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EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 401k Plan overview

Plan NameEMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC.
Plan identification number 501

EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

HORIZON AIR INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:HORIZON AIR INDUSTRIES, INC.
Employer identification number (EIN):911201373
NAIC Classification:481000
NAIC Description: Air Transportation

Additional information about HORIZON AIR INDUSTRIES, INC.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1982-06-17
Company Identification Number: 600448071
Legal Registered Office Address: 19300 INTERNATIONAL BLVD

SEATTLE
United States of America (USA)
98188

More information about HORIZON AIR INDUSTRIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01JOSH MADSEN2024-10-03
5012022-01-01JOSH MADSEN2023-10-05
5012021-01-01JOSHUA MADSEN2022-10-10
5012020-01-01JOSHUA MADSEN2021-10-04
5012019-01-01JOSHUA MADSEN2020-10-06
5012019-01-01JOSHUA MADSEN2020-12-15
5012018-01-01JOSHUA MADSEN2019-10-02
5012017-01-01PANKAJ KADAM
5012016-01-01KEITH ABERNATHY
5012015-01-01KEITH ABERNATHY
5012014-01-01KEITH ABERNATHY
5012013-01-01THOMAS RICHARDS THOMAS RICHARDS2014-10-10
5012012-01-01THOMAS RICHARDS THOMAS RICHARDS2013-10-10
5012011-01-01THOMAS RICHARDS THOMAS RICHARDS2012-09-19
5012010-01-01THOMAS RICHARDS THOMAS RICHARDS2011-10-03
5012009-01-01THOMAS RICHARDS THOMAS RICHARDS2010-10-04

Plan Statistics for EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC.

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC.

Measure Date Value
2023: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2023 401k membership
Total participants, beginning-of-year2023-01-012,911
Total number of active participants reported on line 7a of the Form 55002023-01-012,894
Number of retired or separated participants receiving benefits2023-01-0128
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-012,922
Number of employers contributing to the scheme2023-01-010
2022: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2022 401k membership
Total participants, beginning-of-year2022-01-012,022
Total number of active participants reported on line 7a of the Form 55002022-01-012,653
Number of retired or separated participants receiving benefits2022-01-0134
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-012,687
2021: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2021 401k membership
Total participants, beginning-of-year2021-01-013,165
Total number of active participants reported on line 7a of the Form 55002021-01-013,007
Number of retired or separated participants receiving benefits2021-01-0163
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-013,070
2020: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2020 401k membership
Total participants, beginning-of-year2020-01-013,846
Total number of active participants reported on line 7a of the Form 55002020-01-013,224
Number of retired or separated participants receiving benefits2020-01-0195
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-013,319
2019: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2019 401k membership
Total participants, beginning-of-year2019-01-013,230
Total number of active participants reported on line 7a of the Form 55002019-01-013,509
Number of retired or separated participants receiving benefits2019-01-0136
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-013,545
2018: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2018 401k membership
Total participants, beginning-of-year2018-01-012,528
Total number of active participants reported on line 7a of the Form 55002018-01-013,061
Number of retired or separated participants receiving benefits2018-01-0143
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-013,104
2017: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2017 401k membership
Total participants, beginning-of-year2017-01-013,484
Total number of active participants reported on line 7a of the Form 55002017-01-013,321
Number of retired or separated participants receiving benefits2017-01-0127
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-013,348
2016: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2016 401k membership
Total participants, beginning-of-year2016-01-013,208
Total number of active participants reported on line 7a of the Form 55002016-01-013,342
Number of retired or separated participants receiving benefits2016-01-01142
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-013,484
2015: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2015 401k membership
Total participants, beginning-of-year2015-01-013,339
Total number of active participants reported on line 7a of the Form 55002015-01-013,081
Number of retired or separated participants receiving benefits2015-01-0126
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-013,107
2014: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2014 401k membership
Total participants, beginning-of-year2014-01-012,743
Total number of active participants reported on line 7a of the Form 55002014-01-013,313
Number of retired or separated participants receiving benefits2014-01-0126
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-013,339
2013: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-012,838
Total number of active participants reported on line 7a of the Form 55002013-01-012,697
Number of retired or separated participants receiving benefits2013-01-0145
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-012,743
2012: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-012,973
Total number of active participants reported on line 7a of the Form 55002012-01-012,783
Number of retired or separated participants receiving benefits2012-01-0155
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-012,838
2011: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-013,074
Total number of active participants reported on line 7a of the Form 55002011-01-012,922
Number of retired or separated participants receiving benefits2011-01-0151
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-012,973
2010: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2010 401k membership
Total participants, beginning-of-year2010-01-013,662
Total number of active participants reported on line 7a of the Form 55002010-01-012,965
Number of retired or separated participants receiving benefits2010-01-01109
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-013,074
2009: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-013,693
Total number of active participants reported on line 7a of the Form 55002009-01-013,542
Number of retired or separated participants receiving benefits2009-01-01120
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-013,662
Total participants2009-01-010

Form 5500 Responses for EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC.

2023: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2020 form 5500 responses
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 – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: EMPLOYEE BENEFIT PLAN FOR FULL-TIME AND PART-TIME EMPLOYEES HORIZON AIR INDUSTRIES, INC. 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 – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804018G
Policy instance 3
Insurance contract or identification number804018G
Number of Individuals Covered3295
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $24,407
Total amount of fees paid to insurance companyUSD $28,530
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $922,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VIVACITY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHAI
Policy instance 2
Insurance contract or identification numberHAI
Number of Individuals Covered2558
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $29,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number46002-LTC
Policy instance 1
Insurance contract or identification number46002-LTC
Number of Individuals Covered55
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $89,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number46002-LTC
Policy instance 1
Insurance contract or identification number46002-LTC
Number of Individuals Covered53
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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
Other welfare benefits providedLONG TERM CARE
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 $79,944
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VIVACITY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHAI
Policy instance 2
Insurance contract or identification numberHAI
Number of Individuals Covered2653
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
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 $48,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 3
Insurance contract or identification numberLTD 123872
Number of Individuals Covered2017
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,666
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 BenefitYes
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 $574,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804018G
Policy instance 4
Insurance contract or identification number804018G
Number of Individuals Covered3089
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $10,817
Total amount of fees paid to insurance companyUSD $6,763
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $502,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804018G
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 3
VIVACITY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHAI
Policy instance 2
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number46002-LTC
Policy instance 1
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number46002-LTC
Policy instance 1
VIVACITY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHAI
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804018G
Policy instance 4
VIVACITY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHAI
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0652182-HORIZON
Policy instance 4
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804018G
Policy instance 5
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number46002-LTC
Policy instance 1
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number46002-LTC
Policy instance 2
VIVACITY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHAI
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 4
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0652182-HORIZON
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 5
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12092577
Policy instance 4
VIVACITY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHAI
Policy instance 3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number46002-LTC
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0652182-HORIZON
Policy instance 1
LIFEWORKS (National Association of Insurance Commissioners NAIC id number: 54121 )
Policy contract number17197
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number652182-HORZNAIR
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number12092577
Policy instance 3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number652182-HORZNAIR
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 2
CERIDIAN CORPORATION (National Association of Insurance Commissioners NAIC id number: 54121 )
Policy contract number17197
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number12092577
Policy instance 4
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number652182-HORIZONA
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number12092577
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123872
Policy instance 3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number622095
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number12092577
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number652182-ERG
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVTL003705
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number12092577
Policy instance 1
LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 )
Policy contract numberWA-570400
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVTL003705
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number12092577
Policy instance 1
LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 )
Policy contract numberWA-570400
Policy instance 3

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