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BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 401k Plan overview

Plan NameBLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE
Plan identification number 501

BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE Benefits

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

401k Sponsoring company profile

BLUE CROSS AND BLUE SHIELD OF ALABAMA has sponsored the creation of one or more 401k plans.

Company Name:BLUE CROSS AND BLUE SHIELD OF ALABAMA
Employer identification number (EIN):630103830
NAIC Classification:524140

Additional information about BLUE CROSS AND BLUE SHIELD OF ALABAMA

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2891783

More information about BLUE CROSS AND BLUE SHIELD OF ALABAMA

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-10-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01BURT SCHUESSLER BURT SCHUESSLER2018-09-05
5012016-01-01BURT SCHUESSLER BURT SCHUESSLER2017-09-05
5012015-01-01BURT SCHUESSLER
5012014-01-01BURT SCHUESSLER BURT SCHUESSLER2015-09-15
5012013-01-01BURT SCHUESSLER BURT SCHUESSLER2014-09-09
5012012-01-01BURT SCHUESSLER
5012011-01-01BURT SCHUESSLER
5012009-01-01BURT SCHUESSLER

Plan Statistics for BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE

401k plan membership statisitcs for BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE

Measure Date Value
2022: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2022 401k membership
Total participants, beginning-of-year2022-01-014,270
Total number of active participants reported on line 7a of the Form 55002022-01-014,082
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-014,082
2021: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2021 401k membership
Total participants, beginning-of-year2021-01-013,904
Total number of active participants reported on line 7a of the Form 55002021-01-013,987
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-013,987
2020: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2020 401k membership
Total participants, beginning-of-year2020-10-01658
Total number of active participants reported on line 7a of the Form 55002020-10-01664
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01664
Total participants, beginning-of-year2020-01-013,874
Total number of active participants reported on line 7a of the Form 55002020-01-013,970
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-013,970
2019: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2019 401k membership
Total participants, beginning-of-year2019-01-013,160
Total number of active participants reported on line 7a of the Form 55002019-01-013,410
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-013,410
2018: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2018 401k membership
Total participants, beginning-of-year2018-01-013,163
Total number of active participants reported on line 7a of the Form 55002018-01-013,162
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-013,162
2017: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2017 401k membership
Total participants, beginning-of-year2017-01-013,107
Total number of active participants reported on line 7a of the Form 55002017-01-013,163
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-013,163
2016: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2016 401k membership
Total participants, beginning-of-year2016-01-013,122
Total number of active participants reported on line 7a of the Form 55002016-01-013,107
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-013,107
2015: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2015 401k membership
Total participants, beginning-of-year2015-01-013,185
Total number of active participants reported on line 7a of the Form 55002015-01-013,127
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-013,127
2014: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2014 401k membership
Total participants, beginning-of-year2014-01-013,157
Total number of active participants reported on line 7a of the Form 55002014-01-013,187
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-013,187
2013: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2013 401k membership
Total participants, beginning-of-year2013-01-012,842
Total number of active participants reported on line 7a of the Form 55002013-01-013,161
Number of retired or separated participants receiving benefits2013-01-0159
Total of all active and inactive participants2013-01-013,220
2012: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2012 401k membership
Total participants, beginning-of-year2012-01-013,711
Total number of active participants reported on line 7a of the Form 55002012-01-013,577
Number of retired or separated participants receiving benefits2012-01-0183
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-013,660
2011: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2011 401k membership
Total participants, beginning-of-year2011-01-013,715
Total number of active participants reported on line 7a of the Form 55002011-01-013,711
Number of retired or separated participants receiving benefits2011-01-01102
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-013,813
2009: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2009 401k membership
Total participants, beginning-of-year2009-01-014,117
Total number of active participants reported on line 7a of the Form 55002009-01-013,851
Number of retired or separated participants receiving benefits2009-01-01582
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-014,433

Financial Data on BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE

Measure Date Value
2020 : BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$120,366
Total income from all sources (including contributions)2020-12-31$1,377,742
Total of all expenses incurred2020-12-31$1,498,108
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,295,507
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,377,742
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$202,601
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31No
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$65,144
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$1,295,507
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$120,366
Administrative expenses (other) incurred2020-12-31$23,620
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-120,366
Value of net assets at end of year (total assets less liabilities)2020-12-31$-120,366
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,312,598
Contract administrator fees2020-12-31$178,981
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No

Form 5500 Responses for BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE

2022: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01First time form 5500 has been submittedYes
2020-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 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 filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 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 – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: BLUE CROSS AND BLUE SHIELD OF ALABAMA GROUP HEALTH AND DENTAL CARE 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 – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

IRON REINSURANCE COMPANY, INC (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered664
Insurance policy start date2020-10-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS AND BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number0079027
Policy instance 1
Insurance contract or identification number0079027
Number of Individuals Covered148
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAIRMED, DISEASE MGMT, FSA, HRA
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS AND BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number0079027
Policy instance 1
Insurance contract or identification number0079027
Number of Individuals Covered156
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAIRMED, DISEASE MGMT, FSA, HRA
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS AND BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number0079027
Policy instance 1
Insurance contract or identification number0079027
Number of Individuals Covered156
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAIRMED, DISEASE MGMT, FSA, HRA
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 $6,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10154044*
Policy instance 1
Insurance contract or identification number10154044*
Number of Individuals Covered1484
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $108,956
Total amount of fees paid to insurance companyUSD $9,307
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $726,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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