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GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameGPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN
Plan identification number 502

GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

HUB FOLDING BOX COMPANY has sponsored the creation of one or more 401k plans.

Company Name:HUB FOLDING BOX COMPANY
Employer identification number (EIN):042192575
NAIC Classification:322200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-07-01FELICIA E. NELSON2025-01-23 FELICIA E. NELSON2025-01-23
5022022-07-01FELICIA E. NELSON2024-01-24
5022021-07-01
5022021-07-01FELICIA E. NELSON2024-04-17
5022020-07-01FELICIA E. NELSON2024-04-17
5022020-06-01
5022019-07-01
5022019-07-01FELICIA E. NELSON2024-04-17
5022019-06-01
5022018-07-01
5022018-07-01NEIL SCHNEIDER
5022018-06-01
5022017-07-01
5022017-07-01NEIL SCHNEIDER
5022017-06-01STEPHEN SYLVIA STEPHEN SYLVIA2019-03-12
5022016-07-01
5022016-07-01NEIL SCHNEIDER
5022016-06-01STEPHEN SYLVIA STEPHEN SYLVIA2018-03-12
5022015-07-01
5022015-07-01NEIL SCHNEIDER
5022015-06-01STEPHEN SYLVIA STEPHEN SYLVIA2017-03-14
5022014-07-01
5022014-07-01NEIL SCHNEIDER
5022014-06-01STEPHEN SYLVIA STEPHEN SYLVIA2016-03-15
5022013-07-01
5022013-07-01NEIL SCHNEIDER
5022013-06-01STEPHEN SYLVIA STEPHEN SYLVIA2015-03-16
5022012-07-01
5022012-07-01NEIL SCHNEIDER
5022012-06-01STEPHEN SYLVIA STEPHEN SYLVIA2014-03-14
5022011-07-01
5022011-07-01NEIL SCHNEIDER
5022011-06-01HAROLD WILLMOTT HAROLD WILLMOTT2013-03-14
5022011-06-01
5022011-06-01NEIL SCHNEIDER
5022009-06-01HAROLD WILLMOTT HAROLD WILLMOTT2011-03-15

Plan Statistics for GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN

401k plan membership statisitcs for GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN

Measure Date Value
2023: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-07-01204
Total number of active participants reported on line 7a of the Form 55002023-07-01210
Number of retired or separated participants receiving benefits2023-07-012
Number of other retired or separated participants entitled to future benefits2023-07-013
Total of all active and inactive participants2023-07-01215
Number of employers contributing to the scheme2023-07-010
2022: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01194
Total number of active participants reported on line 7a of the Form 55002022-07-01197
Number of retired or separated participants receiving benefits2022-07-011
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01198
2021: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01159
Total number of active participants reported on line 7a of the Form 55002021-07-01185
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01185
2020: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01141
Total number of active participants reported on line 7a of the Form 55002020-07-01159
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01159
Total participants, beginning-of-year2020-06-01206
Total number of active participants reported on line 7a of the Form 55002020-06-01204
Number of retired or separated participants receiving benefits2020-06-011
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01205
2019: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01139
Total number of active participants reported on line 7a of the Form 55002019-07-01141
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01141
Total participants, beginning-of-year2019-06-01142
Total number of active participants reported on line 7a of the Form 55002019-06-01205
Number of retired or separated participants receiving benefits2019-06-011
Total of all active and inactive participants2019-06-01206
Total participants2019-06-01206
2018: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01151
Total number of active participants reported on line 7a of the Form 55002018-07-01139
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01139
Total participants, beginning-of-year2018-06-01129
Total number of active participants reported on line 7a of the Form 55002018-06-01142
Total of all active and inactive participants2018-06-01142
Total participants2018-06-01142
2017: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01153
Total number of active participants reported on line 7a of the Form 55002017-07-01151
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01151
Total participants, beginning-of-year2017-06-01153
Total number of active participants reported on line 7a of the Form 55002017-06-01151
Total of all active and inactive participants2017-06-01151
2016: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01159
Total number of active participants reported on line 7a of the Form 55002016-07-01153
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01153
Total participants, beginning-of-year2016-06-01159
Total number of active participants reported on line 7a of the Form 55002016-06-01153
Total of all active and inactive participants2016-06-01153
2015: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01171
Total number of active participants reported on line 7a of the Form 55002015-07-01159
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01159
Total participants, beginning-of-year2015-06-01171
Total number of active participants reported on line 7a of the Form 55002015-06-01159
Total of all active and inactive participants2015-06-01159
2014: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01168
Total number of active participants reported on line 7a of the Form 55002014-07-01171
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01171
Total participants, beginning-of-year2014-06-01168
Total number of active participants reported on line 7a of the Form 55002014-06-01171
Total of all active and inactive participants2014-06-01171
2013: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01180
Total number of active participants reported on line 7a of the Form 55002013-07-01168
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01168
Total participants, beginning-of-year2013-06-01180
Total number of active participants reported on line 7a of the Form 55002013-06-01168
Total of all active and inactive participants2013-06-01168
2012: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01193
Total number of active participants reported on line 7a of the Form 55002012-07-01180
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01180
Total participants, beginning-of-year2012-06-01193
Total number of active participants reported on line 7a of the Form 55002012-06-01180
Total of all active and inactive participants2012-06-01180
2011: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01199
Total number of active participants reported on line 7a of the Form 55002011-07-01193
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01193
Total participants, beginning-of-year2011-06-01199
Total number of active participants reported on line 7a of the Form 55002011-06-01193
Total of all active and inactive participants2011-06-01193
Number of retired or separated participants receiving benefits2011-06-010
Number of other retired or separated participants entitled to future benefits2011-06-010
2009: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-01215
Total number of active participants reported on line 7a of the Form 55002009-06-01197
Total of all active and inactive participants2009-06-01197

Form 5500 Responses for GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN

2023: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-07-01Type of plan entitySingle employer plan
2023-07-01Plan funding arrangement – InsuranceYes
2023-07-01Plan funding arrangement – General assets of the sponsorYes
2023-07-01Plan benefit arrangement – InsuranceYes
2023-07-01Plan benefit arrangement – General assets of the sponsorYes
2022: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedYes
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
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)No
2020-06-01Plan is a collectively bargained planNo
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedYes
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedYes
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-06-01Type of plan entitySingle employer plan
2018-06-01Submission has been amendedNo
2018-06-01This submission is the final filingNo
2018-06-01This return/report is a short plan year return/report (less than 12 months)No
2018-06-01Plan is a collectively bargained planNo
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedYes
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedYes
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedYes
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedYes
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedYes
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedYes
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-06-01Type of plan entitySingle employer plan
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes
2011: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedYes
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-06-01Type of plan entitySingle employer plan
2011-06-01Submission has been amendedYes
2011-06-01This submission is the final filingNo
2011-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2011-06-01Plan is a collectively bargained planNo
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – InsuranceYes
2009: GPA GLOBAL AND ITS US SUBSIDIARIES HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01This submission is the final filingNo
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number230795
Policy instance 3
Insurance contract or identification number230795
Number of Individuals Covered15
Insurance policy start date2024-01-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $4,260
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number230795
Policy instance 2
Insurance contract or identification number230795
Number of Individuals Covered24
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $11,380
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $206,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00457403
Policy instance 1
Insurance contract or identification number00457403
Number of Individuals Covered175
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $5,873
Total amount of fees paid to insurance companyUSD $1,530
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $167,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00457403
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00457403
Policy instance 1
ELITE UNDERWRITING (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract numberGMICMSL20191046
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00457403
Policy instance 1
Insurance contract or identification number00457403
Number of Individuals Covered106
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $3,302
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $86,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
ELITE UNDERWRITING (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract numberGMICMSL20191046
Policy instance 1
ELITE UNDERWRITING (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract numberGMICMSL20191046
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00457403
Policy instance 1
Insurance contract or identification number00457403
Number of Individuals Covered102
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $3,332
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $86,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
ELITE UNDERWRITING (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract numberGMICMSL20191046
Policy instance 1
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31235
Policy instance 1
Insurance contract or identification numberHCL31235
Number of Individuals Covered139
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $48,000
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31235
Policy instance 1
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
Insurance contract or identification numberUS079125
Number of Individuals Covered151
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $48,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $492,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
Insurance contract or identification numberUS079125
Number of Individuals Covered153
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $48,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $469,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
Insurance contract or identification numberUS079125
Number of Individuals Covered159
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $48,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $485,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
Insurance contract or identification numberUS079125
Number of Individuals Covered171
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $24,210
Total amount of fees paid to insurance companyUSD $30,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $434,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
Insurance contract or identification numberUS079125
Number of Individuals Covered168
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $23,393
Total amount of fees paid to insurance companyUSD $30,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $412,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
Insurance contract or identification numberUS079125
Number of Individuals Covered180
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $26,597
Total amount of fees paid to insurance companyUSD $30,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $468,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DHR/US FIRE (National Association of Insurance Commissioners NAIC id number: 2113 )
Policy contract numberUS079125
Policy instance 1
INTERNATIONAL INSURANCE AGENCY (National Association of Insurance Commissioners NAIC id number: 86355 )
Policy contract numberIIS1880
Policy instance 1
Insurance contract or identification numberIIS1880
Number of Individuals Covered193
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $23,239
Total amount of fees paid to insurance companyUSD $30,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $417,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INTERNATIONAL INSURANCE AGENCY (National Association of Insurance Commissioners NAIC id number: 86355 )
Policy contract numberIIS1880
Policy instance 1
INTERNATIONAL INSURANCE AGENCY (National Association of Insurance Commissioners NAIC id number: 86355 )
Policy contract numberIIS1880
Policy instance 1
Insurance contract or identification numberIIS1880
Number of Individuals Covered199
Insurance policy start date2011-06-01
Insurance policy end date2011-06-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
INTERNATIONAL INSURANCE AGENCY (National Association of Insurance Commissioners NAIC id number: 86355 )
Policy contract numberIIS1769
Policy instance 1

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