UNITED STEELWORKERS INTL. UNION LOCAL 4-149 WELFARE FUND has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND
401k plan membership statisitcs for UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND
| Measure | Date | Value |
|---|
| 2018 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2018 401k financial data |
|---|
| Total transfer of assets from this plan | 2018-12-31 | $17,500 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $160,815 |
| Total income from all sources (including contributions) | 2018-12-31 | $197,381 |
| Total of all expenses incurred | 2018-12-31 | $129,372 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $98,160 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $44,504 |
| Value of total assets at end of year | 2018-12-31 | $0 |
| Value of total assets at beginning of year | 2018-12-31 | $110,306 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $31,212 |
| Total interest from all sources | 2018-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | Yes |
| Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan | 2018-12-31 | $0 |
| Administrative expenses professional fees incurred | 2018-12-31 | $25,875 |
| Was this plan covered by a fidelity bond | 2018-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $24,443 |
| Other income not declared elsewhere | 2018-12-31 | $152,877 |
| Administrative expenses (other) incurred | 2018-12-31 | $5,337 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $0 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $160,815 |
| Total non interest bearing cash at end of year | 2018-12-31 | $0 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $64,516 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $68,009 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $-50,509 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Interest earned on other investments | 2018-12-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $0 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $27,172 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $27,172 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $98,160 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $20,061 |
| Employer contributions (assets) at end of year | 2018-12-31 | $0 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $18,618 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-12-31 | No |
| Did the plan have assets held for investment | 2018-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | MSPC CERTIFIED PUBLIC ACCOUNTANTS & |
| Accountancy firm EIN | 2018-12-31 | 222951202 |
| 2017 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $0 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $160,815 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $373,843 |
| Total income from all sources (including contributions) | 2017-12-31 | $328,317 |
| Total of all expenses incurred | 2017-12-31 | $222,263 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $179,212 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $326,893 |
| Value of total assets at end of year | 2017-12-31 | $110,306 |
| Value of total assets at beginning of year | 2017-12-31 | $217,280 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $43,051 |
| Total interest from all sources | 2017-12-31 | $2 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | Yes |
| Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan | 2017-12-31 | $0 |
| Administrative expenses professional fees incurred | 2017-12-31 | $20,500 |
| Was this plan covered by a fidelity bond | 2017-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $43,502 |
| Other income not declared elsewhere | 2017-12-31 | $1,422 |
| Administrative expenses (other) incurred | 2017-12-31 | $22,551 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $160,815 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $267,383 |
| Total non interest bearing cash at end of year | 2017-12-31 | $64,516 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $20,793 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $106,054 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $-50,509 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $-156,563 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Interest earned on other investments | 2017-12-31 | $2 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $27,172 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2017-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2017-12-31 | $142,978 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $179,212 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $283,391 |
| Employer contributions (assets) at end of year | 2017-12-31 | $18,618 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $53,509 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $0 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $106,460 |
| Did the plan have assets held for investment | 2017-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | MSPC CERTIFIED PUBLIC ACCOUNTANTS & |
| Accountancy firm EIN | 2017-12-31 | 222951202 |
| 2016 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $3,425 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $3,425 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $373,843 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $150,912 |
| Total income from all sources (including contributions) | 2016-12-31 | $1,451,133 |
| Total of all expenses incurred | 2016-12-31 | $1,661,072 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $1,616,405 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $1,443,740 |
| Value of total assets at end of year | 2016-12-31 | $217,280 |
| Value of total assets at beginning of year | 2016-12-31 | $204,288 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $44,667 |
| Total interest from all sources | 2016-12-31 | $3,968 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Administrative expenses professional fees incurred | 2016-12-31 | $8,900 |
| Was this plan covered by a fidelity bond | 2016-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $38,376 |
| Administrative expenses (other) incurred | 2016-12-31 | $35,767 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $267,383 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $912 |
| Total non interest bearing cash at end of year | 2016-12-31 | $20,793 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $22,074 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $-209,939 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $-156,563 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $53,376 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Interest earned on other investments | 2016-12-31 | $3,968 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2016-12-31 | $142,978 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2016-12-31 | $135,586 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $1,616,405 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $1,405,364 |
| Employer contributions (assets) at end of year | 2016-12-31 | $53,509 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $46,628 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $106,460 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $150,000 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | MSPC CERTIFIED PUBLIC ACCOUNTANTS & |
| Accountancy firm EIN | 2016-12-31 | 222951202 |
| 2015 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $807 |
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $807 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $150,912 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $248,621 |
| Total income from all sources (including contributions) | 2015-12-31 | $1,565,139 |
| Total of all expenses incurred | 2015-12-31 | $1,589,749 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $1,537,482 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $1,561,258 |
| Value of total assets at end of year | 2015-12-31 | $204,288 |
| Value of total assets at beginning of year | 2015-12-31 | $326,607 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $52,267 |
| Total interest from all sources | 2015-12-31 | $711 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Administrative expenses professional fees incurred | 2015-12-31 | $16,090 |
| Was this plan covered by a fidelity bond | 2015-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $78,236 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $42,351 |
| Other income not declared elsewhere | 2015-12-31 | $2,363 |
| Administrative expenses (other) incurred | 2015-12-31 | $36,177 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $912 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $492 |
| Total non interest bearing cash at end of year | 2015-12-31 | $22,074 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $11,294 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $-24,610 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $53,376 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $77,986 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Interest earned on other investments | 2015-12-31 | $711 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2015-12-31 | $135,586 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2015-12-31 | $152,690 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $1,537,482 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $1,483,022 |
| Employer contributions (assets) at end of year | 2015-12-31 | $46,628 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $120,272 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $150,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $248,129 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | MSPC CERTIFIED PUBLIC ACCOUNTANTS & |
| Accountancy firm EIN | 2015-12-31 | 222951202 |
| 2014 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $-988 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $-988 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $248,621 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $193,444 |
| Total income from all sources (including contributions) | 2014-12-31 | $1,963,521 |
| Total of all expenses incurred | 2014-12-31 | $2,022,179 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $2,007,771 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $1,821,172 |
| Value of total assets at end of year | 2014-12-31 | $326,607 |
| Value of total assets at beginning of year | 2014-12-31 | $330,088 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $14,408 |
| Total interest from all sources | 2014-12-31 | $10,378 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Administrative expenses professional fees incurred | 2014-12-31 | $10,423 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $400,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $93,151 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $42,351 |
| Other income not declared elsewhere | 2014-12-31 | $132,959 |
| Administrative expenses (other) incurred | 2014-12-31 | $3,985 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $492 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $3,000 |
| Total non interest bearing cash at end of year | 2014-12-31 | $11,294 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $46,654 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $-58,658 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $77,986 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $136,644 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Interest earned on other investments | 2014-12-31 | $10,378 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2014-12-31 | $152,690 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2014-12-31 | $143,301 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $2,007,771 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $1,728,021 |
| Employer contributions (assets) at end of year | 2014-12-31 | $120,272 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $140,133 |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $248,129 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $190,444 |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | WASILEWSKI & KEATING PC |
| Accountancy firm EIN | 2014-12-31 | 222676761 |
| 2013 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $11,635 |
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $11,635 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $193,444 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $493,215 |
| Total income from all sources (including contributions) | 2013-12-31 | $2,259,807 |
| Total of all expenses incurred | 2013-12-31 | $2,188,346 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $2,171,007 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $2,176,673 |
| Value of total assets at end of year | 2013-12-31 | $330,088 |
| Value of total assets at beginning of year | 2013-12-31 | $558,398 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $17,339 |
| Total interest from all sources | 2013-12-31 | $10,129 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Administrative expenses professional fees incurred | 2013-12-31 | $10,300 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $400,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $101,621 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $15,061 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-12-31 | $118,890 |
| Other income not declared elsewhere | 2013-12-31 | $61,370 |
| Administrative expenses (other) incurred | 2013-12-31 | $7,039 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $3,000 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $11,700 |
| Total non interest bearing cash at end of year | 2013-12-31 | $46,654 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $270,248 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $71,461 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $136,644 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $65,183 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Interest earned on other investments | 2013-12-31 | $10,129 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2013-12-31 | $143,301 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2013-12-31 | $121,538 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $2,171,007 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $2,075,052 |
| Employer contributions (assets) at end of year | 2013-12-31 | $140,133 |
| Employer contributions (assets) at beginning of year | 2013-12-31 | $151,551 |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $190,444 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $362,625 |
| Did the plan have assets held for investment | 2013-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | WASILEWSKI & KEATING PC |
| Accountancy firm EIN | 2013-12-31 | 222676761 |
| 2012 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $-7,357 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $-7,357 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $493,215 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $323,085 |
| Total income from all sources (including contributions) | 2012-12-31 | $2,217,725 |
| Total of all expenses incurred | 2012-12-31 | $2,271,549 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $2,240,525 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $2,141,377 |
| Value of total assets at end of year | 2012-12-31 | $558,398 |
| Value of total assets at beginning of year | 2012-12-31 | $442,092 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $31,024 |
| Total interest from all sources | 2012-12-31 | $22,740 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Administrative expenses professional fees incurred | 2012-12-31 | $9,833 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $99,478 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $15,061 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-12-31 | $118,890 |
| Other income not declared elsewhere | 2012-12-31 | $60,965 |
| Administrative expenses (other) incurred | 2012-12-31 | $21,191 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $11,700 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $6,400 |
| Total non interest bearing cash at end of year | 2012-12-31 | $270,248 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $33,409 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-53,824 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $65,183 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $119,007 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Interest earned on other investments | 2012-12-31 | $22,740 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2012-12-31 | $121,538 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2012-12-31 | $276,156 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $2,240,525 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $2,041,899 |
| Employer contributions (assets) at end of year | 2012-12-31 | $151,551 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $132,527 |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $362,625 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $316,685 |
| Did the plan have assets held for investment | 2012-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | WASILEWSKI & KEATING PC |
| Accountancy firm EIN | 2012-12-31 | 222676761 |
| 2011 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $-26,895 |
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $-26,895 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $323,085 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $382,149 |
| Total income from all sources (including contributions) | 2011-12-31 | $2,035,936 |
| Total of all expenses incurred | 2011-12-31 | $2,054,392 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $2,021,802 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $2,004,411 |
| Value of total assets at end of year | 2011-12-31 | $442,092 |
| Value of total assets at beginning of year | 2011-12-31 | $519,612 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $32,590 |
| Total interest from all sources | 2011-12-31 | $13,054 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Administrative expenses professional fees incurred | 2011-12-31 | $6,400 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $110,929 |
| Other income not declared elsewhere | 2011-12-31 | $45,366 |
| Administrative expenses (other) incurred | 2011-12-31 | $26,190 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $6,400 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $268 |
| Total non interest bearing cash at end of year | 2011-12-31 | $33,409 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $149,813 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $-18,456 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $119,007 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $137,463 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Interest earned on other investments | 2011-12-31 | $13,054 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-12-31 | $276,156 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-12-31 | $290,000 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $2,021,802 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $1,893,482 |
| Employer contributions (assets) at end of year | 2011-12-31 | $132,527 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $79,799 |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $316,685 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $381,881 |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | WASILEWSKI & KEATING PC |
| Accountancy firm EIN | 2011-12-31 | 222676761 |
| 2010 : UNITED STEEL WORKERS INTERNATIONAL UNION LOCAL 4-149 WELFARE FUND 2010 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2010-12-31 | $-10,000 |
| Total unrealized appreciation/depreciation of assets | 2010-12-31 | $-10,000 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $382,149 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $128,327 |
| Total income from all sources (including contributions) | 2010-12-31 | $2,051,279 |
| Total of all expenses incurred | 2010-12-31 | $1,958,774 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $1,928,279 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $2,061,140 |
| Value of total assets at end of year | 2010-12-31 | $519,612 |
| Value of total assets at beginning of year | 2010-12-31 | $173,285 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $30,495 |
| Total interest from all sources | 2010-12-31 | $139 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Administrative expenses professional fees incurred | 2010-12-31 | $4,677 |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $93,951 |
| Participant contributions at beginning of year | 2010-12-31 | $506 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $352 |
| Administrative expenses (other) incurred | 2010-12-31 | $25,818 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $268 |
| Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $380 |
| Total non interest bearing cash at end of year | 2010-12-31 | $149,813 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $92,505 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $137,463 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $44,958 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $42,248 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $42,248 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $139 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2010-12-31 | $290,000 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $1,928,279 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $1,967,189 |
| Employer contributions (assets) at end of year | 2010-12-31 | $79,799 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $129,594 |
| Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $381,881 |
| Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $127,947 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2010-12-31 | $585 |
| Did the plan have assets held for investment | 2010-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
| Accountancy firm name | 2010-12-31 | WASILEWSKI & KEATING PC |
| Accountancy firm EIN | 2010-12-31 | 222676761 |
| UNITED HEALTHCARE INSURANCE CO/AARP (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 7 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $25,671 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337681 |
| Policy instance | 3 |
| Insurance contract or identification number | 3337681 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $601 | | Total amount of fees paid to insurance company | USD $419 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $271,926 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $601 | | Amount paid for insurance broker fees | 419 | | Additional information about fees paid to insurance broker | BENEFIT ADVISOR PAYMENT | | Insurance broker organization code? | 3 | | Insurance broker name | BUNKER HILL INSURANCE & CONSULTING |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92738 ) |
| Policy contract number | 844374 |
| Policy instance | 2 |
| Insurance contract or identification number | 844374 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for group deferred annuity? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE CO/AARP (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 7 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $23,621 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE CO/AARP (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 11 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $36,260 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00487735 |
| Policy instance | 1 |
| Insurance contract or identification number | 00487735 | | Number of Individuals Covered | 35 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $1,766 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,543 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,731 | | Insurance broker organization code? | 3 | | Insurance broker name | CERTIFIED FINANCIAL SERVICE LLC |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92738 ) |
| Policy contract number | 844374 |
| Policy instance | 4 |
| Insurance contract or identification number | 844374 | | Number of Individuals Covered | 146 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for group deferred annuity? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1006024000 |
| Policy instance | 3 |
| Insurance contract or identification number | 1006024000 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $2,136 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337681 |
| Policy instance | 5 |
| Insurance contract or identification number | 3337681 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,328 | | Total amount of fees paid to insurance company | USD $63,288 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,616,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,328 | | Amount paid for insurance broker fees | 63288 | | Additional information about fees paid to insurance broker | BENEFIT ADVISOR PAYMENTS | | Insurance broker organization code? | 3 | | Insurance broker name | BUNKER HILL INSURANCE & CONSULTING |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2203/GJ2204 |
| Policy instance | 3 |
| Insurance contract or identification number | GJ2203/GJ2204 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,227 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,215 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,722 | | Insurance broker organization code? | 3 | | Insurance broker name | CORE BENEFITS GROUP INC |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 619365 |
| Policy instance | 4 |
| Insurance contract or identification number | 619365 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $964 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,771 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $964 | | Insurance broker organization code? | 3 | | Insurance broker name | BUNKER HILL INSUR & CONSULTING LLC |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | AE00370K |
| Policy instance | 5 |
| Insurance contract or identification number | AE00370K | | Number of Individuals Covered | 4 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $19,639 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00487735 |
| Policy instance | 2 |
| Insurance contract or identification number | 00487735 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,360 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,006 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,251 | | Insurance broker organization code? | 3 | | Insurance broker name | CERTIFIED FINANCIAL SERVICE LLC |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92738 ) |
| Policy contract number | 844374 |
| Policy instance | 8 |
| Insurance contract or identification number | 844374 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Are there contracts with allocated funds for group deferred annuity? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1006024000 |
| Policy instance | 7 |
| Insurance contract or identification number | 1006024000 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337681 |
| Policy instance | 9 |
| Insurance contract or identification number | 3337681 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,833 | | Total amount of fees paid to insurance company | USD $71,581 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,841,379 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,833 | | Amount paid for insurance broker fees | 71581 | | Additional information about fees paid to insurance broker | BENEFIT ADVISOR PAYMENTS | | Insurance broker organization code? | 3 | | Insurance broker name | BUNKER HILL INSURANCE & CONSULTING |
|
| UNITED HEALTHCARE INSURANCE CO/AARP (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | |
| Policy instance | 6 |
| Number of Individuals Covered | 17 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $47,390 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
| Policy contract number | US00370K |
| Policy instance | 1 |
| Insurance contract or identification number | US00370K | | Number of Individuals Covered | 167 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $27,056 | | Welfare Benefit Premiums Paid to Carrier | USD $16,219 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,056 | | Insurance broker organization code? | 3 | | Insurance broker name | BUNKER HILL INSURANCE & CONSULTING |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92738 ) |
| Policy contract number | 844374 |
| Policy instance | 8 |
| Insurance contract or identification number | 844374 | | Number of Individuals Covered | 192 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Are there contracts with allocated funds for group deferred annuity? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1006024000 |
| Policy instance | 7 |
| Insurance contract or identification number | 1006024000 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,152 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE CO/AARP (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | |
| Policy instance | 6 |
| Number of Individuals Covered | 17 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $52,277 | | 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 number | 619365 |
| Policy instance | 4 |
| Insurance contract or identification number | 619365 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $3,847 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH/DISMEMBERMNT | | Welfare Benefit Premiums Paid to Carrier | USD $90,995 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $580 | | Insurance broker name | BUNKER HILL INSUR & CONSULTING LLC |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2203/GJ2204 |
| Policy instance | 3 |
| Insurance contract or identification number | GJ2203/GJ2204 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,946 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,941 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,578 | | Insurance broker name | CORE BENEFITS GROUP INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00487735 |
| Policy instance | 2 |
| Insurance contract or identification number | 00487735 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,452 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,385 | | Insurance broker name | CETIFIED FINANCIAL SERVICE LLC |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
| Policy contract number | US00370K |
| Policy instance | 1 |
| Insurance contract or identification number | US00370K | | Number of Individuals Covered | 270 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $100,252 | | Welfare Benefit Premiums Paid to Carrier | USD $1,903,740 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $100,252 | | Insurance broker name | BUNKER HILL INSURANCE & CONSULTING |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | AE00370K |
| Policy instance | 5 |
| Insurance contract or identification number | AE00370K | | Number of Individuals Covered | 4 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $16,432 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1006024000 |
| Policy instance | 7 |
| Insurance contract or identification number | 1006024000 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $430 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
| Policy contract number | US00370K |
| Policy instance | 1 |
| Insurance contract or identification number | US00370K | | Number of Individuals Covered | 354 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $90,949 | | Welfare Benefit Premiums Paid to Carrier | USD $1,991,767 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,254 | | Insurance broker name | B&N INSURANCE & CONSULTING INC |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | AE00370K |
| Policy instance | 5 |
| Insurance contract or identification number | AE00370K | | Number of Individuals Covered | 4 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $15,214 | | 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 number | 619365 |
| Policy instance | 4 |
| Insurance contract or identification number | 619365 | | Number of Individuals Covered | 293 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $9,111 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH/DISMEMBERMNT | | Welfare Benefit Premiums Paid to Carrier | USD $145,331 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,111 | | Insurance broker name | B&N INSURANCE & CONSULTING INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | L010/L016/L0428 |
| Policy instance | 2 |
| Insurance contract or identification number | L010/L016/L0428 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,250 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2203 |
| Policy instance | 3 |
| Insurance contract or identification number | GJ2203 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,300 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,300 | | Insurance broker name | B&N INSURANCE & CONSULTING INC |
|
| UNITED HEALTHCARE INSURANCE CO/AARP (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | |
| Policy instance | 6 |
| Number of Individuals Covered | 23 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $59,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92738 ) |
| Policy contract number | 844374 |
| Policy instance | 8 |
| Insurance contract or identification number | 844374 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,450 | | Are there contracts with allocated funds for group deferred annuity? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,450 | | Insurance broker name | B&N INSURANCE & CONSULTING INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | L010L016L0428 |
| Policy instance | 2 |
| Insurance contract or identification number | L010L016L0428 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,499 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2203 |
| Policy instance | 3 |
| Insurance contract or identification number | GJ2203 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $877 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN NATIONAL LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 47047 ) |
| Policy contract number | 10017608 |
| Policy instance | 4 |
| Insurance contract or identification number | 10017608 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,131 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | AE00370K |
| Policy instance | 5 |
| Insurance contract or identification number | AE00370K | | Number of Individuals Covered | 4 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $11,510 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE CO/AARP (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | |
| Policy instance | 6 |
| Number of Individuals Covered | 23 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $78,191 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1006024000 |
| Policy instance | 7 |
| Insurance contract or identification number | 1006024000 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $684 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2204 |
| Policy instance | 9 |
| Insurance contract or identification number | GJ2204 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $236 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,522 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92738 ) |
| Policy contract number | 844374 |
| Policy instance | 8 |
| Insurance contract or identification number | 844374 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,150 | | Are there contracts with allocated funds for group deferred annuity? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
| Policy contract number | US00370K |
| Policy instance | 1 |
| Insurance contract or identification number | US00370K | | Number of Individuals Covered | 354 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $88,656 | | Welfare Benefit Premiums Paid to Carrier | USD $1,883,368 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
| Policy contract number | US00370K |
| Policy instance | 1 |
| Insurance contract or identification number | US00370K | | Number of Individuals Covered | 350 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $76,787 | | Welfare Benefit Premiums Paid to Carrier | USD $1,571,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | L010L016L0428 |
| Policy instance | 2 |
| Insurance contract or identification number | L010L016L0428 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,748 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2203 |
| Policy instance | 3 |
| Insurance contract or identification number | GJ2203 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $526 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,578 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 80351 |
| Policy instance | 4 |
| Insurance contract or identification number | 80351 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-05-31 | | Total amount of commissions paid to insurance broker | USD $2,834 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,420 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL137021 |
| Policy instance | 5 |
| Insurance contract or identification number | GL137021 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,032 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,154 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN NATIONAL LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 47047 ) |
| Policy contract number | 10017608 |
| Policy instance | 6 |
| Insurance contract or identification number | 10017608 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,601 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 ) |
| Policy contract number | AE00370K |
| Policy instance | 7 |
| Insurance contract or identification number | AE00370K | | Number of Individuals Covered | 2 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $11,140 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE CO/AARP (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | |
| Policy instance | 8 |
| Number of Individuals Covered | 27 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $90,305 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 1006024000 |
| Policy instance | 9 |
| Insurance contract or identification number | 1006024000 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $585 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 80351 |
| Policy instance | 10 |
| Insurance contract or identification number | 80351 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-05-31 | | Total amount of commissions paid to insurance broker | USD $1,084 | | Welfare Benefit Premiums Paid to Carrier | USD $21,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92738 ) |
| Policy contract number | 844374 |
| Policy instance | 11 |
| Insurance contract or identification number | 844374 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2010-11-30 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $18,000 | | Are there contracts with allocated funds for group deferred annuity? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
