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AMICA HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameAMICA HEALTH AND WELFARE PLAN
Plan identification number 501

AMICA HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

AMICA MUTUAL INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:AMICA MUTUAL INSURANCE COMPANY
Employer identification number (EIN):050348344
NAIC Classification:524150

Additional information about AMICA MUTUAL INSURANCE COMPANY

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 565037

More information about AMICA MUTUAL INSURANCE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMICA HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01SAMUEL C. PALMISANO2023-10-10
5012021-01-01JILL H. ANDY2022-09-23
5012020-01-01JILL H. ANDY2021-10-08
5012020-01-01
5012019-01-01
5012019-01-01
5012018-01-01
5012017-01-01JILL H. ANDY
5012016-01-01JILL H. ANDY
5012015-01-01JILL H. ANDY
5012014-01-01JILL H. ANDY
5012013-01-01JILL ANDY, SENIOR VICE PRESIDENT JILL ANDY, SENIOR VICE PRESIDENT2014-09-11
5012012-01-01MARY WILLIAMSON, VICE PRESIDENT MARY WILLIAMSON, VICE PRESIDENT2013-09-12
5012011-01-01MARY WILLIAMSON, VICE PRESIDENT MARY WILLIAMSON, VICE PRESIDENT2012-09-13
5012009-01-01MARY WILLIAMSON, VICE PRESIDENT MARY WILLIAMSON, VICE PRESIDENT2010-09-14
5012007-01-01MARIBETH WILLIAMSON, VICE PRESIDENT MARIBETH WILLIAMSON, VICE PRESIDENT2010-04-05
5012006-01-01MARIBETH WILLIAMSON, VICE PRESIDENT MARIBETH WILLIAMSON, VICE PRESIDENT2010-04-05

Plan Statistics for AMICA HEALTH AND WELFARE PLAN

401k plan membership statisitcs for AMICA HEALTH AND WELFARE PLAN

Measure Date Value
2022: AMICA HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-013,468
Total number of active participants reported on line 7a of the Form 55002022-01-013,486
Total of all active and inactive participants2022-01-013,486
Total participants2022-01-010
2021: AMICA HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-015,431
Total number of active participants reported on line 7a of the Form 55002021-01-013,468
Total of all active and inactive participants2021-01-013,468
Total participants2021-01-010
2020: AMICA HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-015,543
Total number of active participants reported on line 7a of the Form 55002020-01-013,803
Number of retired or separated participants receiving benefits2020-01-011,628
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-015,431
Total participants2020-01-010
2019: AMICA HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-015,286
Total number of active participants reported on line 7a of the Form 55002019-01-013,984
Number of retired or separated participants receiving benefits2019-01-011,559
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-015,543
2018: AMICA HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-015,164
Total number of active participants reported on line 7a of the Form 55002018-01-013,771
Number of retired or separated participants receiving benefits2018-01-011,515
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-015,286
2017: AMICA HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-015,053
Total number of active participants reported on line 7a of the Form 55002017-01-013,673
Number of retired or separated participants receiving benefits2017-01-011,491
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-015,164
2016: AMICA HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-014,924
Total number of active participants reported on line 7a of the Form 55002016-01-013,645
Number of retired or separated participants receiving benefits2016-01-011,408
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-015,053
2015: AMICA HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-014,689
Total number of active participants reported on line 7a of the Form 55002015-01-013,555
Number of retired or separated participants receiving benefits2015-01-011,369
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-014,924
2014: AMICA HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-014,529
Total number of active participants reported on line 7a of the Form 55002014-01-013,367
Number of retired or separated participants receiving benefits2014-01-011,322
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-014,689
2013: AMICA HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-014,401
Total number of active participants reported on line 7a of the Form 55002013-01-013,233
Number of retired or separated participants receiving benefits2013-01-011,296
Total of all active and inactive participants2013-01-014,529
2012: AMICA HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-014,470
Total number of active participants reported on line 7a of the Form 55002012-01-013,137
Number of retired or separated participants receiving benefits2012-01-011,264
Total of all active and inactive participants2012-01-014,401
2011: AMICA HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-014,470
Total number of active participants reported on line 7a of the Form 55002011-01-013,081
Number of retired or separated participants receiving benefits2011-01-011,230
Total of all active and inactive participants2011-01-014,311
2009: AMICA HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-014,279
Total number of active participants reported on line 7a of the Form 55002009-01-013,180
Number of retired or separated participants receiving benefits2009-01-011,138
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-014,318
2007: AMICA HEALTH AND WELFARE PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-014,151
Total number of active participants reported on line 7a of the Form 55002007-01-013,009
Number of retired or separated participants receiving benefits2007-01-011,183
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-014,192
2006: AMICA HEALTH AND WELFARE PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-014,118
Total number of active participants reported on line 7a of the Form 55002006-01-013,007
Number of retired or separated participants receiving benefits2006-01-011,144
Number of other retired or separated participants entitled to future benefits2006-01-010
Total of all active and inactive participants2006-01-014,151

Financial Data on AMICA HEALTH AND WELFARE PLAN

Measure Date Value
2020 : AMICA HEALTH AND WELFARE PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$4,420,283
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,761,791
Total income from all sources (including contributions)2020-12-31$75,198,338
Total of all expenses incurred2020-12-31$67,693,085
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$64,243,313
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$59,263,465
Value of total assets at end of year2020-12-31$148,592,318
Value of total assets at beginning of year2020-12-31$140,428,573
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$3,449,772
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
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$14,893,618
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$89,449
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$57,234,771
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$7,505,253
Value of net assets at end of year (total assets less liabilities)2020-12-31$144,172,035
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$136,666,782
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in master investment trust accounts at end of year2020-12-31$148,592,318
Value of interest in master investment trust accounts at beginning of year2020-12-31$140,428,573
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$7,008,542
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$44,280,398
Contract administrator fees2020-12-31$3,449,772
Liabilities. Value of benefit claims payable at end of year2020-12-31$4,420,283
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$3,761,791
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 name2020-12-31KPMG LLP
Accountancy firm EIN2020-12-31135565207
2019 : AMICA HEALTH AND WELFARE PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets from this plan2019-12-31$166,375,716
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,761,791
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$8,149,658
Total income from all sources (including contributions)2019-12-31$79,929,889
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$64,936,743
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$61,873,776
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$57,227,687
Value of total assets at end of year2019-12-31$140,428,573
Value of total assets at beginning of year2019-12-31$296,199,010
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,062,967
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2019-12-31$106,000
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$10,000,000
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
Contributions received from participants2019-12-31$13,807,187
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$54,083,619
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$103,000
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$55,370,905
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$1,154,954
Assets. Loans (other than to participants) at beginning of year2019-12-31$2,116,152
Liabilities. Value of operating payables at beginning of year2019-12-31$4,385,142
Total non interest bearing cash at beginning of year2019-12-31$757
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$14,993,146
Value of net assets at end of year (total assets less liabilities)2019-12-31$136,666,782
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$288,049,352
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 leases to which the plan was party in default or uncollectible2019-12-31No
Assets. partnership/joint venture interests at beginning of year2019-12-31$20,585,310
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,932,832
Value of interest in master investment trust accounts at end of year2019-12-31$140,428,573
Value of interest in master investment trust accounts at beginning of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$55,223,369
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$9,493,018
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$9,493,018
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$6,502,871
Asset value of US Government securities at beginning of year2019-12-31$16,083,548
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
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$43,317,500
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$8,355,003
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$20,613,678
Contract administrator fees2019-12-31$3,062,967
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$105,450,770
Liabilities. Value of benefit claims payable at end of year2019-12-31$3,761,791
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$3,764,516
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31KPMG LLP
Accountancy firm EIN2019-12-31135565207
2018 : AMICA HEALTH AND WELFARE PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$-22,800,511
Total unrealized appreciation/depreciation of assets2018-12-31$-22,800,511
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$8,149,658
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,365,475
Total income from all sources (including contributions)2018-12-31$62,649,067
Total loss/gain on sale of assets2018-12-31$14,393,993
Total of all expenses incurred2018-12-31$74,516,489
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$71,493,528
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$74,022,512
Value of total assets at end of year2018-12-31$296,199,010
Value of total assets at beginning of year2018-12-31$303,282,249
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$3,022,961
Total interest from all sources2018-12-31$3,448,860
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$2,883,668
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$67,731
Assets. Corporate prefeered stocks other than exployer securities at end of year2018-12-31$106,000
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$10,000,000
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$13,533,093
Assets. Other investments not covered elsewhere at end of year2018-12-31$54,083,619
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$54,130,827
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$123,153
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$63,697,727
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$1,154,954
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$924,940
Assets. Loans (other than to participants) at end of year2018-12-31$2,116,152
Assets. Loans (other than to participants) at beginning of year2018-12-31$1,620,394
Other income not declared elsewhere2018-12-31$-43,953
Liabilities. Value of operating payables at end of year2018-12-31$4,385,142
Liabilities. Value of operating payables at beginning of year2018-12-31$94,936
Total non interest bearing cash at end of year2018-12-31$757
Total non interest bearing cash at beginning of year2018-12-31$1,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-11,867,422
Value of net assets at end of year (total assets less liabilities)2018-12-31$288,049,352
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$299,916,774
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
Assets. partnership/joint venture interests at end of year2018-12-31$20,585,310
Assets. partnership/joint venture interests at beginning of year2018-12-31$15,990,226
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,932,832
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$0
Income. Interest from loans (other than to participants)2018-12-31$83,338
Interest earned on other investments2018-12-31$1,828,297
Income. Interest from US Government securities2018-12-31$405,043
Income. Interest from corporate debt instruments2018-12-31$1,072,613
Value of interest in common/collective trusts at end of year2018-12-31$55,223,369
Value of interest in common/collective trusts at beginning of year2018-12-31$49,805,273
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$9,493,018
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$3,022,915
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$3,022,915
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$59,569
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$6,291,176
Asset value of US Government securities at end of year2018-12-31$16,083,548
Asset value of US Government securities at beginning of year2018-12-31$14,289,627
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-704,629
Net investment gain or loss from common/collective trusts2018-12-31$-8,550,873
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
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$60,366,266
Income. Dividends from preferred stock2018-12-31$2,363
Income. Dividends from common stock2018-12-31$2,813,574
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,504,625
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$8,355,003
Asset. Corporate debt instrument preferred debt at beginning of year2018-12-31$6,236,108
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$20,613,678
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$20,415,509
Contract administrator fees2018-12-31$3,022,961
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$105,450,770
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$136,845,255
Liabilities. Value of benefit claims payable at end of year2018-12-31$3,764,516
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$3,270,539
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$653,905,168
Aggregate carrying amount (costs) on sale of assets2018-12-31$639,511,175
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 name2018-12-31KPMG LLP
Accountancy firm EIN2018-12-31135565207
2017 : AMICA HEALTH AND WELFARE PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$15,021,862
Total unrealized appreciation/depreciation of assets2017-12-31$15,021,862
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$3,365,475
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$7,979,415
Total income from all sources (including contributions)2017-12-31$104,430,776
Total loss/gain on sale of assets2017-12-31$6,376,078
Total of all expenses incurred2017-12-31$66,909,092
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$64,273,130
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$66,286,607
Value of total assets at end of year2017-12-31$303,282,249
Value of total assets at beginning of year2017-12-31$270,374,505
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,635,962
Total interest from all sources2017-12-31$2,674,161
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$2,904,314
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$10,000,000
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$12,888,364
Assets. Other investments not covered elsewhere at end of year2017-12-31$54,130,827
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$44,771,062
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$466,134
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$57,028,885
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$924,940
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$5,656,045
Assets. Loans (other than to participants) at end of year2017-12-31$1,620,394
Assets. Loans (other than to participants) at beginning of year2017-12-31$643,364
Other income not declared elsewhere2017-12-31$-4,274
Liabilities. Value of operating payables at end of year2017-12-31$94,936
Liabilities. Value of operating payables at beginning of year2017-12-31$5,331,361
Total non interest bearing cash at end of year2017-12-31$1,175
Total non interest bearing cash at beginning of year2017-12-31$286,184
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$37,521,684
Value of net assets at end of year (total assets less liabilities)2017-12-31$299,916,774
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$262,395,090
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
Assets. partnership/joint venture interests at end of year2017-12-31$15,990,226
Assets. partnership/joint venture interests at beginning of year2017-12-31$12,632,172
Income. Interest from loans (other than to participants)2017-12-31$53,803
Interest earned on other investments2017-12-31$1,483,736
Income. Interest from US Government securities2017-12-31$382,234
Income. Interest from corporate debt instruments2017-12-31$734,704
Value of interest in common/collective trusts at end of year2017-12-31$49,805,273
Value of interest in common/collective trusts at beginning of year2017-12-31$38,649,150
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$3,022,915
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$16,229,704
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$16,229,704
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$19,684
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$6,114,433
Asset value of US Government securities at end of year2017-12-31$14,289,627
Asset value of US Government securities at beginning of year2017-12-31$11,602,271
Net investment gain or loss from common/collective trusts2017-12-31$11,172,028
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
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$52,932,109
Income. Dividends from common stock2017-12-31$2,904,314
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,129,812
Asset. Corporate debt instrument preferred debt at end of year2017-12-31$6,236,108
Asset. Corporate debt instrument preferred debt at beginning of year2017-12-31$6,622,459
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$20,415,509
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$3,300,938
Contract administrator fees2017-12-31$2,635,962
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$136,845,255
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$129,981,156
Liabilities. Value of benefit claims payable at end of year2017-12-31$3,270,539
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$2,648,054
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$524,169,614
Aggregate carrying amount (costs) on sale of assets2017-12-31$517,793,536
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 name2017-12-31KPMG LLP
Accountancy firm EIN2017-12-31135565207
2016 : AMICA HEALTH AND WELFARE PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$7,658,729
Total unrealized appreciation/depreciation of assets2016-12-31$7,658,729
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$7,979,415
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$3,040,421
Total income from all sources (including contributions)2016-12-31$89,579,524
Total loss/gain on sale of assets2016-12-31$5,744,527
Total of all expenses incurred2016-12-31$69,088,555
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$66,625,628
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$69,000,731
Value of total assets at end of year2016-12-31$270,374,505
Value of total assets at beginning of year2016-12-31$244,944,542
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,462,927
Total interest from all sources2016-12-31$2,176,944
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$2,944,181
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$10,000,000
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$12,661,220
Assets. Other investments not covered elsewhere at end of year2016-12-31$44,771,062
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$37,838,885
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$125,607
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$59,933,392
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$5,656,045
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$649,779
Assets. Loans (other than to participants) at end of year2016-12-31$643,364
Assets. Loans (other than to participants) at beginning of year2016-12-31$177,423
Other income not declared elsewhere2016-12-31$-15,489
Administrative expenses (other) incurred2016-12-31$3,229
Liabilities. Value of operating payables at end of year2016-12-31$5,331,361
Liabilities. Value of operating payables at beginning of year2016-12-31$480,191
Total non interest bearing cash at end of year2016-12-31$286,184
Total non interest bearing cash at beginning of year2016-12-31$1,094
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$20,490,969
Value of net assets at end of year (total assets less liabilities)2016-12-31$262,395,090
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$241,904,121
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
Assets. partnership/joint venture interests at end of year2016-12-31$12,632,172
Assets. partnership/joint venture interests at beginning of year2016-12-31$10,448,116
Income. Interest from loans (other than to participants)2016-12-31$17,489
Interest earned on other investments2016-12-31$1,271,723
Income. Interest from US Government securities2016-12-31$367,766
Income. Interest from corporate debt instruments2016-12-31$369,681
Value of interest in common/collective trusts at end of year2016-12-31$38,649,150
Value of interest in common/collective trusts at beginning of year2016-12-31$35,549,355
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$16,229,704
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$13,167,537
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$13,167,537
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$150,285
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$5,835,163
Asset value of US Government securities at end of year2016-12-31$11,602,271
Asset value of US Government securities at beginning of year2016-12-31$14,907,097
Net investment gain or loss from common/collective trusts2016-12-31$2,069,901
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
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$56,213,904
Income. Dividends from common stock2016-12-31$2,944,181
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$857,073
Asset. Corporate debt instrument preferred debt at end of year2016-12-31$6,622,459
Asset. Corporate debt instrument preferred debt at beginning of year2016-12-31$4,619,432
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$3,300,938
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$5,948,764
Contract administrator fees2016-12-31$2,459,698
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$129,981,156
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$121,637,060
Liabilities. Value of benefit claims payable at end of year2016-12-31$2,648,054
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$2,560,230
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$52,872,850
Aggregate carrying amount (costs) on sale of assets2016-12-31$47,128,323
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31KPMG LLP
Accountancy firm EIN2016-12-31135565207
2015 : AMICA HEALTH AND WELFARE PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-12,083,419
Total unrealized appreciation/depreciation of assets2015-12-31$-12,083,419
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$3,040,421
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$16,171,592
Total income from all sources (including contributions)2015-12-31$63,274,513
Total loss/gain on sale of assets2015-12-31$6,274,994
Total of all expenses incurred2015-12-31$65,816,936
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$63,505,529
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$66,028,299
Value of total assets at end of year2015-12-31$244,944,542
Value of total assets at beginning of year2015-12-31$260,618,136
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,311,407
Total interest from all sources2015-12-31$2,076,990
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$2,820,384
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$10,000,000
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$13,274,236
Assets. Other investments not covered elsewhere at end of year2015-12-31$37,838,885
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$19,901,901
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$141,916
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$57,799,163
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$649,779
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$13,498,543
Assets. Loans (other than to participants) at end of year2015-12-31$177,423
Assets. Loans (other than to participants) at beginning of year2015-12-31$0
Other income not declared elsewhere2015-12-31$-19,158
Administrative expenses (other) incurred2015-12-31$40,497
Liabilities. Value of operating payables at end of year2015-12-31$480,191
Liabilities. Value of operating payables at beginning of year2015-12-31$13,400,000
Total non interest bearing cash at end of year2015-12-31$1,094
Total non interest bearing cash at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-2,542,423
Value of net assets at end of year (total assets less liabilities)2015-12-31$241,904,121
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$244,446,544
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
Assets. partnership/joint venture interests at end of year2015-12-31$10,448,116
Assets. partnership/joint venture interests at beginning of year2015-12-31$8,091,613
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$30,433,648
Income. Interest from loans (other than to participants)2015-12-31$4,157
Interest earned on other investments2015-12-31$979,833
Income. Interest from US Government securities2015-12-31$505,161
Income. Interest from corporate debt instruments2015-12-31$486,642
Value of interest in common/collective trusts at end of year2015-12-31$35,549,355
Value of interest in common/collective trusts at beginning of year2015-12-31$2,549,285
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$13,167,537
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$11,352,650
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$11,352,650
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$101,197
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$5,145,343
Asset value of US Government securities at end of year2015-12-31$14,907,097
Asset value of US Government securities at beginning of year2015-12-31$29,441,720
Net investment gain or loss from common/collective trusts2015-12-31$-1,823,577
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
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$52,612,147
Income. Dividends from common stock2015-12-31$2,820,384
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$561,023
Asset. Corporate debt instrument preferred debt at end of year2015-12-31$4,619,432
Asset. Corporate debt instrument preferred debt at beginning of year2015-12-31$8,997,623
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$5,948,764
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$6,348,060
Contract administrator fees2015-12-31$2,270,910
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$121,637,060
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$130,003,093
Liabilities. Value of benefit claims payable at end of year2015-12-31$2,560,230
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$2,771,592
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$58,924,731
Aggregate carrying amount (costs) on sale of assets2015-12-31$52,649,737
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 name2015-12-31KPMG LLP
Accountancy firm EIN2015-12-31135565207
2014 : AMICA HEALTH AND WELFARE PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$7,053,399
Total unrealized appreciation/depreciation of assets2014-12-31$7,053,399
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$16,171,592
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,215,360
Total income from all sources (including contributions)2014-12-31$83,303,726
Total loss/gain on sale of assets2014-12-31$6,455,152
Total of all expenses incurred2014-12-31$65,614,488
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$63,107,624
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$65,058,256
Value of total assets at end of year2014-12-31$260,618,136
Value of total assets at beginning of year2014-12-31$228,972,666
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,506,864
Total interest from all sources2014-12-31$2,001,333
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$2,735,586
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$10,000,000
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$12,366,524
Assets. Other investments not covered elsewhere at end of year2014-12-31$19,901,901
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$15,565,626
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$130,946
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$59,029,989
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$13,498,543
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$584,594
Administrative expenses (other) incurred2014-12-31$41,721
Liabilities. Value of operating payables at end of year2014-12-31$13,400,000
Liabilities. Value of operating payables at beginning of year2014-12-31$0
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$17,689,238
Value of net assets at end of year (total assets less liabilities)2014-12-31$244,446,544
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$226,757,306
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
Assets. partnership/joint venture interests at end of year2014-12-31$8,091,613
Assets. partnership/joint venture interests at beginning of year2014-12-31$6,648,056
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$30,433,648
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$31,119,343
Interest earned on other investments2014-12-31$658,917
Income. Interest from US Government securities2014-12-31$759,912
Income. Interest from corporate debt instruments2014-12-31$519,669
Value of interest in common/collective trusts at end of year2014-12-31$2,549,285
Value of interest in common/collective trusts at beginning of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$11,352,650
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$12,788,233
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$12,788,233
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$62,835
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$4,077,635
Asset value of US Government securities at end of year2014-12-31$29,441,720
Asset value of US Government securities at beginning of year2014-12-31$28,838,926
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
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$52,560,786
Income. Dividends from common stock2014-12-31$2,735,586
Asset. Corporate debt instrument preferred debt at end of year2014-12-31$8,997,623
Asset. Corporate debt instrument preferred debt at beginning of year2014-12-31$7,355,547
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$6,348,060
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$6,238,988
Contract administrator fees2014-12-31$2,465,143
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$130,003,093
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$119,833,353
Liabilities. Value of benefit claims payable at end of year2014-12-31$2,771,592
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$2,215,360
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$43,198,505
Aggregate carrying amount (costs) on sale of assets2014-12-31$36,743,353
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 name2014-12-31KPMG LLP
Accountancy firm EIN2014-12-31135565207
2013 : AMICA HEALTH AND WELFARE PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$22,753,188
Total unrealized appreciation/depreciation of assets2013-12-31$22,753,188
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,215,360
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,450,636
Total income from all sources (including contributions)2013-12-31$90,333,626
Total loss/gain on sale of assets2013-12-31$2,988,046
Total of all expenses incurred2013-12-31$53,454,051
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$50,931,149
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$60,389,328
Value of total assets at end of year2013-12-31$228,972,666
Value of total assets at beginning of year2013-12-31$192,328,367
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$2,522,902
Total interest from all sources2013-12-31$1,738,784
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$2,464,280
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$10,000,000
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$11,874,783
Assets. Other investments not covered elsewhere at end of year2013-12-31$15,565,626
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$11,382,637
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$73,561
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$47,045,973
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$584,594
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$486,591
Administrative expenses (other) incurred2013-12-31$39,702
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$36,879,575
Value of net assets at end of year (total assets less liabilities)2013-12-31$226,757,306
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$189,877,731
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
Assets. partnership/joint venture interests at end of year2013-12-31$6,648,056
Assets. partnership/joint venture interests at beginning of year2013-12-31$5,520,159
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$31,119,343
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$22,924,563
Interest earned on other investments2013-12-31$503,943
Income. Interest from US Government securities2013-12-31$725,978
Income. Interest from corporate debt instruments2013-12-31$437,460
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$12,788,233
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$11,202,208
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$11,202,208
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$71,403
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$3,885,176
Asset value of US Government securities at end of year2013-12-31$28,838,926
Asset value of US Government securities at beginning of year2013-12-31$27,740,844
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
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$48,440,984
Income. Dividends from common stock2013-12-31$2,464,280
Asset. Corporate debt instrument preferred debt at end of year2013-12-31$7,355,547
Asset. Corporate debt instrument preferred debt at beginning of year2013-12-31$6,209,737
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$6,238,988
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$5,137,701
Contract administrator fees2013-12-31$2,483,200
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
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$119,833,353
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$101,723,927
Liabilities. Value of benefit claims payable at end of year2013-12-31$2,215,360
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$2,450,636
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$28,067,649
Aggregate carrying amount (costs) on sale of assets2013-12-31$25,079,603
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 name2013-12-31KPMG LLP
Accountancy firm EIN2013-12-31135565207
2012 : AMICA HEALTH AND WELFARE PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$12,073,699
Total unrealized appreciation/depreciation of assets2012-12-31$12,073,699
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,450,636
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,134,132
Total income from all sources (including contributions)2012-12-31$84,182,667
Total loss/gain on sale of assets2012-12-31$2,981,299
Total of all expenses incurred2012-12-31$58,411,728
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$56,188,536
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$65,095,225
Value of total assets at end of year2012-12-31$192,328,367
Value of total assets at beginning of year2012-12-31$166,240,924
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,223,192
Total interest from all sources2012-12-31$1,735,504
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$2,296,940
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$10,000,000
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$11,557,930
Assets. Other investments not covered elsewhere at end of year2012-12-31$11,382,637
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$11,599,356
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$98,218
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$52,342,238
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$486,591
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$490,732
Administrative expenses (other) incurred2012-12-31$36,758
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$25,770,939
Value of net assets at end of year (total assets less liabilities)2012-12-31$189,877,731
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$164,106,792
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
Assets. partnership/joint venture interests at end of year2012-12-31$5,520,159
Assets. partnership/joint venture interests at beginning of year2012-12-31$5,396,437
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$22,924,563
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$15,180,879
Interest earned on other investments2012-12-31$456,673
Income. Interest from US Government securities2012-12-31$769,370
Income. Interest from corporate debt instruments2012-12-31$448,871
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$11,202,208
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$5,882,762
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$5,882,762
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$60,590
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$3,846,298
Asset value of US Government securities at end of year2012-12-31$27,740,844
Asset value of US Government securities at beginning of year2012-12-31$23,584,565
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
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$53,439,077
Income. Dividends from common stock2012-12-31$2,296,940
Asset. Corporate debt instrument preferred debt at end of year2012-12-31$6,209,737
Asset. Corporate debt instrument preferred debt at beginning of year2012-12-31$6,055,208
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$5,137,701
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$4,144,378
Contract administrator fees2012-12-31$2,186,434
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
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$101,723,927
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$93,906,607
Liabilities. Value of benefit claims payable at end of year2012-12-31$2,450,636
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$2,134,132
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$36,137,839
Aggregate carrying amount (costs) on sale of assets2012-12-31$33,156,540
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31KPMG LLP
Accountancy firm EIN2012-12-31135565207
2011 : AMICA HEALTH AND WELFARE PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-3,771,776
Total unrealized appreciation/depreciation of assets2011-12-31$-3,771,776
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,134,132
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$3,264,897
Total income from all sources (including contributions)2011-12-31$62,323,827
Total loss/gain on sale of assets2011-12-31$2,165,428
Total of all expenses incurred2011-12-31$56,129,297
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$53,884,296
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$60,090,062
Value of total assets at end of year2011-12-31$166,240,924
Value of total assets at beginning of year2011-12-31$161,177,159
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$2,245,001
Total interest from all sources2011-12-31$1,723,351
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$2,116,762
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$10,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$11,229,134
Assets. Other investments not covered elsewhere at end of year2011-12-31$11,599,356
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$9,255,145
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$128,814
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$50,499,032
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$490,732
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$490,856
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$1,070,000
Administrative expenses (other) incurred2011-12-31$38,529
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$6,194,530
Value of net assets at end of year (total assets less liabilities)2011-12-31$164,106,792
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$157,912,262
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Assets. partnership/joint venture interests at end of year2011-12-31$5,396,437
Assets. partnership/joint venture interests at beginning of year2011-12-31$4,759,904
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$15,180,879
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$8,078,872
Interest earned on other investments2011-12-31$433,481
Income. Interest from US Government securities2011-12-31$827,495
Income. Interest from corporate debt instruments2011-12-31$431,109
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$5,882,762
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$10,381,198
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$10,381,198
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$31,266
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$3,385,264
Asset value of US Government securities at end of year2011-12-31$23,584,565
Asset value of US Government securities at beginning of year2011-12-31$22,892,339
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$48,732,114
Income. Dividends from common stock2011-12-31$2,116,762
Asset. Corporate debt instrument preferred debt at end of year2011-12-31$6,055,208
Asset. Corporate debt instrument preferred debt at beginning of year2011-12-31$5,372,876
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$4,144,378
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$3,131,540
Contract administrator fees2011-12-31$2,206,472
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$93,906,607
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$96,814,429
Liabilities. Value of benefit claims payable at end of year2011-12-31$2,134,132
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$2,194,897
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$36,772,184
Aggregate carrying amount (costs) on sale of assets2011-12-31$34,606,756
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31KPMG LLP
Accountancy firm EIN2011-12-31135565207
2010 : AMICA HEALTH AND WELFARE PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$10,385,517
Total unrealized appreciation/depreciation of assets2010-12-31$10,385,517
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$3,264,897
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$2,901,807
Total income from all sources (including contributions)2010-12-31$79,207,476
Total loss/gain on sale of assets2010-12-31$438,882
Total of all expenses incurred2010-12-31$54,725,996
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$52,365,299
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$63,932,906
Value of total assets at end of year2010-12-31$161,177,159
Value of total assets at beginning of year2010-12-31$136,332,589
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$2,360,697
Total interest from all sources2010-12-31$1,583,223
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$1,979,820
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$10,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$11,051,333
Assets. Other investments not covered elsewhere at end of year2010-12-31$9,255,145
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$6,109,182
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$239,535
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$48,423,781
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$490,856
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$487,684
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$1,070,000
Administrative expenses (other) incurred2010-12-31$30,429
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$24,481,480
Value of net assets at end of year (total assets less liabilities)2010-12-31$157,912,262
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$133,430,782
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Assets. partnership/joint venture interests at end of year2010-12-31$4,759,904
Assets. partnership/joint venture interests at beginning of year2010-12-31$4,708,230
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$8,078,872
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$6,840,770
Interest earned on other investments2010-12-31$361,780
Income. Interest from US Government securities2010-12-31$792,005
Income. Interest from corporate debt instruments2010-12-31$402,530
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$10,381,198
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$6,633,393
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$6,633,393
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$26,908
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$3,941,518
Asset value of US Government securities at end of year2010-12-31$22,892,339
Asset value of US Government securities at beginning of year2010-12-31$22,156,527
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$887,128
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$52,642,038
Income. Dividends from common stock2010-12-31$1,979,820
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$0
Asset. Corporate debt instrument preferred debt at end of year2010-12-31$5,372,876
Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$4,487,254
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$3,131,540
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$3,499,662
Contract administrator fees2010-12-31$2,330,268
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$96,814,429
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$81,409,887
Liabilities. Value of benefit claims payable at end of year2010-12-31$2,194,897
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$2,901,807
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$25,557,596
Aggregate carrying amount (costs) on sale of assets2010-12-31$25,118,714
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31KPMG LLP
Accountancy firm EIN2010-12-31135565207

Form 5500 Responses for AMICA HEALTH AND WELFARE PLAN

2022: AMICA HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: AMICA HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: AMICA HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
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: AMICA HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – 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: AMICA HEALTH AND WELFARE 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: AMICA HEALTH AND WELFARE 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: AMICA HEALTH AND WELFARE 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: AMICA HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – 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: AMICA HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – 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: AMICA HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – 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: AMICA HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: AMICA HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: AMICA HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: AMICA HEALTH AND WELFARE PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedYes
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – TrustYes
2007-01-01Plan funding arrangement – General assets of the sponsorYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement - TrustYes
2007-01-01Plan benefit arrangement – General assets of the sponsorYes
2006: AMICA HEALTH AND WELFARE PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedYes
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan funding arrangement – TrustYes
2006-01-01Plan funding arrangement – General assets of the sponsorYes
2006-01-01Plan benefit arrangement – InsuranceYes
2006-01-01Plan benefit arrangement - TrustYes
2006-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97281301001
Policy instance 8
Insurance contract or identification number97281301001
Number of Individuals Covered25
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered3411
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number17889-0001-001
Policy instance 2
Insurance contract or identification number17889-0001-001
Number of Individuals Covered2300
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Other welfare benefits providedLEGAL PLAN
Welfare Benefit Premiums Paid to CarrierUSD $227,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965644
Policy instance 3
Insurance contract or identification numberLK965644
Number of Individuals Covered3343
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $21,941
Total amount of fees paid to insurance companyUSD $3,326
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $479,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,941
Amount paid for insurance broker fees3326
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYD075570
Policy instance 4
Insurance contract or identification numberNYD075570
Number of Individuals Covered115
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,157
Other welfare benefits providedSTATUTORY DISABILITY NY
Welfare Benefit Premiums Paid to CarrierUSD $66,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,157
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number6408-31-18
Policy instance 5
Insurance contract or identification number6408-31-18
Number of Individuals Covered3343
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Other welfare benefits providedACCIDENTAL DEATH&DISMEMBERMENT INS.
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNKD075570
Policy instance 6
Insurance contract or identification numberNKD075570
Number of Individuals Covered115
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 $536
Other welfare benefits providedSTATUTORY DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees536
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97281221001
Policy instance 7
Insurance contract or identification number613953
Number of Individuals Covered142
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
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
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $291,390
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered5228
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number17889-0001-001
Policy instance 2
Insurance contract or identification number17889-0001-001
Number of Individuals Covered2100
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Other welfare benefits providedLEGAL PLAN
Welfare Benefit Premiums Paid to CarrierUSD $2,463,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965644
Policy instance 3
Insurance contract or identification numberLK965644
Number of Individuals Covered3369
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $26,792
Total amount of fees paid to insurance companyUSD $3,586
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $535,973
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,658
Insurance broker organization code?3
Amount paid for insurance broker fees3586
Additional information about fees paid to insurance brokerSALES & SERVICE
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYD075570
Policy instance 4
Insurance contract or identification numberNYD075570
Number of Individuals Covered127
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,504
Other welfare benefits providedSTATUTORY DISABILITY NY
Welfare Benefit Premiums Paid to CarrierUSD $70,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,504
Insurance broker organization code?3
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number6408-31-18
Policy instance 5
Insurance contract or identification number6408-31-18
Number of Individuals Covered3369
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $1,225
Other welfare benefits providedACCIDENTAL DEATH&DISMEMBERMENT INS.
Welfare Benefit Premiums Paid to CarrierUSD $21,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1225
Additional information about fees paid to insurance brokerCONTINGENT COMMISSIONS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10305351001
Policy instance 6
Insurance contract or identification number10305351001
Number of Individuals Covered1039
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,070
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 numberAE467690-SHORT
Policy instance 7
Insurance contract or identification numberAE467690-SHORT
Number of Individuals Covered845
Insurance policy start date2021-06-01
Insurance policy end date2021-12-31
Welfare Benefit Premiums Paid to CarrierUSD $333,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNKD075570
Policy instance 8
Insurance contract or identification numberNKD075570
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,234
Total amount of fees paid to insurance companyUSD $381
Other welfare benefits providedSTATUTORY DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $24,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,234
Amount paid for insurance broker fees381
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered5444
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number97281301001
Policy instance 2
Insurance contract or identification number97281301001
Number of Individuals Covered28
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number97281221001
Policy instance 3
Insurance contract or identification number97281221001
Number of Individuals Covered5769
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $324,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number17889-0001-001
Policy instance 4
Insurance contract or identification number17889-0001-001
Number of Individuals Covered2102
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Other welfare benefits providedLEGAL PLAN
Welfare Benefit Premiums Paid to CarrierUSD $219,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965644
Policy instance 5
Insurance contract or identification numberLK965644
Number of Individuals Covered3710
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $22,742
Total amount of fees paid to insurance companyUSD $3,354
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $461,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,742
Amount paid for insurance broker fees3354
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYD075570
Policy instance 6
Insurance contract or identification numberNYD075570
Number of Individuals Covered157
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,834
Total amount of fees paid to insurance companyUSD $307
Other welfare benefits providedSTATUTORY DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $36,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,834
Amount paid for insurance broker fees307
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number6408-31-18
Policy instance 7
Insurance contract or identification number6408-31-18
Number of Individuals Covered3712
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Other welfare benefits providedACCIDENTAL DEATH&DISMEMBERMENT INS.
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered5580
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 BenefitYes
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
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 2
Insurance contract or identification number000064083118
Number of Individuals Covered3988
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number97281221001
Policy instance 3
Insurance contract or identification number97281221001
Number of Individuals Covered5797
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 $387,075
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number17889-0001-001
Policy instance 4
Insurance contract or identification number17889-0001-001
Number of Individuals Covered2086
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedLEGAL PLAN
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 $214,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number97281301001
Policy instance 5
Insurance contract or identification number97281301001
Number of Individuals Covered14
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 $1,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965644
Policy instance 6
Insurance contract or identification numberLK965644
Number of Individuals Covered3937
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $22,094
Total amount of fees paid to insurance companyUSD $2,567
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $482,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,094
Amount paid for insurance broker fees2567
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberNYD075570
Policy instance 7
Insurance contract or identification numberNYD075570
Number of Individuals Covered181
Insurance policy start date2019-04-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,187
Total amount of fees paid to insurance companyUSD $234
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedNY DISABILITY AND PAID FAMILY LEAVE
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 $43,737
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,187
Amount paid for insurance broker fees234
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered5290
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 BenefitYes
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
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number127676
Policy instance 2
Insurance contract or identification number127676
Number of Individuals Covered3569
Insurance policy start date2018-01-01
Insurance policy end date2018-04-01
Total amount of commissions paid to insurance brokerUSD $9,144
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 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 $146,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,144
Insurance broker organization code?3
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 3
Insurance contract or identification number000064083118
Number of Individuals Covered3799
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
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $21,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number97281221001
Policy instance 4
Insurance contract or identification number97281221001
Number of Individuals Covered5341
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 $330,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number17889-0001-001
Policy instance 5
Insurance contract or identification number17889-0001-001
Number of Individuals Covered1904
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
Other welfare benefits providedLEGAL PLAN
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 $210,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number97281301001
Policy instance 6
Insurance contract or identification number97281301001
Number of Individuals Covered21
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 $1,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number904262
Policy instance 7
Insurance contract or identification number904262
Number of Individuals Covered547
Insurance policy start date2018-01-01
Insurance policy end date2018-04-01
Total amount of commissions paid to insurance brokerUSD $470
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
Other welfare benefits providedNY DISABILITY AND PAID FAMILY LEAVE
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 $11,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $470
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965644
Policy instance 8
Insurance contract or identification numberLK965644
Number of Individuals Covered3626
Insurance policy start date2018-04-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,411
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 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 $335,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,411
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberNYD075570
Policy instance 9
Insurance contract or identification numberNYD075570
Number of Individuals Covered180
Insurance policy start date2018-04-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,424
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
Other welfare benefits providedNY DISABILITY AND PAID FAMILY LEAVE
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 $28,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,424
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number97281301001
Policy instance 6
Insurance contract or identification number97281301001
Number of Individuals Covered15
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 $1,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14559 )
Policy contract number17889-0001-001
Policy instance 5
Insurance contract or identification number17889-0001-001
Number of Individuals Covered1702
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
Other welfare benefits providedLEGAL PLAN
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 $164,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number97281221001
Policy instance 4
Insurance contract or identification number97281221001
Number of Individuals Covered4702
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 $308,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 3
Insurance contract or identification number000064083118
Number of Individuals Covered3695
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
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
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
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number127676
Policy instance 2
Insurance contract or identification number127676
Number of Individuals Covered3570
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $28,937
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 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 $462,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,937
Insurance broker organization code?3
Insurance broker nameAON CONSULTING-BOSTON
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered5159
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 BenefitYes
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
GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14559 )
Policy contract number17889-0001-001
Policy instance 5
Insurance contract or identification number17889-0001-001
Number of Individuals Covered1500
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedLEGAL PLAN
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 $157,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9728122
Policy instance 4
Insurance contract or identification number9728122
Number of Individuals Covered4115
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $238,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 3
Insurance contract or identification number000064083118
Number of Individuals Covered3555
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 $211
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $21,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees211
Additional information about fees paid to insurance brokerGUARANTEED SUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameGENCORP INSURANCE GROUP, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number127676
Policy instance 2
Insurance contract or identification number127676
Number of Individuals Covered3311
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $28,079
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $442,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,079
Insurance broker organization code?3
Insurance broker nameAON CONSULTING-BOSTON
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered4608
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9728130
Policy instance 6
Insurance contract or identification number9728130
Number of Individuals Covered11
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $1,370
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 number127676
Policy instance 2
Insurance contract or identification number127676
Number of Individuals Covered3193
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $31,627
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $428,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,627
Insurance broker organization code?3
Insurance broker nameAON CONSULTING-BOSTON
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9728122
Policy instance 4
Insurance contract or identification number9728122
Number of Individuals Covered3920
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $207,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 3
Insurance contract or identification number000064083118
Number of Individuals Covered3406
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
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameGENCORP INSURANCE GROUP, INC.
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered4420
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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
GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14559 )
Policy contract number17889-0001-001
Policy instance 5
Insurance contract or identification number17889-0001-001
Number of Individuals Covered1392
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedLEGAL PLAN
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 $145,072
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 number127676
Policy instance 2
Insurance contract or identification number127676
Number of Individuals Covered3108
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $29,595
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $473,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,595
Insurance broker organization code?3
Insurance broker nameAON CONSULTING-BOSTON
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 3
Insurance contract or identification number000064083118
Number of Individuals Covered3273
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
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
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
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered4265
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
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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
GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14559 )
Policy contract number1788900010001
Policy instance 5
Insurance contract or identification number1788900010001
Number of Individuals Covered1396
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
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $147,128
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9728122
Policy instance 4
Insurance contract or identification number9728122
Number of Individuals Covered3687
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
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $229,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9728122
Policy instance 4
Insurance contract or identification number9728122
Number of Individuals Covered3515
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $198,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered4177
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 3
Insurance contract or identification number000064083118
Number of Individuals Covered3166
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
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
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number127676
Policy instance 2
Insurance contract or identification number127676
Number of Individuals Covered3026
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $29,485
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $556,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,485
Insurance broker organization code?3
Insurance broker nameAON CONSULTING-BOSTON
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9728122
Policy instance 4
Insurance contract or identification number9728122
Number of Individuals Covered3228
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $184,517
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 3
Insurance contract or identification number000064083118
Number of Individuals Covered3127
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
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
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number127676
Policy instance 2
Insurance contract or identification number127676
Number of Individuals Covered3110
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $62,971
Total amount of fees paid to insurance companyUSD $15,743
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 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 $510,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered4173
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number22233
Policy instance 8
Insurance contract or identification number22233
Number of Individuals Covered30
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $145,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number30445A
Policy instance 7
Insurance contract or identification number30445A
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-03-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $8,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number4441294
Policy instance 6
Insurance contract or identification number4441294
Number of Individuals Covered43
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $165,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number778185
Policy instance 5
Insurance contract or identification number778185
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $273
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $5,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $273
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP BENEFIT OPTIONS, LLC
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 )
Policy contract number10000627
Policy instance 4
Insurance contract or identification number10000627
Number of Individuals Covered13
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $67,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000064083118
Policy instance 3
Insurance contract or identification number000064083118
Number of Individuals Covered3195
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
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 fees0
Insurance broker name
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number127676
Policy instance 2
Insurance contract or identification number127676
Number of Individuals Covered2963
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $735,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72222 )
Policy contract number2-10001
Policy instance 1
Insurance contract or identification number2-10001
Number of Individuals Covered4199
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 181 )
Policy contract numberA009190212
Policy instance 11
Insurance contract or identification numberA009190212
Number of Individuals Covered10
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $92,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9728122
Policy instance 10
Insurance contract or identification number9728122
Number of Individuals Covered2833
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $161,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )
Policy contract numberA0091900501
Policy instance 9
Insurance contract or identification numberA0091900501
Number of Individuals Covered0
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $7,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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