TRUSTEES OF PLUMBERS AND PIPEFITTERS LOCAL 104 H&W PLAN has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN
401k plan membership statisitcs for PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN
| Measure | Date | Value |
|---|
| 2022 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2022 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2022-06-30 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $21,545 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $10,118 |
| Total income from all sources (including contributions) | 2022-06-30 | $4,730,465 |
| Total loss/gain on sale of assets | 2022-06-30 | $0 |
| Total of all expenses incurred | 2022-06-30 | $4,766,207 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-06-30 | $4,627,862 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-06-30 | $4,702,972 |
| Value of total assets at end of year | 2022-06-30 | $8,699,961 |
| Value of total assets at beginning of year | 2022-06-30 | $8,724,276 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-06-30 | $138,345 |
| Total interest from all sources | 2022-06-30 | $119,624 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-06-30 | No |
| Administrative expenses professional fees incurred | 2022-06-30 | $29,244 |
| Was this plan covered by a fidelity bond | 2022-06-30 | Yes |
| Value of fidelity bond cover | 2022-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2022-06-30 | $27,400 |
| Assets. Other investments not covered elsewhere at beginning of year | 2022-06-30 | $27,400 |
| Other income not declared elsewhere | 2022-06-30 | $314,628 |
| Administrative expenses (other) incurred | 2022-06-30 | $98,603 |
| Liabilities. Value of operating payables at end of year | 2022-06-30 | $21,545 |
| Liabilities. Value of operating payables at beginning of year | 2022-06-30 | $10,118 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Value of net income/loss | 2022-06-30 | $-35,742 |
| Value of net assets at end of year (total assets less liabilities) | 2022-06-30 | $8,678,416 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-06-30 | $8,714,158 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-06-30 | No |
| Investment advisory and management fees | 2022-06-30 | $10,498 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-06-30 | $3,692,821 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-06-30 | $4,179,673 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-06-30 | $807,850 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-06-30 | $497,284 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-06-30 | $497,284 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-06-30 | $119,624 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2022-06-30 | $3,708,078 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2022-06-30 | $3,624,176 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-06-30 | $4,627,862 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-06-30 | $-406,759 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-06-30 | No |
| Contributions received in cash from employer | 2022-06-30 | $4,702,972 |
| Employer contributions (assets) at end of year | 2022-06-30 | $463,812 |
| Employer contributions (assets) at beginning of year | 2022-06-30 | $395,743 |
| Did the plan have assets held for investment | 2022-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-06-30 | Unqualified |
| Accountancy firm name | 2022-06-30 | LAPIER, DILLON & ASSOCIATES PC |
| Accountancy firm EIN | 2022-06-30 | 320048525 |
| 2021 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2021 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2021-06-30 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $10,118 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $454,394 |
| Total income from all sources (including contributions) | 2021-06-30 | $5,039,271 |
| Total loss/gain on sale of assets | 2021-06-30 | $0 |
| Total of all expenses incurred | 2021-06-30 | $4,413,301 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-06-30 | $4,288,868 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-06-30 | $4,202,124 |
| Value of total assets at end of year | 2021-06-30 | $8,724,276 |
| Value of total assets at beginning of year | 2021-06-30 | $8,542,582 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-06-30 | $124,433 |
| Total interest from all sources | 2021-06-30 | $140,156 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-06-30 | No |
| Administrative expenses professional fees incurred | 2021-06-30 | $22,785 |
| Was this plan covered by a fidelity bond | 2021-06-30 | Yes |
| Value of fidelity bond cover | 2021-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2021-06-30 | $27,400 |
| Assets. Other investments not covered elsewhere at beginning of year | 2021-06-30 | $27,400 |
| Other income not declared elsewhere | 2021-06-30 | $319,542 |
| Administrative expenses (other) incurred | 2021-06-30 | $93,600 |
| Liabilities. Value of operating payables at end of year | 2021-06-30 | $10,118 |
| Liabilities. Value of operating payables at beginning of year | 2021-06-30 | $454,394 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Value of net income/loss | 2021-06-30 | $625,970 |
| Value of net assets at end of year (total assets less liabilities) | 2021-06-30 | $8,714,158 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-06-30 | $8,088,188 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-06-30 | No |
| Investment advisory and management fees | 2021-06-30 | $8,048 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-06-30 | $4,179,673 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-06-30 | $3,497,388 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-06-30 | $497,284 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-06-30 | $1,090,509 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-06-30 | $1,090,509 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-06-30 | $140,156 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2021-06-30 | $3,624,176 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2021-06-30 | $3,529,212 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-06-30 | $4,288,868 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-06-30 | $377,449 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-06-30 | No |
| Contributions received in cash from employer | 2021-06-30 | $4,202,124 |
| Employer contributions (assets) at end of year | 2021-06-30 | $395,743 |
| Employer contributions (assets) at beginning of year | 2021-06-30 | $398,073 |
| Did the plan have assets held for investment | 2021-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-06-30 | Unqualified |
| Accountancy firm name | 2021-06-30 | LAPIER DILLON AND ASSOCIATES PC |
| Accountancy firm EIN | 2021-06-30 | 320048525 |
| 2020 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-06-30 | $-234,859 |
| Total unrealized appreciation/depreciation of assets | 2020-06-30 | $-234,859 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $454,394 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $8,163 |
| Total income from all sources (including contributions) | 2020-06-30 | $4,765,557 |
| Total loss/gain on sale of assets | 2020-06-30 | $0 |
| Total of all expenses incurred | 2020-06-30 | $6,060,443 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $5,868,830 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $4,605,999 |
| Value of total assets at end of year | 2020-06-30 | $8,542,582 |
| Value of total assets at beginning of year | 2020-06-30 | $9,391,237 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-06-30 | $191,613 |
| Total interest from all sources | 2020-06-30 | $169,934 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Administrative expenses professional fees incurred | 2020-06-30 | $40,225 |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2020-06-30 | $27,400 |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-06-30 | $27,400 |
| Other income not declared elsewhere | 2020-06-30 | $224,483 |
| Administrative expenses (other) incurred | 2020-06-30 | $140,091 |
| Liabilities. Value of operating payables at end of year | 2020-06-30 | $454,394 |
| Liabilities. Value of operating payables at beginning of year | 2020-06-30 | $8,163 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $-1,294,886 |
| Value of net assets at end of year (total assets less liabilities) | 2020-06-30 | $8,088,188 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-06-30 | $9,383,074 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Investment advisory and management fees | 2020-06-30 | $11,297 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-06-30 | $3,497,388 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-06-30 | $4,691,840 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-06-30 | $1,090,509 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-06-30 | $502,734 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-06-30 | $502,734 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-06-30 | $169,934 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2020-06-30 | $3,529,212 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2020-06-30 | $3,668,236 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $4,605,999 |
| Employer contributions (assets) at end of year | 2020-06-30 | $398,073 |
| Employer contributions (assets) at beginning of year | 2020-06-30 | $501,027 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-06-30 | $5,868,830 |
| Did the plan have assets held for investment | 2020-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-06-30 | Unqualified |
| Accountancy firm name | 2020-06-30 | LAPIER, DILLON & ASSOCIATES, P.C. |
| Accountancy firm EIN | 2020-06-30 | 320048525 |
| 2019 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-06-30 | $11,590 |
| Total unrealized appreciation/depreciation of assets | 2019-06-30 | $11,590 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $8,163 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $37,254 |
| Total income from all sources (including contributions) | 2019-06-30 | $4,794,154 |
| Total loss/gain on sale of assets | 2019-06-30 | $0 |
| Total of all expenses incurred | 2019-06-30 | $4,881,257 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $4,720,913 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $4,272,280 |
| Value of total assets at end of year | 2019-06-30 | $9,391,237 |
| Value of total assets at beginning of year | 2019-06-30 | $9,507,431 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-06-30 | $160,344 |
| Total interest from all sources | 2019-06-30 | $293,856 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Administrative expenses professional fees incurred | 2019-06-30 | $18,745 |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2019-06-30 | $27,400 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-06-30 | $27,400 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-06-30 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-06-30 | $18,245 |
| Other income not declared elsewhere | 2019-06-30 | $216,428 |
| Administrative expenses (other) incurred | 2019-06-30 | $129,424 |
| Liabilities. Value of operating payables at end of year | 2019-06-30 | $8,163 |
| Liabilities. Value of operating payables at beginning of year | 2019-06-30 | $37,254 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $-87,103 |
| Value of net assets at end of year (total assets less liabilities) | 2019-06-30 | $9,383,074 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-06-30 | $9,470,177 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Investment advisory and management fees | 2019-06-30 | $12,175 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-06-30 | $4,691,840 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-06-30 | $4,568,780 |
| Interest earned on other investments | 2019-06-30 | $318 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-06-30 | $502,734 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-06-30 | $682,168 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-06-30 | $682,168 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-06-30 | $293,538 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2019-06-30 | $3,668,236 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2019-06-30 | $3,577,666 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $4,272,280 |
| Employer contributions (assets) at end of year | 2019-06-30 | $501,027 |
| Employer contributions (assets) at beginning of year | 2019-06-30 | $633,172 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-06-30 | $4,720,913 |
| Did the plan have assets held for investment | 2019-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-06-30 | Unqualified |
| Accountancy firm name | 2019-06-30 | NICHOLAS LAPIER CPA PC |
| Accountancy firm EIN | 2019-06-30 | 320048525 |
| 2018 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-06-30 | $-76,287 |
| Total unrealized appreciation/depreciation of assets | 2018-06-30 | $-76,287 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $37,254 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $265,726 |
| Total income from all sources (including contributions) | 2018-06-30 | $5,199,502 |
| Total loss/gain on sale of assets | 2018-06-30 | $0 |
| Total of all expenses incurred | 2018-06-30 | $5,273,390 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-06-30 | $5,139,918 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-06-30 | $4,979,663 |
| Value of total assets at end of year | 2018-06-30 | $9,507,431 |
| Value of total assets at beginning of year | 2018-06-30 | $9,809,791 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-06-30 | $133,472 |
| Total interest from all sources | 2018-06-30 | $260,485 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-06-30 | No |
| Administrative expenses professional fees incurred | 2018-06-30 | $30,118 |
| Was this plan covered by a fidelity bond | 2018-06-30 | Yes |
| Value of fidelity bond cover | 2018-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2018-06-30 | $27,400 |
| Assets. Other investments not covered elsewhere at beginning of year | 2018-06-30 | $23,500 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-06-30 | $18,245 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-06-30 | $280,289 |
| Other income not declared elsewhere | 2018-06-30 | $35,641 |
| Administrative expenses (other) incurred | 2018-06-30 | $91,410 |
| Liabilities. Value of operating payables at end of year | 2018-06-30 | $37,254 |
| Liabilities. Value of operating payables at beginning of year | 2018-06-30 | $265,726 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Value of net income/loss | 2018-06-30 | $-73,888 |
| Value of net assets at end of year (total assets less liabilities) | 2018-06-30 | $9,470,177 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-06-30 | $9,544,065 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-06-30 | No |
| Investment advisory and management fees | 2018-06-30 | $11,944 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-06-30 | $4,568,780 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-06-30 | $4,689,118 |
| Interest earned on other investments | 2018-06-30 | $1,022 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-06-30 | $682,168 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-06-30 | $764,037 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-06-30 | $764,037 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-06-30 | $259,463 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2018-06-30 | $3,577,666 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2018-06-30 | $3,492,082 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-06-30 | No |
| Contributions received in cash from employer | 2018-06-30 | $4,979,663 |
| Employer contributions (assets) at end of year | 2018-06-30 | $633,172 |
| Employer contributions (assets) at beginning of year | 2018-06-30 | $560,765 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-06-30 | $5,139,918 |
| Did the plan have assets held for investment | 2018-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-06-30 | Unqualified |
| Accountancy firm name | 2018-06-30 | NICHOLAS LAPIER CPA PC |
| Accountancy firm EIN | 2018-06-30 | 320048525 |
| 2017 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-06-30 | $101,150 |
| Total unrealized appreciation/depreciation of assets | 2017-06-30 | $101,150 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $265,726 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $2,462 |
| Total income from all sources (including contributions) | 2017-06-30 | $4,698,310 |
| Total loss/gain on sale of assets | 2017-06-30 | $0 |
| Total of all expenses incurred | 2017-06-30 | $4,620,895 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-06-30 | $4,479,125 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-06-30 | $4,338,639 |
| Value of total assets at end of year | 2017-06-30 | $9,809,791 |
| Value of total assets at beginning of year | 2017-06-30 | $9,469,112 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-06-30 | $141,770 |
| Total interest from all sources | 2017-06-30 | $267,390 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-06-30 | No |
| Administrative expenses professional fees incurred | 2017-06-30 | $29,382 |
| Was this plan covered by a fidelity bond | 2017-06-30 | Yes |
| Value of fidelity bond cover | 2017-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2017-06-30 | $23,500 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-06-30 | $56,678 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-06-30 | $280,289 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-06-30 | $97,805 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-06-30 | $2,126 |
| Other income not declared elsewhere | 2017-06-30 | $10,230 |
| Administrative expenses (other) incurred | 2017-06-30 | $100,218 |
| Liabilities. Value of operating payables at end of year | 2017-06-30 | $265,726 |
| Liabilities. Value of operating payables at beginning of year | 2017-06-30 | $336 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Value of net income/loss | 2017-06-30 | $77,415 |
| Value of net assets at end of year (total assets less liabilities) | 2017-06-30 | $9,544,065 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-06-30 | $9,466,650 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-06-30 | No |
| Investment advisory and management fees | 2017-06-30 | $12,170 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-06-30 | $4,689,118 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-06-30 | $8,495,413 |
| Interest earned on other investments | 2017-06-30 | $2,821 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-06-30 | $764,037 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-06-30 | $481,168 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-06-30 | $481,168 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-06-30 | $264,569 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2017-06-30 | $3,492,082 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-06-30 | $4,479,125 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-06-30 | $-19,099 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-06-30 | No |
| Contributions received in cash from employer | 2017-06-30 | $4,338,639 |
| Employer contributions (assets) at end of year | 2017-06-30 | $560,765 |
| Employer contributions (assets) at beginning of year | 2017-06-30 | $338,048 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-06-30 | No |
| Did the plan have assets held for investment | 2017-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-06-30 | Unqualified |
| Accountancy firm name | 2017-06-30 | NICHOLAS LAPIER CPA PC |
| Accountancy firm EIN | 2017-06-30 | 320048525 |
| 2016 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-06-30 | $436 |
| Total unrealized appreciation/depreciation of assets | 2016-06-30 | $436 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $2,462 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $40,946 |
| Total income from all sources (including contributions) | 2016-06-30 | $3,938,692 |
| Total loss/gain on sale of assets | 2016-06-30 | $0 |
| Total of all expenses incurred | 2016-06-30 | $4,867,546 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-06-30 | $4,748,498 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-06-30 | $3,862,758 |
| Value of total assets at end of year | 2016-06-30 | $9,469,112 |
| Value of total assets at beginning of year | 2016-06-30 | $10,436,450 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-06-30 | $119,048 |
| Total interest from all sources | 2016-06-30 | $255,313 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-06-30 | No |
| Administrative expenses professional fees incurred | 2016-06-30 | $29,033 |
| Was this plan covered by a fidelity bond | 2016-06-30 | Yes |
| Value of fidelity bond cover | 2016-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2016-06-30 | $56,678 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-06-30 | $23,500 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-06-30 | $97,805 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-06-30 | $49,553 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-06-30 | $2,126 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-06-30 | $31,218 |
| Other income not declared elsewhere | 2016-06-30 | $738 |
| Administrative expenses (other) incurred | 2016-06-30 | $90,015 |
| Liabilities. Value of operating payables at end of year | 2016-06-30 | $336 |
| Liabilities. Value of operating payables at beginning of year | 2016-06-30 | $9,728 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Value of net income/loss | 2016-06-30 | $-928,854 |
| Value of net assets at end of year (total assets less liabilities) | 2016-06-30 | $9,466,650 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-06-30 | $10,395,504 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-06-30 | $8,495,413 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-06-30 | $8,255,588 |
| Interest earned on other investments | 2016-06-30 | $1,767 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-06-30 | $481,168 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-06-30 | $1,624,320 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-06-30 | $1,624,320 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-06-30 | $253,546 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-06-30 | $4,748,498 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-06-30 | $-180,553 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-06-30 | No |
| Contributions received in cash from employer | 2016-06-30 | $3,862,758 |
| Employer contributions (assets) at end of year | 2016-06-30 | $338,048 |
| Employer contributions (assets) at beginning of year | 2016-06-30 | $483,489 |
| Did the plan have assets held for investment | 2016-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-06-30 | Unqualified |
| Accountancy firm name | 2016-06-30 | NICHOLAS LAPIER PC CPA |
| Accountancy firm EIN | 2016-06-30 | 320048525 |
| 2015 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-06-30 | $-260,846 |
| Total unrealized appreciation/depreciation of assets | 2015-06-30 | $-260,846 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $40,946 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $2,682 |
| Total income from all sources (including contributions) | 2015-06-30 | $4,230,071 |
| Total loss/gain on sale of assets | 2015-06-30 | $0 |
| Total of all expenses incurred | 2015-06-30 | $4,140,668 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-06-30 | $3,970,941 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-06-30 | $4,187,559 |
| Value of total assets at end of year | 2015-06-30 | $10,436,450 |
| Value of total assets at beginning of year | 2015-06-30 | $10,308,783 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-06-30 | $169,727 |
| Total interest from all sources | 2015-06-30 | $291,163 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-06-30 | No |
| Administrative expenses professional fees incurred | 2015-06-30 | $25,892 |
| Was this plan covered by a fidelity bond | 2015-06-30 | Yes |
| Value of fidelity bond cover | 2015-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2015-06-30 | $23,500 |
| Assets. Other investments not covered elsewhere at beginning of year | 2015-06-30 | $23,500 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-06-30 | $49,553 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-06-30 | $3,087 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-06-30 | $31,218 |
| Other income not declared elsewhere | 2015-06-30 | $12,195 |
| Administrative expenses (other) incurred | 2015-06-30 | $143,835 |
| Liabilities. Value of operating payables at end of year | 2015-06-30 | $9,728 |
| Liabilities. Value of operating payables at beginning of year | 2015-06-30 | $2,682 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Value of net income/loss | 2015-06-30 | $89,403 |
| Value of net assets at end of year (total assets less liabilities) | 2015-06-30 | $10,395,504 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-06-30 | $10,306,101 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-06-30 | $8,255,588 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-06-30 | $8,281,969 |
| Interest earned on other investments | 2015-06-30 | $55,588 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-06-30 | $1,624,320 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-06-30 | $1,441,993 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-06-30 | $1,441,993 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-06-30 | $235,575 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-06-30 | $3,970,941 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-06-30 | No |
| Contributions received in cash from employer | 2015-06-30 | $4,187,559 |
| Employer contributions (assets) at end of year | 2015-06-30 | $483,489 |
| Employer contributions (assets) at beginning of year | 2015-06-30 | $558,234 |
| Did the plan have assets held for investment | 2015-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-06-30 | Unqualified |
| Accountancy firm name | 2015-06-30 | NICHOLAS LAPIER PC CPA |
| Accountancy firm EIN | 2015-06-30 | 320048525 |
| 2014 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-06-30 | $158,417 |
| Total unrealized appreciation/depreciation of assets | 2014-06-30 | $158,417 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $2,682 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $38,498 |
| Total income from all sources (including contributions) | 2014-06-30 | $4,096,722 |
| Total loss/gain on sale of assets | 2014-06-30 | $0 |
| Total of all expenses incurred | 2014-06-30 | $4,338,499 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-06-30 | $4,205,310 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-06-30 | $3,643,418 |
| Value of total assets at end of year | 2014-06-30 | $10,308,783 |
| Value of total assets at beginning of year | 2014-06-30 | $10,586,376 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-06-30 | $133,189 |
| Total interest from all sources | 2014-06-30 | $237,145 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-06-30 | No |
| Administrative expenses professional fees incurred | 2014-06-30 | $22,062 |
| Was this plan covered by a fidelity bond | 2014-06-30 | Yes |
| Value of fidelity bond cover | 2014-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2014-06-30 | $23,500 |
| Assets. Other investments not covered elsewhere at beginning of year | 2014-06-30 | $76,211 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-06-30 | $3,087 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-06-30 | $115,528 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-06-30 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-06-30 | $1,665 |
| Other income not declared elsewhere | 2014-06-30 | $57,742 |
| Administrative expenses (other) incurred | 2014-06-30 | $111,127 |
| Liabilities. Value of operating payables at end of year | 2014-06-30 | $2,682 |
| Liabilities. Value of operating payables at beginning of year | 2014-06-30 | $36,833 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Value of net income/loss | 2014-06-30 | $-241,777 |
| Value of net assets at end of year (total assets less liabilities) | 2014-06-30 | $10,306,101 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-06-30 | $10,547,878 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-06-30 | $8,281,969 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-06-30 | $7,920,017 |
| Interest earned on other investments | 2014-06-30 | $23,331 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-06-30 | $1,441,993 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-06-30 | $2,013,857 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-06-30 | $2,013,857 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-06-30 | $213,814 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-06-30 | $4,205,310 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-06-30 | No |
| Contributions received in cash from employer | 2014-06-30 | $3,643,418 |
| Employer contributions (assets) at end of year | 2014-06-30 | $558,234 |
| Employer contributions (assets) at beginning of year | 2014-06-30 | $460,763 |
| Did the plan have assets held for investment | 2014-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-06-30 | Unqualified |
| Accountancy firm name | 2014-06-30 | NICHOLAS LAPIER PC CPA |
| Accountancy firm EIN | 2014-06-30 | 320048525 |
| 2013 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-06-30 | $-112,985 |
| Total unrealized appreciation/depreciation of assets | 2013-06-30 | $-112,985 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $38,498 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $73,150 |
| Total income from all sources (including contributions) | 2013-06-30 | $4,540,786 |
| Total loss/gain on sale of assets | 2013-06-30 | $0 |
| Total of all expenses incurred | 2013-06-30 | $4,199,792 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-06-30 | $4,111,988 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-06-30 | $4,283,554 |
| Value of total assets at end of year | 2013-06-30 | $10,586,376 |
| Value of total assets at beginning of year | 2013-06-30 | $10,280,034 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-06-30 | $87,804 |
| Total interest from all sources | 2013-06-30 | $260,145 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-06-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-06-30 | No |
| Administrative expenses professional fees incurred | 2013-06-30 | $17,489 |
| Was this plan covered by a fidelity bond | 2013-06-30 | Yes |
| Value of fidelity bond cover | 2013-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2013-06-30 | $76,211 |
| Assets. Other investments not covered elsewhere at beginning of year | 2013-06-30 | $108,506 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-06-30 | $115,528 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-06-30 | $28,639 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-06-30 | $1,665 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-06-30 | $1,665 |
| Other income not declared elsewhere | 2013-06-30 | $110,072 |
| Administrative expenses (other) incurred | 2013-06-30 | $70,315 |
| Liabilities. Value of operating payables at end of year | 2013-06-30 | $36,833 |
| Liabilities. Value of operating payables at beginning of year | 2013-06-30 | $71,485 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Value of net income/loss | 2013-06-30 | $340,994 |
| Value of net assets at end of year (total assets less liabilities) | 2013-06-30 | $10,547,878 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-06-30 | $10,206,884 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-06-30 | $7,920,017 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-06-30 | $7,536,904 |
| Interest earned on other investments | 2013-06-30 | $8,541 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-06-30 | $2,013,857 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-06-30 | $2,186,424 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-06-30 | $2,186,424 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-06-30 | $251,604 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-06-30 | $4,111,988 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-06-30 | No |
| Contributions received in cash from employer | 2013-06-30 | $4,283,554 |
| Employer contributions (assets) at end of year | 2013-06-30 | $460,763 |
| Employer contributions (assets) at beginning of year | 2013-06-30 | $419,561 |
| Did the plan have assets held for investment | 2013-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-06-30 | Unqualified |
| Accountancy firm name | 2013-06-30 | NICHOLAS LAPIER PC CPA |
| Accountancy firm EIN | 2013-06-30 | 320048525 |
| 2012 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-06-30 | $-7,399 |
| Total unrealized appreciation/depreciation of assets | 2012-06-30 | $-7,399 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $73,150 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $70,877 |
| Total income from all sources (including contributions) | 2012-06-30 | $4,509,298 |
| Total of all expenses incurred | 2012-06-30 | $3,646,690 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-06-30 | $3,548,686 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-06-30 | $4,251,485 |
| Value of total assets at end of year | 2012-06-30 | $10,280,034 |
| Value of total assets at beginning of year | 2012-06-30 | $9,415,153 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-06-30 | $98,004 |
| Total interest from all sources | 2012-06-30 | $256,758 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-06-30 | No |
| Administrative expenses professional fees incurred | 2012-06-30 | $13,404 |
| Was this plan covered by a fidelity bond | 2012-06-30 | Yes |
| Value of fidelity bond cover | 2012-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2012-06-30 | $108,506 |
| Assets. Other investments not covered elsewhere at beginning of year | 2012-06-30 | $69,186 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-06-30 | $28,639 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-06-30 | $91,240 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-06-30 | $1,665 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-06-30 | $1,665 |
| Other income not declared elsewhere | 2012-06-30 | $8,454 |
| Administrative expenses (other) incurred | 2012-06-30 | $84,600 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Value of net income/loss | 2012-06-30 | $862,608 |
| Value of net assets at end of year (total assets less liabilities) | 2012-06-30 | $10,206,884 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-06-30 | $9,344,276 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-06-30 | $7,536,904 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-06-30 | $7,252,411 |
| Interest earned on other investments | 2012-06-30 | $19,691 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-06-30 | $2,186,424 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-06-30 | $1,500,418 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-06-30 | $1,500,418 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-06-30 | $237,067 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-06-30 | $3,548,686 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-06-30 | No |
| Contributions received in cash from employer | 2012-06-30 | $4,251,485 |
| Employer contributions (assets) at end of year | 2012-06-30 | $419,561 |
| Employer contributions (assets) at beginning of year | 2012-06-30 | $501,898 |
| Liabilities. Value of benefit claims payable at end of year | 2012-06-30 | $71,485 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-06-30 | $69,212 |
| Did the plan have assets held for investment | 2012-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-06-30 | Unqualified |
| Accountancy firm name | 2012-06-30 | NICHOLAS LAPIER PC CPA |
| Accountancy firm EIN | 2012-06-30 | 320048525 |
| 2011 : PLUMBERS AND PIPEFITTERS LOCAL 104 H AND W PLAN 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-06-30 | $210,485 |
| Total unrealized appreciation/depreciation of assets | 2011-06-30 | $210,485 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $70,877 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $158,498 |
| Total income from all sources (including contributions) | 2011-06-30 | $4,256,425 |
| Total of all expenses incurred | 2011-06-30 | $3,774,503 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-06-30 | $3,683,285 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-06-30 | $3,771,412 |
| Value of total assets at end of year | 2011-06-30 | $9,415,153 |
| Value of total assets at beginning of year | 2011-06-30 | $9,020,857 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-06-30 | $91,218 |
| Total interest from all sources | 2011-06-30 | $166,068 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-06-30 | No |
| Administrative expenses professional fees incurred | 2011-06-30 | $13,774 |
| Was this plan covered by a fidelity bond | 2011-06-30 | Yes |
| Value of fidelity bond cover | 2011-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-06-30 | No |
| Assets. Other investments not covered elsewhere at end of year | 2011-06-30 | $69,186 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-06-30 | $79,239 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-06-30 | $91,240 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-06-30 | $19,516 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-06-30 | $1,665 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-06-30 | $2,057 |
| Other income not declared elsewhere | 2011-06-30 | $108,460 |
| Administrative expenses (other) incurred | 2011-06-30 | $77,444 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Value of net income/loss | 2011-06-30 | $481,922 |
| Value of net assets at end of year (total assets less liabilities) | 2011-06-30 | $9,344,276 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-06-30 | $8,862,359 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-06-30 | $4,573,008 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-06-30 | $4,207,347 |
| Interest earned on other investments | 2011-06-30 | $46,454 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-06-30 | $4,179,821 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-06-30 | $4,144,782 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-06-30 | $4,144,782 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-06-30 | $119,614 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-06-30 | $3,683,285 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-06-30 | No |
| Contributions received in cash from employer | 2011-06-30 | $3,771,412 |
| Employer contributions (assets) at end of year | 2011-06-30 | $501,898 |
| Employer contributions (assets) at beginning of year | 2011-06-30 | $569,973 |
| Liabilities. Value of benefit claims payable at end of year | 2011-06-30 | $69,212 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-06-30 | $156,441 |
| Did the plan have assets held for investment | 2011-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-06-30 | Unqualified |
| Accountancy firm name | 2011-06-30 | NICHOLAS LAPIER CPA PC |
| Accountancy firm EIN | 2011-06-30 | 320048525 |
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 003057 |
| Policy instance | 4 |
| Insurance contract or identification number | 003057 | | Number of Individuals Covered | 787 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G320/C4525 |
| Policy instance | 3 |
| Insurance contract or identification number | G320/C4525 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL 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 Carrier | USD $33,323 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | BCBS-0367011 |
| Policy instance | 2 |
| Insurance contract or identification number | BCBS-0367011 | | Number of Individuals Covered | 755 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 1 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 0030570000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0030570000 | | Number of Individuals Covered | 778 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | BCBS-0367011 |
| Policy instance | 2 |
| Insurance contract or identification number | BCBS-0367011 | | Number of Individuals Covered | 768 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G320/C4525 |
| Policy instance | 3 |
| Insurance contract or identification number | G320/C4525 | | Number of Individuals Covered | 280 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $26,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 1 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201915 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-201915 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | STOP LOSS INSURANCE | | 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 Carrier | USD $345,479 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,347 |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 1 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 0030570000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0030570000 | | Number of Individuals Covered | 815 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | BCBS-0367011 |
| Policy instance | 2 |
| Insurance contract or identification number | BCBS-0367011 | | Number of Individuals Covered | 1110 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 3 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 0030570000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0030570000 | | Number of Individuals Covered | 819 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201915 |
| Policy instance | 2 |
| Insurance contract or identification number | UNI-201915 | | Number of Individuals Covered | 327 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | STOP LOSS INSURANCE | | 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 Carrier | USD $358,318 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,783 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | BCBS-0367011 |
| Policy instance | 1 |
| Insurance contract or identification number | BCBS-0367011 | | Number of Individuals Covered | 1123 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 0030570000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0030570000 | | Number of Individuals Covered | 832 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | BCBS-0367011 |
| Policy instance | 4 |
| Insurance contract or identification number | BCBS-0367011 | | Number of Individuals Covered | 1143 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 2 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201915 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-201915 | | Number of Individuals Covered | 325 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | STOP LOSS INSURANCE | | 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 Carrier | USD $313,964 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201915 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-201915 | | Number of Individuals Covered | 299 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $17,704 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $252,912 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,704 | | Insurance broker name | EFS INSURANCE AGENCY |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 2 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 003057 |
| Policy instance | 1 |
| Insurance contract or identification number | 003057 | | Number of Individuals Covered | 823 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of fees paid to insurance company | USD $26,978 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 1 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 003057000 |
| Policy instance | 2 |
| Insurance contract or identification number | 003057000 | | Number of Individuals Covered | 819 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of fees paid to insurance company | USD $24,652 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201915 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-201915 | | Number of Individuals Covered | 297 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $13,976 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $217,173 | | 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 number | 000QL303 |
| Policy instance | 3 |
| Insurance contract or identification number | 000QL303 | | Number of Individuals Covered | 278 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $1,268 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | SL 10000012-131 |
| Policy instance | 2 |
| Insurance contract or identification number | SL 10000012-131 | | Number of Individuals Covered | 298 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $17,416 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $248,802 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 4 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 0030570000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0030570000 | | Number of Individuals Covered | 754 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of fees paid to insurance company | USD $25,392 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 0367011 |
| Policy instance | 2 |
| Insurance contract or identification number | 0367011 | | Number of Individuals Covered | 306 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 0030570000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0030570000 | | Number of Individuals Covered | 785 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of fees paid to insurance company | USD $31,736 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 069000 |
| Policy instance | 5 |
| Insurance contract or identification number | 069000 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
|
| COMMERCIAL TRAVELERS MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81426 ) |
| Policy contract number | 12-16712 |
| Policy instance | 4 |
| Insurance contract or identification number | 12-16712 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $5,485 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | SL10000012-121 |
| Policy instance | 6 |
| Insurance contract or identification number | SL10000012-121 | | Number of Individuals Covered | 305 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $17,562 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $250,888 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MONITOR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81442 ) |
| Policy contract number | 12-16712 |
| Policy instance | 3 |
| Insurance contract or identification number | 12-16712 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Are there contracts with allocated funds for individual policies? | No | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $12,633 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | SL10000012-11 |
| Policy instance | 1 |
| Insurance contract or identification number | SL10000012-11 | | Number of Individuals Covered | 306 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $17,362 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 0367011 |
| Policy instance | 3 |
| Insurance contract or identification number | 0367011 | | Number of Individuals Covered | 306 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MONITOR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81442 ) |
| Policy contract number | 12-16712 |
| Policy instance | 4 |
| Insurance contract or identification number | 12-16712 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of fees paid to insurance company | USD $12,542 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMERCIAL TRAVELERS MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81426 ) |
| Policy contract number | 12-16712 |
| Policy instance | 5 |
| Insurance contract or identification number | 12-16712 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of fees paid to insurance company | USD $5,433 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 0030570000 |
| Policy instance | 2 |
| Insurance contract or identification number | 0030570000 | | Number of Individuals Covered | 800 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of fees paid to insurance company | USD $29,624 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 0367011 |
| Policy instance | 1 |
| Insurance contract or identification number | 0367011 | | Number of Individuals Covered | 300 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 003057 |
| Policy instance | 2 |
| Insurance contract or identification number | 003057 | | Number of Individuals Covered | 815 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MONITOR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81442 ) |
| Policy contract number | 12-16712 |
| Policy instance | 4 |
| Insurance contract or identification number | 12-16712 | | Number of Individuals Covered | 281 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-06-30 | | Total amount of fees paid to insurance company | USD $6,460 |
|
| COMMERCIAL TRAVELERS MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81426 ) |
| Policy contract number | 12-16712 |
| Policy instance | 5 |
| Insurance contract or identification number | 12-16712 | | Number of Individuals Covered | 283 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-06-30 | | Total amount of fees paid to insurance company | USD $2,805 |
|
| MONITOR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81442 ) |
| Policy contract number | 12-16712 |
| Policy instance | 6 |
| Insurance contract or identification number | 12-16712 | | Number of Individuals Covered | 281 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2010-12-31 | | Total amount of fees paid to insurance company | USD $9,185 |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | SL 10000012-101 |
| Policy instance | 3 |
| Insurance contract or identification number | SL 10000012-101 | | Number of Individuals Covered | 308 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $17,328 |
|
