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EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC
Plan identification number 502

EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC Benefits

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

401k Sponsoring company profile

CLEMENTS MANAGEMENT has sponsored the creation of one or more 401k plans.

Company Name:CLEMENTS MANAGEMENT
Employer identification number (EIN):721488069
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-05-01
5022021-05-01
5022020-05-01
5022019-05-01
5022018-05-01
5022017-05-01JOE CLEMENTS
5022016-05-01JOE CLEMENTS
5022015-05-01JOE CLEMENTS
5022014-05-01JOE CLEMENTS

Plan Statistics for EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2022 401k membership
Total participants, beginning-of-year2022-05-0110
Total number of active participants reported on line 7a of the Form 55002022-05-019
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-019
2021: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2021 401k membership
Total participants, beginning-of-year2021-05-0120
Total number of active participants reported on line 7a of the Form 55002021-05-019
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-019
2020: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2020 401k membership
Total participants, beginning-of-year2020-05-0120
Total number of active participants reported on line 7a of the Form 55002020-05-0119
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-0119
2019: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2019 401k membership
Total participants, beginning-of-year2019-05-0127
Total number of active participants reported on line 7a of the Form 55002019-05-0122
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-0122
2018: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2018 401k membership
Total participants, beginning-of-year2018-05-0131
Total number of active participants reported on line 7a of the Form 55002018-05-0127
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-0127
2017: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2017 401k membership
Total participants, beginning-of-year2017-05-0129
Total number of active participants reported on line 7a of the Form 55002017-05-0128
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 participants2017-05-0128
2016: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2016 401k membership
Total participants, beginning-of-year2016-05-0132
Total number of active participants reported on line 7a of the Form 55002016-05-0124
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 participants2016-05-0124
2015: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2015 401k membership
Total participants, beginning-of-year2015-05-0134
Total number of active participants reported on line 7a of the Form 55002015-05-0131
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 participants2015-05-0131
2014: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2014 401k membership
Total participants, beginning-of-year2014-05-0125
Total number of active participants reported on line 7a of the Form 55002014-05-0117
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 participants2014-05-0117

Financial Data on EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2023 401k financial data
Total income from all sources2023-04-30$74,645
Expenses. Total of all expenses incurred2023-04-30$74,645
Benefits paid (including direct rollovers)2023-04-30$33,817
Value of fidelity bond covering the plan2023-04-30$5,000
Expenses. Other expenses not covered elsewhere2023-04-30$40,828
Net income (gross income less expenses)2023-04-30$0
Net plan assets at end of year (total assets less liabilities)2023-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$0
Total contributions received or receivable from employer(s)2023-04-30$74,645
2022 : EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2022 401k financial data
Total income from all sources2022-04-30$97,977
Expenses. Total of all expenses incurred2022-04-30$97,977
Benefits paid (including direct rollovers)2022-04-30$46,975
Value of fidelity bond covering the plan2022-04-30$5,000
Expenses. Other expenses not covered elsewhere2022-04-30$51,002
Net income (gross income less expenses)2022-04-30$0
Net plan assets at end of year (total assets less liabilities)2022-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$0
Total contributions received or receivable from employer(s)2022-04-30$97,977
2021 : EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$102,485
Expenses. Total of all expenses incurred2021-04-30$102,485
Benefits paid (including direct rollovers)2021-04-30$49,502
Total plan assets at beginning of year2021-04-30$0
Value of fidelity bond covering the plan2021-04-30$15,000
Expenses. Other expenses not covered elsewhere2021-04-30$52,983
Net income (gross income less expenses)2021-04-30$0
Net plan assets at end of year (total assets less liabilities)2021-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$0
Total contributions received or receivable from employer(s)2021-04-30$102,485
2020 : EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2020 401k financial data
Total plan liabilities at end of year2020-04-30$0
Total plan liabilities at beginning of year2020-04-30$0
Total income from all sources2020-04-30$104,942
Expenses. Total of all expenses incurred2020-04-30$104,942
Benefits paid (including direct rollovers)2020-04-30$44,236
Total plan assets at end of year2020-04-30$0
Total plan assets at beginning of year2020-04-30$0
Value of fidelity bond covering the plan2020-04-30$15,000
Expenses. Other expenses not covered elsewhere2020-04-30$60,706
Net income (gross income less expenses)2020-04-30$0
Net plan assets at end of year (total assets less liabilities)2020-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$0
Total contributions received or receivable from employer(s)2020-04-30$104,942
2018 : EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 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$138,476
Expenses. Total of all expenses incurred2018-04-30$138,476
Benefits paid (including direct rollovers)2018-04-30$63,307
Total plan assets at end of year2018-04-30$0
Total plan assets at beginning of year2018-04-30$0
Value of fidelity bond covering the plan2018-04-30$15,000
Expenses. Other expenses not covered elsewhere2018-04-30$75,169
Net income (gross income less expenses)2018-04-30$0
Net plan assets at end of year (total assets less liabilities)2018-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$0
Total contributions received or receivable from employer(s)2018-04-30$138,476
2017 : EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 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$133,633
Expenses. Total of all expenses incurred2017-04-30$133,633
Benefits paid (including direct rollovers)2017-04-30$60,454
Total plan assets at end of year2017-04-30$0
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$73,179
Net income (gross income less expenses)2017-04-30$0
Net plan assets at end of year (total assets less liabilities)2017-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$0
Total contributions received or receivable from employer(s)2017-04-30$133,633
2016 : EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$1,119
Total income from all sources2016-04-30$159,493
Expenses. Total of all expenses incurred2016-04-30$159,493
Benefits paid (including direct rollovers)2016-04-30$69,024
Total plan assets at end of year2016-04-30$0
Total plan assets at beginning of year2016-04-30$1,119
Value of fidelity bond covering the plan2016-04-30$20,000
Expenses. Other expenses not covered elsewhere2016-04-30$90,469
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$159,493
2015 : EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2015 401k financial data
Total plan liabilities at end of year2015-04-30$1,119
Total plan liabilities at beginning of year2015-04-30$2,784
Total income from all sources2015-04-30$149,716
Expenses. Total of all expenses incurred2015-04-30$149,716
Benefits paid (including direct rollovers)2015-04-30$66,948
Total plan assets at end of year2015-04-30$1,119
Total plan assets at beginning of year2015-04-30$2,784
Value of fidelity bond covering the plan2015-04-30$25,000
Expenses. Other expenses not covered elsewhere2015-04-30$82,768
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$149,716

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC

2022: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC 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 CLEMENTS MANAGEMENT,LLC 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 CLEMENTS MANAGEMENT,LLC 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 CLEMENTS MANAGEMENT,LLC 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

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number12001 NFA 0031
Policy instance 1
Insurance contract or identification number12001 NFA 0031
Number of Individuals Covered12
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $31,387
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 number12001 NFA 0031
Policy instance 1
Insurance contract or identification number12001 NFA 0031
Number of Individuals Covered13
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $41,658
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 number12001 NFA 0031
Policy instance 1
Insurance contract or identification number12001 NFA 0031
Number of Individuals Covered24
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $41,259
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 number12001 NFA 0031
Policy instance 1
Insurance contract or identification number12001 NFA 0031
Number of Individuals Covered31
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $43,825
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 number12001 NFA 0031
Policy instance 1
Insurance contract or identification number12001 NFA 0031
Number of Individuals Covered37
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $62,736
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 number12001 NFA 0031
Policy instance 1
Insurance contract or identification number12001 NFA 0031
Number of Individuals Covered40
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $58,647
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 number12001 NFA 0031
Policy instance 1
Insurance contract or identification number12001 NFA 0031
Number of Individuals Covered41
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 $65,676
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 number12001 NFA 0031
Policy instance 1
Insurance contract or identification number12001 NFA 0031
Number of Individuals Covered25
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 $61,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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