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PERLO CONSTRUCTION GROUP RETIREMENT PLAN 401k Plan overview

Plan NamePERLO CONSTRUCTION GROUP RETIREMENT PLAN
Plan identification number 001

PERLO CONSTRUCTION GROUP RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PERLO CONSTRUCTION GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:PERLO CONSTRUCTION GROUP, INC.
Employer identification number (EIN):931295790
NAIC Classification:236200

Additional information about PERLO CONSTRUCTION GROUP, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 2000-05-25
Company Identification Number: 75566589
Legal Registered Office Address: 1211 SW FIFTH AVE

PORTLAND
United States of America (USA)
97204

More information about PERLO CONSTRUCTION GROUP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PERLO CONSTRUCTION GROUP RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-06-01
0012019-06-01DEBRA COBUN2020-12-07
0012018-06-01DEBRA COBUN2019-12-02
0012017-06-01DEBRA COBUN2018-11-06
0012016-06-01DEBRA COBUN2017-11-20
0012015-06-01DEBRA COBUN2017-06-09
0012015-06-01DEBRA COBUN2016-12-19
0012014-06-01DEBRA COBUN2015-10-23
0012013-06-01DEBRA COBUN2014-12-03
0012012-06-01DEBRA COBUN2013-12-09
0012011-06-01DEBRA L. COBUN2012-10-29
0012010-06-01DEBRA L COBUN2011-11-17 DEBRA L COBUN2011-11-17

Plan Statistics for PERLO CONSTRUCTION GROUP RETIREMENT PLAN

401k plan membership statisitcs for PERLO CONSTRUCTION GROUP RETIREMENT PLAN

Measure Date Value
2022: PERLO CONSTRUCTION GROUP RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01143
Total number of active participants reported on line 7a of the Form 55002022-01-0194
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-0141
Total of all active and inactive participants2022-01-01136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01136
Number of participants with account balances2022-01-01128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0112
2021: PERLO CONSTRUCTION GROUP RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01128
Total number of active participants reported on line 7a of the Form 55002021-01-01109
Number of retired or separated participants receiving benefits2021-01-0134
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01143
Number of participants with account balances2021-01-01126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0110
2020: PERLO CONSTRUCTION GROUP RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01133
Total number of active participants reported on line 7a of the Form 55002020-06-01102
Number of retired or separated participants receiving benefits2020-06-010
Number of other retired or separated participants entitled to future benefits2020-06-0126
Total of all active and inactive participants2020-06-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-06-010
Total participants2020-06-01128
Number of participants with account balances2020-06-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-06-015

Financial Data on PERLO CONSTRUCTION GROUP RETIREMENT PLAN

Measure Date Value
2022 : PERLO CONSTRUCTION GROUP RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$92,415
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$68,300
Total income from all sources (including contributions)2022-12-31$-2,024,615
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$488,595
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$400,482
Value of total corrective distributions2022-12-31$2,470
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,464,267
Value of total assets at end of year2022-12-31$25,848,117
Value of total assets at beginning of year2022-12-31$28,337,212
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$85,643
Total interest from all sources2022-12-31$8,711
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$768,499
Participant contributions at end of year2022-12-31$192,924
Participant contributions at beginning of year2022-12-31$208,839
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$85,785
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$92,415
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$68,300
Administrative expenses (other) incurred2022-12-31$750
Total non interest bearing cash at end of year2022-12-31$79,682
Total non interest bearing cash at beginning of year2022-12-31$62,493
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,513,210
Value of net assets at end of year (total assets less liabilities)2022-12-31$25,755,702
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$28,268,912
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$23,967,226
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$26,451,145
Income. Interest from loans (other than to participants)2022-12-31$8,711
Net investment gain/loss from pooled separate accounts2022-12-31$-4,497,593
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,609,983
Employer contributions (assets) at end of year2022-12-31$1,608,285
Employer contributions (assets) at beginning of year2022-12-31$1,614,735
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$400,482
Contract administrator fees2022-12-31$84,893
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31HOFFMAN STEWART & SCHMIDT
Accountancy firm EIN2022-12-31930743240
2021 : PERLO CONSTRUCTION GROUP RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$68,300
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$765
Total income from all sources (including contributions)2021-12-31$6,037,241
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$861,782
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$766,686
Value of total corrective distributions2021-12-31$8,173
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,689,182
Value of total assets at end of year2021-12-31$28,337,212
Value of total assets at beginning of year2021-12-31$23,094,218
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$86,923
Total interest from all sources2021-12-31$9,735
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$693,903
Participant contributions at end of year2021-12-31$208,839
Participant contributions at beginning of year2021-12-31$226,378
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$381,274
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$68,300
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$765
Administrative expenses (other) incurred2021-12-31$500
Total non interest bearing cash at end of year2021-12-31$62,493
Total non interest bearing cash at beginning of year2021-12-31$79,762
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$5,175,459
Value of net assets at end of year (total assets less liabilities)2021-12-31$28,268,912
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$23,093,453
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$26,451,145
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$22,123,956
Interest on participant loans2021-12-31$9,735
Net investment gain/loss from pooled separate accounts2021-12-31$3,338,324
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,614,005
Employer contributions (assets) at end of year2021-12-31$1,614,735
Employer contributions (assets) at beginning of year2021-12-31$664,122
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$766,686
Contract administrator fees2021-12-31$86,423
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31HOFFMAN STEWART & SCHMIDT
Accountancy firm EIN2021-12-31930743240
2020 : PERLO CONSTRUCTION GROUP RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$765
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$5,252,509
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,051,154
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,009,715
Value of total corrective distributions2020-12-31$765
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,207,799
Value of total assets at end of year2020-12-31$23,094,218
Value of total assets at beginning of year2020-12-31$18,892,098
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$40,674
Total interest from all sources2020-12-31$4,654
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$421,698
Participant contributions at end of year2020-12-31$226,378
Participant contributions at beginning of year2020-12-31$80,592
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$42,217
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$765
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Administrative expenses (other) incurred2020-12-31$800
Total non interest bearing cash at end of year2020-12-31$79,762
Total non interest bearing cash at beginning of year2020-12-31$401,909
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$4,201,355
Value of net assets at end of year (total assets less liabilities)2020-12-31$23,093,453
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$18,892,098
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$22,123,956
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$17,216,682
Interest on participant loans2020-12-31$4,654
Net investment gain/loss from pooled separate accounts2020-12-31$4,040,056
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$743,884
Employer contributions (assets) at end of year2020-12-31$664,122
Employer contributions (assets) at beginning of year2020-12-31$1,192,915
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,009,715
Contract administrator fees2020-12-31$39,874
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31HOFFMAN STEWART & SCHMIDT
Accountancy firm EIN2020-12-31930743240

Form 5500 Responses for PERLO CONSTRUCTION GROUP RETIREMENT PLAN

2022: PERLO CONSTRUCTION GROUP RETIREMENT PLAN 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 – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: PERLO CONSTRUCTION GROUP RETIREMENT PLAN 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 – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PERLO CONSTRUCTION GROUP RETIREMENT PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Submission has been amendedNo
2020-06-01This submission is the final filingNo
2020-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-06-01Plan is a collectively bargained planNo
2020-06-01Plan funding arrangement – TrustYes
2020-06-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number96631
Policy instance 1
Insurance contract or identification number96631
Number of Individuals Covered121
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $36,984
Total amount of fees paid to insurance companyUSD $13,183
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,984
Insurance broker organization code?3
Amount paid for insurance broker fees13183
Additional information about fees paid to insurance brokerTPA COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number96631
Policy instance 1
Insurance contract or identification number96631
Number of Individuals Covered120
Insurance policy start date2021-06-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $36,814
Total amount of fees paid to insurance companyUSD $12,910
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,814
Insurance broker organization code?3
Amount paid for insurance broker fees12910
Additional information about fees paid to insurance brokerTPA COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number96631
Policy instance 1
Insurance contract or identification number96631
Number of Individuals Covered115
Insurance policy start date2020-06-01
Insurance policy end date2020-12-31
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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