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-03-31$54,874
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-03-31$581
Expenses. Payments to insurance carriers foe the provision of benefits2019-03-31$752,569
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-03-31Yes
Was there a failure to transmit to the plan any participant contributions2019-03-31No
Has the plan failed to provide any benefit when due under the plan2019-03-31No
Contributions received in cash from employer2019-03-31$3,095,571
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-03-31$3,348,950
Did the plan have assets held for investment2019-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-03-31No
Opinion of an independent qualified public accountant for this plan2019-03-31Unqualified
Accountancy firm name2019-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2019-03-31521854049

Form 5500 Responses for NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

2019: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes
2018: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 1
Insurance contract or identification number376515G
Number of Individuals Covered226
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $15,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 2
Insurance contract or identification number376515G
Number of Individuals Covered226
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
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 BenefitYes
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 $39,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 3
Insurance contract or identification number376515G
Number of Individuals Covered268
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
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 BenefitYes
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 $97,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered611
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
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 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 $20,315
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 number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered612
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $267,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered516
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
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 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 $18,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 3
Insurance contract or identification number376515G
Number of Individuals Covered233
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
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 BenefitYes
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 $90,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 2
Insurance contract or identification number376515G
Number of Individuals Covered193
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
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 BenefitYes
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 $35,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 1
Insurance contract or identification number376515G
Number of Individuals Covered193
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $13,937
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 number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered516
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $272,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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