| Insurance contract or identification number | 572043 |
| Number of Individuals Covered | 163 |
| Insurance policy start date | 2023-02-01 |
| Insurance policy end date | 2024-01-31 |
| Total amount of commissions paid to insurance broker | USD $20,542 |
| Total amount of fees paid to insurance company | USD $1,063 |
| Dental Insurance Welfare Benefit | Yes |
| Vision Insurance Welfare Benefit | Yes |
| 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, ACCIDENT, HOSPITAL |
| Welfare Benefit Premiums Paid to Carrier | USD $136,328 |
| Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |