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EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF WHIT-FAM, INC.
Plan identification number 502

EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. Benefits

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

401k Sponsoring company profile

WHIT-FAM, INC. has sponsored the creation of one or more 401k plans.

Company Name:WHIT-FAM, INC.
Employer identification number (EIN):570833438
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-05-01TONY WHITFIELD
5022016-05-01TONY WHITFIELD
5022015-05-01TONY WHITFIELD
5022014-05-01TONY WHITFIELD
5022013-05-01TONY WHITFIELD
5022012-05-01TONY WHITFIELD
5022011-05-01TONY WHITFIELD

Plan Statistics for EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC.

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC.

Measure Date Value
2017: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2017 401k membership
Total participants, beginning-of-year2017-05-018
Total number of active participants reported on line 7a of the Form 55002017-05-017
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 participants2017-05-017
2016: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2016 401k membership
Total participants, beginning-of-year2016-05-016
Total number of active participants reported on line 7a of the Form 55002016-05-015
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 participants2016-05-015
2015: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2015 401k membership
Total participants, beginning-of-year2015-05-0110
Total number of active participants reported on line 7a of the Form 55002015-05-016
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-016
2014: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2014 401k membership
Total participants, beginning-of-year2014-05-016
Total number of active participants reported on line 7a of the Form 55002014-05-015
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-015
2013: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2013 401k membership
Total participants, beginning-of-year2013-05-0110
Total number of active participants reported on line 7a of the Form 55002013-05-016
Number of retired or separated participants receiving benefits2013-05-010
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-016
2012: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2012 401k membership
Total participants, beginning-of-year2012-05-0112
Total number of active participants reported on line 7a of the Form 55002012-05-0110
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-0110
2011: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2011 401k membership
Total participants, beginning-of-year2011-05-0110
Total number of active participants reported on line 7a of the Form 55002011-05-0112
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-0112

Financial Data on EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC.

Measure Date Value
2018 : EMPLOYEE HEALTH PLAN OF WHIT-FAM, 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$40,778
Expenses. Total of all expenses incurred2018-04-30$25,992
Benefits paid (including direct rollovers)2018-04-30$6,036
Total plan assets at end of year2018-04-30$28,811
Total plan assets at beginning of year2018-04-30$14,025
Value of fidelity bond covering the plan2018-04-30$15,000
Expenses. Other expenses not covered elsewhere2018-04-30$19,956
Net income (gross income less expenses)2018-04-30$14,786
Net plan assets at end of year (total assets less liabilities)2018-04-30$28,811
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$14,025
Total contributions received or receivable from employer(s)2018-04-30$40,778
2017 : EMPLOYEE HEALTH PLAN OF WHIT-FAM, 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$81,589
Expenses. Total of all expenses incurred2017-04-30$67,564
Benefits paid (including direct rollovers)2017-04-30$25,992
Total plan assets at end of year2017-04-30$14,025
Total plan assets at beginning of year2017-04-30$0
Value of fidelity bond covering the plan2017-04-30$15,000
Expenses. Other expenses not covered elsewhere2017-04-30$41,572
Net income (gross income less expenses)2017-04-30$14,025
Net plan assets at end of year (total assets less liabilities)2017-04-30$14,025
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$0
Total contributions received or receivable from employer(s)2017-04-30$81,589
2016 : EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$695
Total income from all sources2016-04-30$87,619
Expenses. Total of all expenses incurred2016-04-30$87,619
Benefits paid (including direct rollovers)2016-04-30$42,701
Total plan assets at end of year2016-04-30$0
Total plan assets at beginning of year2016-04-30$695
Value of fidelity bond covering the plan2016-04-30$10,000
Expenses. Other expenses not covered elsewhere2016-04-30$44,918
Net income (gross income less expenses)2016-04-30$0
Net plan assets at end of year (total assets less liabilities)2016-04-30$0
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$87,619
2015 : EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2015 401k financial data
Total plan liabilities at end of year2015-04-30$695
Total plan liabilities at beginning of year2015-04-30$1,246
Total income from all sources2015-04-30$71,325
Expenses. Total of all expenses incurred2015-04-30$71,325
Benefits paid (including direct rollovers)2015-04-30$35,689
Total plan assets at end of year2015-04-30$695
Total plan assets at beginning of year2015-04-30$1,246
Value of fidelity bond covering the plan2015-04-30$10,000
Expenses. Other expenses not covered elsewhere2015-04-30$35,636
Net income (gross income less expenses)2015-04-30$0
Net plan assets at end of year (total assets less liabilities)2015-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$0
Total contributions received or receivable from employer(s)2015-04-30$71,325
2014 : EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2014 401k financial data
Total plan liabilities at end of year2014-04-30$1,246
Total plan liabilities at beginning of year2014-04-30$1,087
Total income from all sources2014-04-30$77,815
Expenses. Total of all expenses incurred2014-04-30$91,292
Benefits paid (including direct rollovers)2014-04-30$48,733
Total plan assets at end of year2014-04-30$1,246
Total plan assets at beginning of year2014-04-30$14,564
Value of fidelity bond covering the plan2014-04-30$25,000
Expenses. Other expenses not covered elsewhere2014-04-30$42,559
Net income (gross income less expenses)2014-04-30$-13,477
Net plan assets at end of year (total assets less liabilities)2014-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2014-04-30$13,477
Total contributions received or receivable from employer(s)2014-04-30$77,815
2013 : EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2013 401k financial data
Total plan liabilities at end of year2013-04-30$1,087
Total plan liabilities at beginning of year2013-04-30$2,205
Total income from all sources2013-04-30$93,108
Expenses. Total of all expenses incurred2013-04-30$100,596
Benefits paid (including direct rollovers)2013-04-30$52,799
Total plan assets at end of year2013-04-30$14,564
Total plan assets at beginning of year2013-04-30$23,170
Expenses. Other expenses not covered elsewhere2013-04-30$47,797
Net income (gross income less expenses)2013-04-30$-7,488
Net plan assets at end of year (total assets less liabilities)2013-04-30$13,477
Net plan assets at beginning of year (total assets less liabilities)2013-04-30$20,965
Total contributions received or receivable from employer(s)2013-04-30$93,108
2012 : EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2012 401k financial data
Total plan liabilities at end of year2012-04-30$2,205
Total plan liabilities at beginning of year2012-04-30$1,442
Total income from all sources2012-04-30$98,067
Expenses. Total of all expenses incurred2012-04-30$91,651
Benefits paid (including direct rollovers)2012-04-30$40,782
Total plan assets at end of year2012-04-30$23,170
Total plan assets at beginning of year2012-04-30$15,991
Expenses. Other expenses not covered elsewhere2012-04-30$50,869
Net income (gross income less expenses)2012-04-30$6,416
Net plan assets at end of year (total assets less liabilities)2012-04-30$20,965
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$14,549
Total contributions received or receivable from employer(s)2012-04-30$98,067
2011 : EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2011 401k financial data
Total plan liabilities at end of year2011-04-30$1,442
Total plan liabilities at beginning of year2011-04-30$0
Total income from all sources2011-04-30$83,868
Expenses. Total of all expenses incurred2011-04-30$69,319
Benefits paid (including direct rollovers)2011-04-30$30,727
Total plan assets at end of year2011-04-30$15,991
Total plan assets at beginning of year2011-04-30$0
Expenses. Other expenses not covered elsewhere2011-04-30$38,592
Net income (gross income less expenses)2011-04-30$14,549
Net plan assets at end of year (total assets less liabilities)2011-04-30$14,549
Net plan assets at beginning of year (total assets less liabilities)2011-04-30$0
Total contributions received or receivable from employer(s)2011-04-30$83,868

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC.

2017: EMPLOYEE HEALTH PLAN OF WHIT-FAM, 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 WHIT-FAM, 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 WHIT-FAM, INC. 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement - TrustYes
2014: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2013: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14300 NFA 0207
Policy instance 1
Insurance contract or identification number14300 NFA 0207
Number of Individuals Covered16
Insurance policy start date2017-05-01
Insurance policy end date2017-09-30
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 $17,360
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 number14300 NFA 0207
Policy instance 1
Insurance contract or identification number14300 NFA 0207
Number of Individuals Covered13
Insurance policy start date2015-05-01
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 $37,021
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 number14300 NFA 0207
Policy instance 1
Insurance contract or identification number14300 NFA 0207
Number of Individuals Covered12
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
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 $30,398
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 number14300 NFA 0207
Policy instance 1
Insurance contract or identification number14300 NFA 0207
Number of Individuals Covered13
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
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 $32,796
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 number14300 NFA 0207
Policy instance 1
Insurance contract or identification number14300 NFA 0207
Number of Individuals Covered17
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
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 $33,786
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 number14300 NFA 0207
Policy instance 1
Insurance contract or identification number14300 NFA 0207
Number of Individuals Covered20
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
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 $35,653
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 number14300 NFA 0207
Policy instance 1
Insurance contract or identification number14300 NFA 0207
Number of Individuals Covered18
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
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 $32,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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