COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION
401k plan membership statisitcs for COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION
| Measure | Date | Value |
|---|
| 2023: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 583 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 583 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 583 |
| Number of employers contributing to the scheme | 2023-01-01 | 0 |
| 2022: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 579 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 606 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 606 |
| Number of employers contributing to the scheme | 2022-01-01 | 0 |
| 2021: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 607 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 601 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 601 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
| 2020: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 604 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 607 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 607 |
| Number of employers contributing to the scheme | 2020-01-01 | 0 |
| 2019: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 578 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 603 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 603 |
| Number of employers contributing to the scheme | 2019-01-01 | 0 |
| 2018: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 556 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 619 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 8 |
| Total of all active and inactive participants | 2018-01-01 | 629 |
| Number of employers contributing to the scheme | 2018-01-01 | 0 |
| 2017: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 536 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 556 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 556 |
| 2016: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 546 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 536 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 536 |
| 2015: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 701 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 546 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 546 |
| 2014: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 718 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 701 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 701 |
| 2013: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 635 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 718 |
| Total of all active and inactive participants | 2013-01-01 | 718 |
| Total participants | 2013-01-01 | 718 |
| 2012: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 626 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 635 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 635 |
| Total participants | 2012-01-01 | 635 |
| 2011: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 399 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 409 |
| Total of all active and inactive participants | 2011-01-01 | 409 |
| Total participants | 2011-01-01 | 409 |
| 2009: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 354 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 410 |
| Total of all active and inactive participants | 2009-04-01 | 410 |
| Total participants | 2009-04-01 | 410 |
| 2023: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | First time form 5500 has been submitted | Yes |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | First time form 5500 has been submitted | Yes |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | First time form 5500 has been submitted | Yes |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: COMMUNITY ACTION PROJECT OF TULSA COUNTY, INC. WELFARE BENEFITS PLAN AND SUMMARY PLAN DESCRIPTION 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | Submission has been amended | No |
| 2009-04-01 | This submission is the final filing | No |
| 2009-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-04-01 | Plan is a collectively bargained plan | No |
| 2009-04-01 | Plan funding arrangement – Insurance | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| MODERN HEALTH ARIZONA P.L.L.C (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | UNKNOWN |
| Policy instance | 4 |
| Insurance contract or identification number | UNKNOWN | | Number of Individuals Covered | 583 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30036985 |
| Policy instance | 3 |
| Insurance contract or identification number | 30036985 | | Number of Individuals Covered | 465 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,953 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,859 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 1454 |
| Policy instance | 2 |
| Insurance contract or identification number | 1454 | | Number of Individuals Covered | 504 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $14,696 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 101630200 |
| Policy instance | 1 |
| Insurance contract or identification number | 101630200 | | Number of Individuals Covered | 583 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $41,948 | | Total amount of fees paid to insurance company | USD $19,235 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $319,901 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 101630200 |
| Policy instance | 1 |
| Insurance contract or identification number | 101630200 | | Number of Individuals Covered | 606 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $53,881 | | Total amount of fees paid to insurance company | USD $17,530 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $496,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | COMMUNITY ACT |
| Policy instance | 2 |
| Insurance contract or identification number | COMMUNITY ACT | | Number of Individuals Covered | 596 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $4,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 1454 |
| Policy instance | 3 |
| Insurance contract or identification number | 1454 | | Number of Individuals Covered | 491 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $13,548 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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: 39616 ) |
| Policy contract number | 30036985 |
| Policy instance | 4 |
| Insurance contract or identification number | 30036985 | | Number of Individuals Covered | 452 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,207 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $52,050 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MODERN HEALTH ARIZONA P.L.L.C (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | UNKNOWN |
| Policy instance | 5 |
| Insurance contract or identification number | UNKNOWN | | Number of Individuals Covered | 606 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 101630200 |
| Policy instance | 1 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | COMMUNITY ACT |
| Policy instance | 2 |
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 1454 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30036985 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30036985 |
| Policy instance | 4 |
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 1454 |
| Policy instance | 3 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | COMMUNITY ACT |
| Policy instance | 2 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 101630200 |
| Policy instance | 1 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 101630200 |
| Policy instance | 1 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | COMMUNITY ACT |
| Policy instance | 2 |
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 1454 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30036985 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30036985 |
| Policy instance | 4 |
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 1454 |
| Policy instance | 3 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | COMMUNITY ACT |
| Policy instance | 2 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 01-016302-00 |
| Policy instance | 1 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30036985 |
| Policy instance | 4 |
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 0001454 |
| Policy instance | 3 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | COMMUNITY ACT |
| Policy instance | 2 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 01-016302-00 |
| Policy instance | 1 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | 00 |
| Policy instance | 1 |
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 1454 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 95478 ) |
| Policy contract number | 30036985 |
| Policy instance | 3 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 01-016302-00 |
| Policy instance | 4 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 142707 |
| Policy instance | 5 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 01-016302-00 |
| Policy instance | 6 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | C01207 |
| Policy instance | 1 |
| DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
| Policy contract number | 1454 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 95478 ) |
| Policy contract number | 30036985 |
| Policy instance | 3 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 01-016302-00 |
| Policy instance | 4 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 01-016302-00 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 95478 ) |
| Policy contract number | 30036985 |
| Policy instance | 3 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) |
| Policy contract number | 600109 |
| Policy instance | 2 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | C01207 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AHXJ |
| Policy instance | 2 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) |
| Policy contract number | 600109 |
| Policy instance | 3 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | C01207 |
| Policy instance | 4 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) |
| Policy contract number | 600109 |
| Policy instance | 5 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AHXJ |
| Policy instance | 6 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AHXJ |
| Policy instance | 7 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AHXJ |
| Policy instance | 1 |
| COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 10001 ) |
| Policy contract number | HD0513 |
| Policy instance | 1 |
