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FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan NameFLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number 502

FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN Benefits

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

401k Sponsoring company profile

FLATIRON CONSTRUCTION CORP. has sponsored the creation of one or more 401k plans.

Company Name:FLATIRON CONSTRUCTION CORP.
Employer identification number (EIN):043147491
NAIC Classification:237310
NAIC Description:Highway, Street, and Bridge Construction

Additional information about FLATIRON CONSTRUCTION CORP.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 2008-08-06
Company Identification Number: 3705362
Legal Registered Office Address: 102 WESTCHESTER AVE.
Westchester
BUCHANAN
United States of America (USA)
10511

More information about FLATIRON CONSTRUCTION CORP.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01TIFFANY HERRON2023-10-11
5022021-01-01
5022020-01-01TIFFANY HERRON2021-10-15
5022019-01-01TIFFANY S HERRON2020-10-15
5022018-01-01
5022018-01-01TIFFANY HERRON2021-03-16
5022017-01-01TIFFANY HERRON
5022017-01-01TIFFANY HERRON2021-03-16
5022016-01-01TIFFANY HERRON
5022016-01-01TIFFANY HERRON2021-03-16
5022015-01-01
5022015-01-01TIFFANY HERRON2021-03-16
5022014-01-01
5022014-01-01TIFFANY HERRON2021-03-16
5022013-01-01CHRISTINE DENIO
5022013-01-01TIFFANY HERRON2021-03-16
5022012-07-01CLAIRE SIDERI
5022012-07-01TIFFANY HERRON2021-03-16
5022011-07-01PAUL R. DRISCOLL
5022011-07-01TIFFANY S HERRON2021-03-22
5022010-07-01NICKI EMERSON
5022010-07-01TIFFANY S HERRON2021-03-22
5022009-07-01NICKI EMERSON
5022009-07-01NICKI EMERSON
5022009-07-01TIFFANY HERRON2021-03-16
5022008-07-01NICKI EMERSON

Plan Statistics for FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN

401k plan membership statisitcs for FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2022: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,243
Total number of active participants reported on line 7a of the Form 55002022-01-011,190
Number of retired or separated participants receiving benefits2022-01-019
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-011,199
Number of employers contributing to the scheme2022-01-010
2021: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,890
Total number of active participants reported on line 7a of the Form 55002021-01-011,243
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011,243
2020: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-012,166
Total number of active participants reported on line 7a of the Form 55002020-01-011,886
Number of retired or separated participants receiving benefits2020-01-014
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-011,890
Number of employers contributing to the scheme2020-01-010
2019: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,006
Total number of active participants reported on line 7a of the Form 55002019-01-011,261
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,261
Number of employers contributing to the scheme2019-01-010
2018: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01868
Total number of active participants reported on line 7a of the Form 55002018-01-01995
Number of retired or separated participants receiving benefits2018-01-0111
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-011,006
Number of employers contributing to the scheme2018-01-010
2017: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01702
Total number of active participants reported on line 7a of the Form 55002017-01-01859
Number of retired or separated participants receiving benefits2017-01-019
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01868
Number of employers contributing to the scheme2017-01-010
2016: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01583
Total number of active participants reported on line 7a of the Form 55002016-01-01695
Number of retired or separated participants receiving benefits2016-01-017
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01702
Number of employers contributing to the scheme2016-01-010
2015: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01532
Total number of active participants reported on line 7a of the Form 55002015-01-01505
Total of all active and inactive participants2015-01-01505
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Number of employers contributing to the scheme2015-01-010
2014: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01496
Total number of active participants reported on line 7a of the Form 55002014-01-01532
Total of all active and inactive participants2014-01-01532
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Number of employers contributing to the scheme2014-01-010
2013: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01497
Total number of active participants reported on line 7a of the Form 55002013-01-01569
Total of all active and inactive participants2013-01-01569
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Number of employers contributing to the scheme2013-01-010
2012: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01602
Total number of active participants reported on line 7a of the Form 55002012-07-01569
Total of all active and inactive participants2012-07-01569
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Number of employers contributing to the scheme2012-07-010
2011: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01602
Total number of active participants reported on line 7a of the Form 55002011-07-01597
Total of all active and inactive participants2011-07-01597
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total participants2011-07-01597
2010: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-01530
Total number of active participants reported on line 7a of the Form 55002010-07-01549
Total of all active and inactive participants2010-07-01549
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total participants2010-07-01549
2009: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01550
Total number of active participants reported on line 7a of the Form 55002009-07-01539
Total of all active and inactive participants2009-07-01539
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Number of employers contributing to the scheme2009-07-010
2008: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-07-01514
Total number of active participants reported on line 7a of the Form 55002008-07-01550
Total of all active and inactive participants2008-07-01550

Financial Data on FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2022 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,765,154
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$2,955,502
Total income from all sources (including contributions)2022-12-31$23,979,380
Total of all expenses incurred2022-12-31$27,701,495
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$26,504,062
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$23,979,380
Value of total assets at end of year2022-12-31$7,752,294
Value of total assets at beginning of year2022-12-31$12,664,757
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$1,197,433
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$4,416,436
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$16,933,186
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$272,029
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$558,284
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$19,526
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$57,180
Total non interest bearing cash at end of year2022-12-31$4,762,748
Total non interest bearing cash at beginning of year2022-12-31$6,138,642
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-3,722,115
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,987,140
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$9,709,255
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$9,553,732
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$19,562,944
Employer contributions (assets) at end of year2022-12-31$2,717,517
Employer contributions (assets) at beginning of year2022-12-31$5,967,831
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$17,144
Contract administrator fees2022-12-31$1,197,433
Liabilities. Value of benefit claims payable at end of year2022-12-31$1,745,628
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$2,898,322
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2022-12-31410746749
2021 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$2,955,502
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$3,460,441
Total income from all sources (including contributions)2021-12-31$28,791,621
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$27,585,414
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$25,905,065
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$28,791,621
Value of total assets at end of year2021-12-31$12,664,757
Value of total assets at beginning of year2021-12-31$11,963,489
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,680,349
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$6,300
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$10,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$4,450,283
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$15,682,720
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$558,284
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$549,367
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$57,180
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$133,224
Total non interest bearing cash at end of year2021-12-31$6,138,642
Total non interest bearing cash at beginning of year2021-12-31$8,459,276
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,206,207
Value of net assets at end of year (total assets less liabilities)2021-12-31$9,709,255
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$8,503,048
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$35,555
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$10,177,589
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$24,341,338
Employer contributions (assets) at end of year2021-12-31$5,967,831
Employer contributions (assets) at beginning of year2021-12-31$2,954,846
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$44,756
Contract administrator fees2021-12-31$1,638,494
Liabilities. Value of benefit claims payable at end of year2021-12-31$2,898,322
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$3,327,217
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2021-12-31410746749
2020 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k financial data
Total transfer of assets to this plan2020-12-31$1,791,303
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,460,441
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$255,748
Total income from all sources (including contributions)2020-12-31$33,126,625
Total of all expenses incurred2020-12-31$34,081,755
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$32,382,216
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$33,126,625
Value of total assets at end of year2020-12-31$11,963,489
Value of total assets at beginning of year2020-12-31$7,922,623
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,699,539
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$1,699,539
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$10,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$5,547,219
Participant contributions at end of year2020-12-31$2,954,846
Participant contributions at beginning of year2020-12-31$5,464,813
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$17,722,653
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$549,367
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$133,224
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$255,748
Total non interest bearing cash at end of year2020-12-31$8,459,276
Total non interest bearing cash at beginning of year2020-12-31$2,457,810
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-955,130
Value of net assets at end of year (total assets less liabilities)2020-12-31$8,503,048
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$7,666,875
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$14,531,897
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$27,579,406
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$127,666
Liabilities. Value of benefit claims payable at end of year2020-12-31$3,327,217
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2020-12-31410746749
2019 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$255,748
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$255,748
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,248,084
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,248,084
Total income from all sources (including contributions)2019-12-31$19,653,213
Total income from all sources (including contributions)2019-12-31$19,653,213
Total of all expenses incurred2019-12-31$15,516,512
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$13,981,241
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$13,981,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$19,653,213
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$19,653,213
Value of total assets at end of year2019-12-31$7,922,623
Value of total assets at end of year2019-12-31$7,922,623
Value of total assets at beginning of year2019-12-31$5,778,258
Value of total assets at beginning of year2019-12-31$5,778,258
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,535,271
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$10,000,000
Value of fidelity bond cover2019-12-31$10,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$2,851,337
Contributions received from participants2019-12-31$2,851,337
Participant contributions at end of year2019-12-31$5,464,813
Participant contributions at end of year2019-12-31$5,464,813
Participant contributions at beginning of year2019-12-31$5,466,258
Participant contributions at beginning of year2019-12-31$5,466,258
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$104,883
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$104,883
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$255,748
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$255,748
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$1,459,602
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$1,459,602
Total non interest bearing cash at end of year2019-12-31$2,457,810
Total non interest bearing cash at end of year2019-12-31$2,457,810
Total non interest bearing cash at beginning of year2019-12-31$312,000
Total non interest bearing cash at beginning of year2019-12-31$312,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$4,136,701
Value of net assets at end of year (total assets less liabilities)2019-12-31$7,666,875
Value of net assets at end of year (total assets less liabilities)2019-12-31$7,666,875
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,530,174
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,530,174
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,516,567
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,516,567
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$16,696,993
Contributions received in cash from employer2019-12-31$16,696,993
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$12,464,674
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$12,464,674
Contract administrator fees2019-12-31$1,535,271
Contract administrator fees2019-12-31$1,535,271
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$788,482
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$788,482
Did the plan have assets held for investment2019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31EIDE BAILLY LLP
Accountancy firm EIN2019-12-31450250958
2018 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,248,084
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,296,829
Total income from all sources (including contributions)2018-12-31$16,624,823
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$15,455,799
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$14,172,941
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$16,624,823
Value of total assets at end of year2018-12-31$5,778,258
Value of total assets at beginning of year2018-12-31$3,657,979
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,282,858
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$5,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$2,481,554
Participant contributions at end of year2018-12-31$5,466,258
Participant contributions at beginning of year2018-12-31$3,471,979
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$1,459,602
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$675,533
Total non interest bearing cash at end of year2018-12-31$312,000
Total non interest bearing cash at beginning of year2018-12-31$186,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$1,169,024
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,530,174
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,361,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$2,071,233
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$14,143,269
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$12,101,708
Contract administrator fees2018-12-31$1,282,858
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$788,482
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$621,296
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31EIDE BAILLY LLP
Accountancy firm EIN2018-12-31450250958
2017 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,296,829
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,112,892
Total income from all sources (including contributions)2017-12-31$12,629,430
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$12,736,826
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$11,680,491
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$12,629,430
Value of total assets at end of year2017-12-31$3,657,979
Value of total assets at beginning of year2017-12-31$3,581,438
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,056,335
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$5,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,866,195
Participant contributions at end of year2017-12-31$3,471,979
Participant contributions at beginning of year2017-12-31$3,162,932
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$675,533
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$706,428
Total non interest bearing cash at end of year2017-12-31$186,000
Total non interest bearing cash at beginning of year2017-12-31$418,506
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-107,396
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,361,150
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,468,546
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$1,545,604
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$10,763,235
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$10,134,887
Contract administrator fees2017-12-31$1,056,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$621,296
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$406,464
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31EIDE BAILLY LLP
Accountancy firm EIN2017-12-31450250958
2016 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$406,464
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$282,806
Total income from all sources (including contributions)2016-12-31$9,703,135
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$9,454,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$8,756,773
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$9,703,135
Value of total assets at end of year2016-12-31$3,581,438
Value of total assets at beginning of year2016-12-31$3,209,422
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$698,004
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$5,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,353,462
Participant contributions at end of year2016-12-31$3,162,932
Participant contributions at beginning of year2016-12-31$2,915,281
Total non interest bearing cash at end of year2016-12-31$418,506
Total non interest bearing cash at beginning of year2016-12-31$268,124
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$248,358
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,174,974
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,926,616
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$26,017
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$26,017
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$1,045,601
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$8,349,673
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$7,711,172
Contract administrator fees2016-12-31$698,004
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$406,464
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$282,806
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31EIDE BAILLY LLP
Accountancy firm EIN2016-12-31450250958
2015 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$967,050
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$3,126,768
Total income from all sources (including contributions)2015-12-31$8,414,979
Total of all expenses incurred2015-12-31$8,014,667
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$7,362,455
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$8,414,979
Value of total assets at end of year2015-12-31$3,209,422
Value of total assets at beginning of year2015-12-31$4,968,828
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$652,212
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$16,957
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$5,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$909,204
Participant contributions at end of year2015-12-31$2,915,281
Participant contributions at beginning of year2015-12-31$2,716,419
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$115,927
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$2,500,000
Administrative expenses (other) incurred2015-12-31$240,342
Total non interest bearing cash at end of year2015-12-31$268,124
Total non interest bearing cash at beginning of year2015-12-31$2,226,392
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$400,312
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,242,372
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,842,060
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$26,017
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$26,017
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$26,017
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$780,154
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$7,389,848
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$6,582,301
Contract administrator fees2015-12-31$394,913
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$967,050
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$626,768
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31EIDE BAILLY LLP
Accountancy firm EIN2015-12-31450250958
2014 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$3,126,768
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$666,028
Total income from all sources (including contributions)2014-12-31$5,287,683
Total of all expenses incurred2014-12-31$6,414,185
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$5,843,198
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$5,287,683
Value of total assets at end of year2014-12-31$4,968,828
Value of total assets at beginning of year2014-12-31$3,634,590
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$570,987
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$15,997
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$5,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$803,437
Participant contributions at end of year2014-12-31$2,716,419
Participant contributions at beginning of year2014-12-31$1,517,709
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$177,515
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$2,500,000
Total non interest bearing cash at end of year2014-12-31$2,226,392
Total non interest bearing cash at beginning of year2014-12-31$2,090,864
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-1,126,502
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,842,060
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,968,562
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$26,017
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$26,017
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$26,017
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$692,101
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$4,306,731
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$5,151,097
Contract administrator fees2014-12-31$554,990
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$626,768
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$666,028
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31EIDE BAILLY LLP
Accountancy firm EIN2014-12-31450250958
2013 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$666,028
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$828,000
Total income from all sources (including contributions)2013-12-31$8,351,654
Total of all expenses incurred2013-12-31$6,922,876
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$6,302,520
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$8,351,654
Value of total assets at end of year2013-12-31$3,634,590
Value of total assets at beginning of year2013-12-31$2,367,784
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$620,356
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$21,994
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$5,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$861,061
Participant contributions at end of year2013-12-31$1,517,709
Participant contributions at beginning of year2013-12-31$805,509
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$134,576
Total non interest bearing cash at end of year2013-12-31$2,090,864
Total non interest bearing cash at beginning of year2013-12-31$1,536,258
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,428,778
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,968,562
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,539,784
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$26,017
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$26,017
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$26,017
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$599,385
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$7,356,017
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$5,703,135
Contract administrator fees2013-12-31$598,362
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$666,028
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$828,000
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31EIDE BAILLY LLP
Accountancy firm EIN2013-12-31450250958
2012 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$828,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,125,840
Total income from all sources (including contributions)2012-12-31$4,779,386
Total of all expenses incurred2012-12-31$4,266,174
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,969,957
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$4,779,386
Value of total assets at end of year2012-12-31$2,367,784
Value of total assets at beginning of year2012-12-31$2,152,412
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$296,217
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$9,993
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$5,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$350,059
Participant contributions at end of year2012-12-31$805,509
Participant contributions at beginning of year2012-12-31$913,260
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$83,341
Liabilities. Value of operating payables at beginning of year2012-12-31$43,840
Total non interest bearing cash at end of year2012-12-31$1,536,258
Total non interest bearing cash at beginning of year2012-12-31$1,213,135
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$513,212
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,539,784
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,026,572
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$26,017
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$26,017
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$26,017
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$266,213
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$4,345,986
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$3,703,744
Contract administrator fees2012-12-31$286,224
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$828,000
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$1,082,000
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31EIDE BAILLY LLP
Accountancy firm EIN2012-12-31450250958
Total unrealized appreciation/depreciation of assets2012-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$1,125,840
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$720,000
Total income from all sources (including contributions)2012-06-30$9,986,880
Total loss/gain on sale of assets2012-06-30$0
Total of all expenses incurred2012-06-30$8,708,208
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$8,107,140
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$9,986,880
Value of total assets at end of year2012-06-30$2,152,412
Value of total assets at beginning of year2012-06-30$467,900
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$601,068
Total interest from all sources2012-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$5,000,000
If this is an individual account plan, was there a blackout period2012-06-30No
Were there any nonexempt tranactions with any party-in-interest2012-06-30Yes
Amount of non-exempt transactions with any party-in-interest2012-06-30$1,200,000
Contributions received from participants2012-06-30$736,593
Participant contributions at end of year2012-06-30$913,260
Income. Received or receivable in cash from other sources (including rollovers)2012-06-30$105,221
Liabilities. Value of operating payables at end of year2012-06-30$43,840
Total non interest bearing cash at end of year2012-06-30$1,213,135
Total non interest bearing cash at beginning of year2012-06-30$441,883
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$1,278,672
Value of net assets at end of year (total assets less liabilities)2012-06-30$1,026,572
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$-252,100
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-06-30$26,017
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-06-30$26,017
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-06-30$26,017
Expenses. Payments to insurance carriers foe the provision of benefits2012-06-30$666,731
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$9,145,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$7,440,409
Contract administrator fees2012-06-30$601,068
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-06-30No
Liabilities. Value of benefit claims payable at end of year2012-06-30$1,082,000
Liabilities. Value of benefit claims payable at beginning of year2012-06-30$720,000
Did the plan have assets held for investment2012-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30No
Opinion of an independent qualified public accountant for this plan2012-06-30Unqualified
Accountancy firm name2012-06-30EIDE BAILLY LLP
Accountancy firm EIN2012-06-30450250958
2011 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$720,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$715,987
Total income from all sources (including contributions)2011-06-30$8,162,480
Total loss/gain on sale of assets2011-06-30$0
Total of all expenses incurred2011-06-30$7,883,610
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$7,330,382
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$8,162,480
Value of total assets at end of year2011-06-30$467,900
Value of total assets at beginning of year2011-06-30$185,017
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$553,228
Total interest from all sources2011-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2011-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$5,000,000
If this is an individual account plan, was there a blackout period2011-06-30No
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Amount of non-exempt transactions with any party-in-interest2011-06-30$2,800,000
Contributions received from participants2011-06-30$632,327
Income. Received or receivable in cash from other sources (including rollovers)2011-06-30$127,187
Liabilities. Value of operating payables at beginning of year2011-06-30$229,087
Total non interest bearing cash at end of year2011-06-30$441,883
Total non interest bearing cash at beginning of year2011-06-30$159,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$278,870
Value of net assets at end of year (total assets less liabilities)2011-06-30$-252,100
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$-530,970
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-06-30$26,017
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-06-30$26,017
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-06-30$26,017
Expenses. Payments to insurance carriers foe the provision of benefits2011-06-30$534,816
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$7,402,966
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$6,795,566
Contract administrator fees2011-06-30$553,228
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-06-30No
Liabilities. Value of benefit claims payable at end of year2011-06-30$720,000
Liabilities. Value of benefit claims payable at beginning of year2011-06-30$486,900
Did the plan have assets held for investment2011-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30No
Opinion of an independent qualified public accountant for this plan2011-06-30Unqualified
Accountancy firm name2011-06-30EIDE BAILLY LLP
Accountancy firm EIN2011-06-30450250958
2010 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-06-30$715,987
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-06-30$1,086,900
Total income from all sources (including contributions)2010-06-30$7,247,523
Total of all expenses incurred2010-06-30$7,226,702
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-06-30$6,747,661
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-06-30$7,247,521
Value of total assets at end of year2010-06-30$185,017
Value of total assets at beginning of year2010-06-30$535,109
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-06-30$479,041
Total interest from all sources2010-06-30$2
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-06-30No
Administrative expenses professional fees incurred2010-06-30$28,502
Was this plan covered by a fidelity bond2010-06-30Yes
Value of fidelity bond cover2010-06-30$5,000,000
If this is an individual account plan, was there a blackout period2010-06-30No
Were there any nonexempt tranactions with any party-in-interest2010-06-30No
Contributions received from participants2010-06-30$710,104
Assets. Other investments not covered elsewhere at beginning of year2010-06-30$47,178
Liabilities. Value of operating payables at end of year2010-06-30$229,087
Liabilities. Value of operating payables at beginning of year2010-06-30$600,000
Total non interest bearing cash at end of year2010-06-30$159,000
Total non interest bearing cash at beginning of year2010-06-30$461,916
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-06-30No
Value of net income/loss2010-06-30$20,821
Value of net assets at end of year (total assets less liabilities)2010-06-30$-530,970
Value of net assets at beginning of year (total assets less liabilities)2010-06-30$-551,791
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2010-06-30No
Were any leases to which the plan was party in default or uncollectible2010-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-06-30$26,017
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-06-30$26,015
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-06-30$26,015
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-06-30$2
Expenses. Payments to insurance carriers foe the provision of benefits2010-06-30$477,142
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-06-30No
Was there a failure to transmit to the plan any participant contributions2010-06-30No
Has the plan failed to provide any benefit when due under the plan2010-06-30No
Contributions received in cash from employer2010-06-30$6,537,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-06-30$6,270,519
Contract administrator fees2010-06-30$450,539
Liabilities. Value of benefit claims payable at end of year2010-06-30$486,900
Liabilities. Value of benefit claims payable at beginning of year2010-06-30$486,900
Did the plan have assets held for investment2010-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-06-30No
Opinion of an independent qualified public accountant for this plan2010-06-30Unqualified
Accountancy firm name2010-06-30EIDE BAILLY LLP
Accountancy firm EIN2010-06-30450250958
2009 : FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2009 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2009-06-30$1,086,900
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2009-06-30$275,000
Total income from all sources (including contributions)2009-06-30$6,223,090
Total of all expenses incurred2009-06-30$6,634,526
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2009-06-30$6,012,676
Total contributions o plan (from employers,participants, others, non cash contrinutions)2009-06-30$6,222,850
Value of total assets at end of year2009-06-30$535,109
Value of total assets at beginning of year2009-06-30$134,645
Total of administrative expenses incurred including professional, contract, advisory and management fees2009-06-30$621,850
Total interest from all sources2009-06-30$240
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2009-06-30No
Administrative expenses professional fees incurred2009-06-30$10,850
Was this plan covered by a fidelity bond2009-06-30Yes
Value of fidelity bond cover2009-06-30$5,000,000
If this is an individual account plan, was there a blackout period2009-06-30No
Were there any nonexempt tranactions with any party-in-interest2009-06-30Yes
Amount of non-exempt transactions with any party-in-interest2009-06-30$3,100,000
Contributions received from participants2009-06-30$666,406
Assets. Other investments not covered elsewhere at end of year2009-06-30$47,178
Liabilities. Value of operating payables at end of year2009-06-30$600,000
Total non interest bearing cash at end of year2009-06-30$461,916
Total non interest bearing cash at beginning of year2009-06-30$108,870
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2009-06-30No
Value of net income/loss2009-06-30$-411,436
Value of net assets at end of year (total assets less liabilities)2009-06-30$-551,791
Value of net assets at beginning of year (total assets less liabilities)2009-06-30$-140,355
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2009-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2009-06-30No
Were any leases to which the plan was party in default or uncollectible2009-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2009-06-30$26,015
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2009-06-30$25,775
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2009-06-30$25,775
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2009-06-30$240
Expenses. Payments to insurance carriers foe the provision of benefits2009-06-30$616,902
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2009-06-30No
Was there a failure to transmit to the plan any participant contributions2009-06-30No
Has the plan failed to provide any benefit when due under the plan2009-06-30No
Contributions received in cash from employer2009-06-30$5,556,444
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2009-06-30$5,395,774
Contract administrator fees2009-06-30$611,000
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32009-06-30No
Liabilities. Value of benefit claims payable at end of year2009-06-30$486,900
Liabilities. Value of benefit claims payable at beginning of year2009-06-30$275,000
Did the plan have assets held for investment2009-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2009-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2009-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2009-06-30No
Opinion of an independent qualified public accountant for this plan2009-06-30Unqualified
Accountancy firm name2009-06-30EIDE BAILLY LLP
Accountancy firm EIN2009-06-30450250958

Form 5500 Responses for FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN

2022: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedYes
2012-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2012-07-01Plan benefit arrangement – General assets of the sponsorYes
2011: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedYes
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan funding arrangement – General assets of the sponsorYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2011-07-01Plan benefit arrangement – General assets of the sponsorYes
2010: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedYes
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan funding arrangement – General assets of the sponsorYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement - TrustYes
2010-07-01Plan benefit arrangement – General assets of the sponsorYes
2009: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedYes
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes
2008: FLATIRON CONSTRUCTION CORP. EMPLOYEE HEALTH BENEFIT PLAN 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01Submission has been amendedYes
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan funding arrangement – TrustYes
2008-07-01Plan benefit arrangement – InsuranceYes
2008-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number805217G
Policy instance 5
Insurance contract or identification number805217G
Number of Individuals Covered478
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $237
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $11,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees237
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 4
Insurance contract or identification number478838
Number of Individuals Covered1016
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $129
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,386,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees129
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202956
Policy instance 3
Insurance contract or identification numberUNI-202956
Number of Individuals Covered1079
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $84,486
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,689,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $84,486
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA BEHAVIORAL HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: N/A )
Policy contract number3228
Policy instance 2
Insurance contract or identification number3228
Number of Individuals Covered3018
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $5,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 1
Insurance contract or identification number201720
Number of Individuals Covered1190
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $740
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $715,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $740
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered1060
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $211,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered1243
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,109
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $682,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,109
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $-86,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 5
Insurance contract or identification number478838
Number of Individuals Covered1052
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $7,559,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number805217G
Policy instance 6
Insurance contract or identification number805217G
Number of Individuals Covered503
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $401
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees401
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202956
Policy instance 4
Insurance contract or identification numberUNI-202956
Number of Individuals Covered1038
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,617,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered1123
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered1125
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered1243
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $912
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $828,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $912
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202956
Policy instance 4
Insurance contract or identification numberUNI-202956
Number of Individuals Covered1109
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,523,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 5
Insurance contract or identification number478838
Number of Individuals Covered1065
Insurance policy start date2020-01-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 6
Insurance contract or identification number478838
Number of Individuals Covered1752
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,535,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number805217G
Policy instance 7
Insurance contract or identification number805217G
Number of Individuals Covered768
Insurance policy start date2020-03-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $16,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered1115
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered1261
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $782
Total amount of fees paid to insurance companyUSD $15,636
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $758,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $422
Amount paid for insurance broker fees15636
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered2648
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,855,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 3
Insurance contract or identification number478838
Number of Individuals Covered1917
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $140
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $7,897,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees88
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered1017
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $178,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered1195
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $800
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $518,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees800
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 4
Insurance contract or identification number3206676
Number of Individuals Covered2418
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,497,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered2418
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,497,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered770
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $137,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered1960
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,123,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 4
Insurance contract or identification number3206676
Number of Individuals Covered1960
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,123,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 3
Insurance contract or identification number478838
Number of Individuals Covered1401
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $87
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,540,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees87
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered859
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $633
Total amount of fees paid to insurance companyUSD $5,549
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $424,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $633
Amount paid for insurance broker fees5549
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameTHE HAYS GROUP
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered702
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $268
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $322,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $159
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered624
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $108,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered1574
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $819,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 4
Insurance contract or identification number12122384
Number of Individuals Covered505
Insurance policy start date2015-07-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 4
Insurance contract or identification number3206676
Number of Individuals Covered1266
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $622,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 3
Insurance contract or identification number478838
Number of Individuals Covered596
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $27,422
Total amount of fees paid to insurance companyUSD $9,310
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,192,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,422
Amount paid for insurance broker fees9310
Additional information about fees paid to insurance broker2014/2015 PPP ENGAGEMENT CREDIT
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES OF CO
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered571
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $267,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered506
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered1266
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $622,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered1281
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $538,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 4
Insurance contract or identification number3206676
Number of Individuals Covered1281
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $538,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered526
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $230,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered467
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 3
Insurance contract or identification number478838
Number of Individuals Covered260
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,926
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $767,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,926
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES OF CO
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 4
Insurance contract or identification number3206676
Number of Individuals Covered1269
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $498,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 3
Insurance contract or identification number478838
Number of Individuals Covered168
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $14,376
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $898,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,376
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES OF CO
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered510
Insurance policy start date2013-01-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered500
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $241,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered1269
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $498,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 3
Insurance contract or identification number3206676
Number of Individuals Covered1570
Insurance policy start date2012-07-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $185,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered601
Insurance policy start date2012-07-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $131,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 3
Insurance contract or identification number478838
Number of Individuals Covered418
Insurance policy start date2012-07-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $11,903
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $782,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,903
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES OF CO
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3206676
Policy instance 4
Insurance contract or identification number3206676
Number of Individuals Covered1570
Insurance policy start date2012-07-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $185,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered602
Insurance policy start date2012-07-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 4
Insurance contract or identification number478838
Number of Individuals Covered561
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $41,590
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,515,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 1
Insurance contract or identification number12122384
Number of Individuals Covered634
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number66621-1
Policy instance 2
Insurance contract or identification number66621-1
Number of Individuals Covered629
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $480,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 2
Insurance contract or identification number201720
Number of Individuals Covered598
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $297,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 3
Insurance contract or identification number201720
Number of Individuals Covered598
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $297,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY - ING (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number66621-1
Policy instance 1
Insurance contract or identification number66621-1
Number of Individuals Covered629
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $7,560
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $480,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,560
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 3
Insurance contract or identification number12122384
Number of Individuals Covered634
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478838
Policy instance 5
Insurance contract or identification number478838
Number of Individuals Covered859
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $36,681
Total amount of fees paid to insurance companyUSD $-11
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,626,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 4
Insurance contract or identification number201720
Number of Individuals Covered550
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $2,367
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $233,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
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
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $2,367
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY - ING (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number66621-1
Policy instance 3
Insurance contract or identification number66621-1
Number of Individuals Covered550
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $7,560
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $382,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
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
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $7,560
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 2
Insurance contract or identification number12122384
Number of Individuals Covered579
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
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
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3206676
Policy instance 1
Insurance contract or identification number3206676
Number of Individuals Covered1440
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedASO
Welfare Benefit Premiums Paid to CarrierUSD $207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
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
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3206676
Policy instance 1
Insurance contract or identification number3206676
Number of Individuals Covered0
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedASO
Welfare Benefit Premiums Paid to CarrierUSD $-69
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 2
Insurance contract or identification number12122384
Number of Individuals Covered539
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY - ING (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number66621-1
Policy instance 3
Insurance contract or identification number66621-1
Number of Individuals Covered524
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $348,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number201720
Policy instance 4
Insurance contract or identification number201720
Number of Individuals Covered524
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $2,134
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $201,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,134
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12122384
Policy instance 2
Insurance contract or identification number12122384
Number of Individuals Covered516
Insurance policy start date2008-07-01
Insurance policy end date2009-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3206676
Policy instance 1
Insurance contract or identification number3206676
Number of Individuals Covered550
Insurance policy start date2008-07-01
Insurance policy end date2009-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedASO
Welfare Benefit Premiums Paid to CarrierUSD $440,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberOCLIGSR12957
Policy instance 3
Insurance contract or identification numberOCLIGSR12957
Number of Individuals Covered560
Insurance policy start date2008-07-01
Insurance policy end date2009-07-01
Total amount of commissions paid to insurance brokerUSD $2,277
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $15,874
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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