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SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 401k Plan overview

Plan NameSID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION
Plan identification number 504

SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION Benefits

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

401k Sponsoring company profile

SID HARVEY INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:SID HARVEY INDUSTRIES, INC.
Employer identification number (EIN):112233773
NAIC Classification:423700

Additional information about SID HARVEY INDUSTRIES, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1971-02-10
Company Identification Number: 302749
Legal Registered Office Address: 28 LIBERTY ST.
Nassau
NEW YORK
United States of America (USA)
10005

More information about SID HARVEY INDUSTRIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-04-01RICHARD G. ROCCO2024-01-16 RICHARD G. ROCCO2024-01-16
5042021-04-01RICHARD G. ROCCO2023-01-17 RICHARD G. ROCCO2023-01-17
5042020-04-01RICHARD G. ROCCO2022-01-12 RICHARD G. ROCCO2022-01-12
5042019-04-01RICHARD G. ROCCO2021-01-13 RICHARD G. ROCCO2021-01-13
5042018-04-01JEFFREY YONKERS2020-01-15 JEFFREY YONKERS2020-01-15
5042017-04-01
5042016-04-01
5042015-04-01
5042014-04-01
5042013-04-01
5042012-04-01RUSSELL TUMSUDEN
5042011-04-01RUSSELL TUMSUDEN
5042009-04-01RUSSELL TUMSUDEN

Plan Statistics for SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION

401k plan membership statisitcs for SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION

Measure Date Value
2022: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2022 401k membership
Total participants, beginning-of-year2022-04-01402
Total number of active participants reported on line 7a of the Form 55002022-04-01498
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01498
2021: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2021 401k membership
Total participants, beginning-of-year2021-04-01361
Total number of active participants reported on line 7a of the Form 55002021-04-01399
Number of retired or separated participants receiving benefits2021-04-013
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01402
Total participants2021-04-01402
2020: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2020 401k membership
Total participants, beginning-of-year2020-04-01345
Total number of active participants reported on line 7a of the Form 55002020-04-01356
Number of retired or separated participants receiving benefits2020-04-015
Total of all active and inactive participants2020-04-01361
Total participants2020-04-01361
2019: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2019 401k membership
Total participants, beginning-of-year2019-04-01316
Total number of active participants reported on line 7a of the Form 55002019-04-01341
Number of retired or separated participants receiving benefits2019-04-014
Total of all active and inactive participants2019-04-01345
2018: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2018 401k membership
Total participants, beginning-of-year2018-04-01308
Total number of active participants reported on line 7a of the Form 55002018-04-01313
Number of retired or separated participants receiving benefits2018-04-013
Total of all active and inactive participants2018-04-01316
2017: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2017 401k membership
Total participants, beginning-of-year2017-04-01293
Total number of active participants reported on line 7a of the Form 55002017-04-01305
Number of retired or separated participants receiving benefits2017-04-013
Total of all active and inactive participants2017-04-01308
2016: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2016 401k membership
Total participants, beginning-of-year2016-04-01289
Total number of active participants reported on line 7a of the Form 55002016-04-01288
Number of retired or separated participants receiving benefits2016-04-015
Total of all active and inactive participants2016-04-01293
2015: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2015 401k membership
Total participants, beginning-of-year2015-04-01291
Total number of active participants reported on line 7a of the Form 55002015-04-01284
Number of retired or separated participants receiving benefits2015-04-015
Total of all active and inactive participants2015-04-01289
2014: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2014 401k membership
Total participants, beginning-of-year2014-04-01285
Total number of active participants reported on line 7a of the Form 55002014-04-01286
Number of retired or separated participants receiving benefits2014-04-015
Total of all active and inactive participants2014-04-01291
2013: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2013 401k membership
Total participants, beginning-of-year2013-04-01306
Total number of active participants reported on line 7a of the Form 55002013-04-01279
Number of retired or separated participants receiving benefits2013-04-016
Total of all active and inactive participants2013-04-01285
2012: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2012 401k membership
Total participants, beginning-of-year2012-04-01288
Total number of active participants reported on line 7a of the Form 55002012-04-01298
Number of retired or separated participants receiving benefits2012-04-018
Total of all active and inactive participants2012-04-01306
2011: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2011 401k membership
Total participants, beginning-of-year2011-04-01286
Total number of active participants reported on line 7a of the Form 55002011-04-01280
Number of retired or separated participants receiving benefits2011-04-018
Total of all active and inactive participants2011-04-01288
2009: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2009 401k membership
Total participants, beginning-of-year2009-04-01274
Total number of active participants reported on line 7a of the Form 55002009-04-01255
Number of retired or separated participants receiving benefits2009-04-018
Number of other retired or separated participants entitled to future benefits2009-04-010
Total of all active and inactive participants2009-04-01263

Financial Data on SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION

Measure Date Value
2023 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2023 401k financial data
Total income from all sources (including contributions)2023-03-31$3,321,058
Total of all expenses incurred2023-03-31$3,321,058
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-03-31$3,321,058
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-03-31$3,321,058
Value of total assets at end of year2023-03-31$1,000
Value of total assets at beginning of year2023-03-31$1,000
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-03-31No
Was this plan covered by a fidelity bond2023-03-31Yes
Value of fidelity bond cover2023-03-31$3,000,000
If this is an individual account plan, was there a blackout period2023-03-31No
Were there any nonexempt tranactions with any party-in-interest2023-03-31No
Total non interest bearing cash at end of year2023-03-31$1,000
Total non interest bearing cash at beginning of year2023-03-31$1,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-03-31No
Value of net income/loss2023-03-31$0
Value of net assets at end of year (total assets less liabilities)2023-03-31$1,000
Value of net assets at beginning of year (total assets less liabilities)2023-03-31$1,000
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-03-31No
Were any leases to which the plan was party in default or uncollectible2023-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2023-03-31$3,321,058
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-03-31No
Was there a failure to transmit to the plan any participant contributions2023-03-31No
Has the plan failed to provide any benefit when due under the plan2023-03-31No
Contributions received in cash from employer2023-03-31$3,321,058
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-03-31No
Did the plan have assets held for investment2023-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-03-31No
Opinion of an independent qualified public accountant for this plan2023-03-31Unqualified
Accountancy firm name2023-03-31MACIAS GINI & O'CONNOLL LLP
Accountancy firm EIN2023-03-31680300457
2022 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-03-31$37,577
Total income from all sources (including contributions)2022-03-31$2,992,774
Total of all expenses incurred2022-03-31$2,992,774
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-03-31$2,991,951
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-03-31$2,992,774
Value of total assets at end of year2022-03-31$1,000
Value of total assets at beginning of year2022-03-31$38,577
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-03-31$823
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-03-31No
Was this plan covered by a fidelity bond2022-03-31Yes
Value of fidelity bond cover2022-03-31$3,000,000
If this is an individual account plan, was there a blackout period2022-03-31No
Were there any nonexempt tranactions with any party-in-interest2022-03-31No
Administrative expenses (other) incurred2022-03-31$823
Liabilities. Value of operating payables at end of year2022-03-31$0
Liabilities. Value of operating payables at beginning of year2022-03-31$37,577
Total non interest bearing cash at end of year2022-03-31$1,000
Total non interest bearing cash at beginning of year2022-03-31$38,577
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Value of net income/loss2022-03-31$0
Value of net assets at end of year (total assets less liabilities)2022-03-31$1,000
Value of net assets at beginning of year (total assets less liabilities)2022-03-31$1,000
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-03-31No
Were any leases to which the plan was party in default or uncollectible2022-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2022-03-31$2,991,951
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-03-31No
Was there a failure to transmit to the plan any participant contributions2022-03-31No
Has the plan failed to provide any benefit when due under the plan2022-03-31No
Contributions received in cash from employer2022-03-31$2,992,774
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-03-31No
Did the plan have assets held for investment2022-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-03-31No
Opinion of an independent qualified public accountant for this plan2022-03-31Unqualified
Accountancy firm name2022-03-31MACIAS GINI & O'CONNOLL LLP
Accountancy firm EIN2022-03-31680300457
2021 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-03-31$37,577
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-03-31$12,262
Total income from all sources (including contributions)2021-03-31$2,715,802
Total of all expenses incurred2021-03-31$2,925,324
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-03-31$2,912,224
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-03-31$2,715,802
Value of total assets at end of year2021-03-31$38,577
Value of total assets at beginning of year2021-03-31$222,784
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-03-31$13,100
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-03-31No
Was this plan covered by a fidelity bond2021-03-31Yes
Value of fidelity bond cover2021-03-31$3,000,000
If this is an individual account plan, was there a blackout period2021-03-31No
Were there any nonexempt tranactions with any party-in-interest2021-03-31No
Administrative expenses (other) incurred2021-03-31$13,100
Liabilities. Value of operating payables at end of year2021-03-31$37,577
Liabilities. Value of operating payables at beginning of year2021-03-31$12,262
Total non interest bearing cash at end of year2021-03-31$38,577
Total non interest bearing cash at beginning of year2021-03-31$222,784
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Value of net income/loss2021-03-31$-209,522
Value of net assets at end of year (total assets less liabilities)2021-03-31$1,000
Value of net assets at beginning of year (total assets less liabilities)2021-03-31$210,522
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-03-31No
Were any leases to which the plan was party in default or uncollectible2021-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-03-31$2,912,224
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-03-31No
Was there a failure to transmit to the plan any participant contributions2021-03-31No
Has the plan failed to provide any benefit when due under the plan2021-03-31No
Contributions received in cash from employer2021-03-31$2,715,802
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-03-31No
Did the plan have assets held for investment2021-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-03-31No
Opinion of an independent qualified public accountant for this plan2021-03-31Unqualified
Accountancy firm name2021-03-31NUSSBAUM BERG KLEIN WOLPOW CPAS LLP
Accountancy firm EIN2021-03-31260221653
2020 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$12,262
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$34,588
Total income from all sources (including contributions)2020-03-31$2,874,886
Total of all expenses incurred2020-03-31$2,829,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-03-31$2,697,735
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-03-31$2,874,886
Value of total assets at end of year2020-03-31$222,784
Value of total assets at beginning of year2020-03-31$199,579
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-03-31$131,620
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-03-31No
Was this plan covered by a fidelity bond2020-03-31Yes
Value of fidelity bond cover2020-03-31$3,000,000
If this is an individual account plan, was there a blackout period2020-03-31No
Were there any nonexempt tranactions with any party-in-interest2020-03-31No
Administrative expenses (other) incurred2020-03-31$131,620
Liabilities. Value of operating payables at end of year2020-03-31$12,262
Liabilities. Value of operating payables at beginning of year2020-03-31$34,588
Total non interest bearing cash at end of year2020-03-31$222,784
Total non interest bearing cash at beginning of year2020-03-31$199,579
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Value of net income/loss2020-03-31$45,531
Value of net assets at end of year (total assets less liabilities)2020-03-31$210,522
Value of net assets at beginning of year (total assets less liabilities)2020-03-31$164,991
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-03-31No
Were any leases to which the plan was party in default or uncollectible2020-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-03-31$2,697,735
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-03-31No
Was there a failure to transmit to the plan any participant contributions2020-03-31No
Has the plan failed to provide any benefit when due under the plan2020-03-31No
Contributions received in cash from employer2020-03-31$2,874,886
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-03-31No
Did the plan have assets held for investment2020-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-03-31No
Opinion of an independent qualified public accountant for this plan2020-03-31Unqualified
Accountancy firm name2020-03-31NUSSBAUM BERG KLEIN WOLPOW CPAS LLP
Accountancy firm EIN2020-03-31260221653
2019 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$34,588
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$38,377
Total income from all sources (including contributions)2019-03-31$2,587,826
Total of all expenses incurred2019-03-31$2,529,396
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-03-31$2,476,688
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-03-31$2,587,826
Value of total assets at end of year2019-03-31$199,579
Value of total assets at beginning of year2019-03-31$144,938
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-03-31$52,708
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-03-31No
Was this plan covered by a fidelity bond2019-03-31Yes
Value of fidelity bond cover2019-03-31$3,000,000
If this is an individual account plan, was there a blackout period2019-03-31No
Were there any nonexempt tranactions with any party-in-interest2019-03-31No
Administrative expenses (other) incurred2019-03-31$52,708
Liabilities. Value of operating payables at end of year2019-03-31$34,588
Liabilities. Value of operating payables at beginning of year2019-03-31$38,377
Total non interest bearing cash at end of year2019-03-31$199,579
Total non interest bearing cash at beginning of year2019-03-31$144,938
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Value of net income/loss2019-03-31$58,430
Value of net assets at end of year (total assets less liabilities)2019-03-31$164,991
Value of net assets at beginning of year (total assets less liabilities)2019-03-31$106,561
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-03-31No
Were any leases to which the plan was party in default or uncollectible2019-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-03-31$2,476,688
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-03-31No
Was there a failure to transmit to the plan any participant contributions2019-03-31No
Has the plan failed to provide any benefit when due under the plan2019-03-31No
Contributions received in cash from employer2019-03-31$2,587,826
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-03-31No
Did the plan have assets held for investment2019-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-03-31No
Opinion of an independent qualified public accountant for this plan2019-03-31Unqualified
Accountancy firm name2019-03-31NUSSBAUM BERG KLEIN WOLPOW CPAS LLP
Accountancy firm EIN2019-03-31260221653
2018 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-03-31$38,377
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-03-31$41,545
Total income from all sources (including contributions)2018-03-31$2,077,446
Total of all expenses incurred2018-03-31$2,053,213
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-03-31$1,998,998
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-03-31$2,077,446
Value of total assets at end of year2018-03-31$144,938
Value of total assets at beginning of year2018-03-31$123,873
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-03-31$54,215
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-03-31No
Was this plan covered by a fidelity bond2018-03-31Yes
Value of fidelity bond cover2018-03-31$3,000,000
If this is an individual account plan, was there a blackout period2018-03-31No
Were there any nonexempt tranactions with any party-in-interest2018-03-31No
Administrative expenses (other) incurred2018-03-31$54,215
Liabilities. Value of operating payables at end of year2018-03-31$38,377
Liabilities. Value of operating payables at beginning of year2018-03-31$41,545
Total non interest bearing cash at end of year2018-03-31$144,938
Total non interest bearing cash at beginning of year2018-03-31$123,873
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Value of net income/loss2018-03-31$24,233
Value of net assets at end of year (total assets less liabilities)2018-03-31$106,561
Value of net assets at beginning of year (total assets less liabilities)2018-03-31$82,328
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-03-31No
Were any leases to which the plan was party in default or uncollectible2018-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-03-31$1,998,998
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-03-31No
Was there a failure to transmit to the plan any participant contributions2018-03-31No
Has the plan failed to provide any benefit when due under the plan2018-03-31No
Contributions received in cash from employer2018-03-31$2,077,446
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-03-31No
Did the plan have assets held for investment2018-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-03-31No
Opinion of an independent qualified public accountant for this plan2018-03-31Unqualified
Accountancy firm name2018-03-31NUSSBAUM YATES BERG KLEIN & WOLPOW
Accountancy firm EIN2018-03-31260221653
2017 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-03-31$41,545
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-03-31$27,081
Total income from all sources (including contributions)2017-03-31$1,940,937
Total of all expenses incurred2017-03-31$1,973,967
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-03-31$1,921,101
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-03-31$1,940,937
Value of total assets at end of year2017-03-31$123,873
Value of total assets at beginning of year2017-03-31$142,439
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-03-31$52,866
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-03-31No
Was this plan covered by a fidelity bond2017-03-31Yes
Value of fidelity bond cover2017-03-31$3,000,000
If this is an individual account plan, was there a blackout period2017-03-31No
Were there any nonexempt tranactions with any party-in-interest2017-03-31No
Administrative expenses (other) incurred2017-03-31$52,866
Liabilities. Value of operating payables at end of year2017-03-31$41,545
Liabilities. Value of operating payables at beginning of year2017-03-31$27,081
Total non interest bearing cash at end of year2017-03-31$123,873
Total non interest bearing cash at beginning of year2017-03-31$142,439
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Value of net income/loss2017-03-31$-33,030
Value of net assets at end of year (total assets less liabilities)2017-03-31$82,328
Value of net assets at beginning of year (total assets less liabilities)2017-03-31$115,358
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-03-31No
Were any leases to which the plan was party in default or uncollectible2017-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-03-31$1,921,101
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-03-31No
Was there a failure to transmit to the plan any participant contributions2017-03-31No
Has the plan failed to provide any benefit when due under the plan2017-03-31No
Contributions received in cash from employer2017-03-31$1,940,937
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-03-31No
Did the plan have assets held for investment2017-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-03-31No
Opinion of an independent qualified public accountant for this plan2017-03-31Unqualified
Accountancy firm name2017-03-31NUSSBAUM YATES BERG KLEIN & WOLPOW
Accountancy firm EIN2017-03-31260221653
2016 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-31$27,081
Total income from all sources (including contributions)2016-03-31$2,222,001
Total of all expenses incurred2016-03-31$2,215,143
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-03-31$2,161,086
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-03-31$2,222,001
Value of total assets at end of year2016-03-31$142,439
Value of total assets at beginning of year2016-03-31$108,500
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-03-31$54,057
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-03-31No
Was this plan covered by a fidelity bond2016-03-31Yes
Value of fidelity bond cover2016-03-31$3,000,000
If this is an individual account plan, was there a blackout period2016-03-31No
Were there any nonexempt tranactions with any party-in-interest2016-03-31No
Administrative expenses (other) incurred2016-03-31$54,057
Liabilities. Value of operating payables at end of year2016-03-31$27,081
Total non interest bearing cash at end of year2016-03-31$142,439
Total non interest bearing cash at beginning of year2016-03-31$108,500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Value of net income/loss2016-03-31$6,858
Value of net assets at end of year (total assets less liabilities)2016-03-31$115,358
Value of net assets at beginning of year (total assets less liabilities)2016-03-31$108,500
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-03-31No
Were any leases to which the plan was party in default or uncollectible2016-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-03-31$2,161,086
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-03-31No
Was there a failure to transmit to the plan any participant contributions2016-03-31No
Has the plan failed to provide any benefit when due under the plan2016-03-31No
Contributions received in cash from employer2016-03-31$2,222,001
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-03-31No
Did the plan have assets held for investment2016-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-03-31No
Opinion of an independent qualified public accountant for this plan2016-03-31Unqualified
Accountancy firm name2016-03-31NUSSBAUM YATES BERG KLEIN & WOLPOW
Accountancy firm EIN2016-03-31260221653
2015 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2015 401k financial data
Total income from all sources (including contributions)2015-03-31$2,242,283
Total of all expenses incurred2015-03-31$2,134,283
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-03-31$2,087,657
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-03-31$2,242,283
Value of total assets at end of year2015-03-31$108,500
Value of total assets at beginning of year2015-03-31$500
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-03-31$46,626
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-03-31No
Was this plan covered by a fidelity bond2015-03-31Yes
Value of fidelity bond cover2015-03-31$3,000,000
If this is an individual account plan, was there a blackout period2015-03-31No
Were there any nonexempt tranactions with any party-in-interest2015-03-31No
Administrative expenses (other) incurred2015-03-31$46,626
Total non interest bearing cash at end of year2015-03-31$108,500
Total non interest bearing cash at beginning of year2015-03-31$500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Value of net income/loss2015-03-31$108,000
Value of net assets at end of year (total assets less liabilities)2015-03-31$108,500
Value of net assets at beginning of year (total assets less liabilities)2015-03-31$500
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-03-31No
Were any leases to which the plan was party in default or uncollectible2015-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-03-31$2,087,657
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-03-31No
Was there a failure to transmit to the plan any participant contributions2015-03-31No
Has the plan failed to provide any benefit when due under the plan2015-03-31No
Contributions received in cash from employer2015-03-31$2,242,283
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-03-31No
Did the plan have assets held for investment2015-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-03-31No
Opinion of an independent qualified public accountant for this plan2015-03-31Unqualified
Accountancy firm name2015-03-31NUSSBAUM YATES BERG KLEIN & WOLPOW,
Accountancy firm EIN2015-03-31260221653
2014 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2014 401k financial data
Total income from all sources (including contributions)2014-03-31$2,346,581
Total of all expenses incurred2014-03-31$2,346,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-03-31$2,346,581
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-03-31$2,346,581
Value of total assets at end of year2014-03-31$500
Value of total assets at beginning of year2014-03-31$500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-03-31No
Was this plan covered by a fidelity bond2014-03-31Yes
Value of fidelity bond cover2014-03-31$3,000,000
If this is an individual account plan, was there a blackout period2014-03-31No
Were there any nonexempt tranactions with any party-in-interest2014-03-31No
Total non interest bearing cash at end of year2014-03-31$500
Total non interest bearing cash at beginning of year2014-03-31$500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Value of net income/loss2014-03-31$0
Value of net assets at end of year (total assets less liabilities)2014-03-31$500
Value of net assets at beginning of year (total assets less liabilities)2014-03-31$500
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-03-31No
Were any leases to which the plan was party in default or uncollectible2014-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-03-31$2,346,581
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-03-31No
Was there a failure to transmit to the plan any participant contributions2014-03-31No
Has the plan failed to provide any benefit when due under the plan2014-03-31No
Contributions received in cash from employer2014-03-31$2,346,581
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-03-31No
Did the plan have assets held for investment2014-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-03-31No
Opinion of an independent qualified public accountant for this plan2014-03-31Unqualified
Accountancy firm name2014-03-31NUSSBAUM YATES BERG KLEIN & WOLPOW,
Accountancy firm EIN2014-03-31260221653
2013 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2013 401k financial data
Total income from all sources (including contributions)2013-03-31$2,167,024
Total of all expenses incurred2013-03-31$2,167,024
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-03-31$2,167,024
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-03-31$2,167,024
Value of total assets at end of year2013-03-31$500
Value of total assets at beginning of year2013-03-31$500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-03-31No
Was this plan covered by a fidelity bond2013-03-31Yes
Value of fidelity bond cover2013-03-31$2,000,000
If this is an individual account plan, was there a blackout period2013-03-31No
Were there any nonexempt tranactions with any party-in-interest2013-03-31No
Total non interest bearing cash at end of year2013-03-31$500
Total non interest bearing cash at beginning of year2013-03-31$500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Value of net income/loss2013-03-31$0
Value of net assets at end of year (total assets less liabilities)2013-03-31$500
Value of net assets at beginning of year (total assets less liabilities)2013-03-31$500
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-03-31No
Were any leases to which the plan was party in default or uncollectible2013-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-03-31$2,167,024
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-03-31No
Was there a failure to transmit to the plan any participant contributions2013-03-31No
Has the plan failed to provide any benefit when due under the plan2013-03-31No
Contributions received in cash from employer2013-03-31$2,167,024
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-03-31No
Did the plan have assets held for investment2013-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-03-31No
Opinion of an independent qualified public accountant for this plan2013-03-31Unqualified
Accountancy firm name2013-03-31NUSSBAUM YATES BERG KLEIN & WOLPOW,
Accountancy firm EIN2013-03-31260221653
2012 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2012 401k financial data
Total income from all sources (including contributions)2012-03-31$1,911,219
Total of all expenses incurred2012-03-31$1,911,219
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-03-31$1,911,219
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-03-31$1,911,219
Value of total assets at end of year2012-03-31$500
Value of total assets at beginning of year2012-03-31$500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-03-31No
Was this plan covered by a fidelity bond2012-03-31Yes
Value of fidelity bond cover2012-03-31$2,000,000
If this is an individual account plan, was there a blackout period2012-03-31No
Were there any nonexempt tranactions with any party-in-interest2012-03-31No
Total non interest bearing cash at end of year2012-03-31$500
Total non interest bearing cash at beginning of year2012-03-31$500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Value of net income/loss2012-03-31$0
Value of net assets at end of year (total assets less liabilities)2012-03-31$500
Value of net assets at beginning of year (total assets less liabilities)2012-03-31$500
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-03-31No
Were any leases to which the plan was party in default or uncollectible2012-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-03-31$1,911,219
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-03-31No
Was there a failure to transmit to the plan any participant contributions2012-03-31No
Has the plan failed to provide any benefit when due under the plan2012-03-31No
Contributions received in cash from employer2012-03-31$1,911,219
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-03-31No
Did the plan have assets held for investment2012-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-03-31No
Opinion of an independent qualified public accountant for this plan2012-03-31Unqualified
Accountancy firm name2012-03-31NUSSBAUM YATES BERG KLEIN & WOLPOW,
Accountancy firm EIN2012-03-31260221653
2011 : SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2011 401k financial data
Total income from all sources (including contributions)2011-03-31$1,761,807
Total of all expenses incurred2011-03-31$1,761,807
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-03-31$1,761,807
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-03-31$1,761,807
Value of total assets at end of year2011-03-31$500
Value of total assets at beginning of year2011-03-31$500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-03-31No
Was this plan covered by a fidelity bond2011-03-31Yes
Value of fidelity bond cover2011-03-31$2,000,000
If this is an individual account plan, was there a blackout period2011-03-31No
Were there any nonexempt tranactions with any party-in-interest2011-03-31No
Total non interest bearing cash at end of year2011-03-31$500
Total non interest bearing cash at beginning of year2011-03-31$500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Value of net income/loss2011-03-31$0
Value of net assets at end of year (total assets less liabilities)2011-03-31$500
Value of net assets at beginning of year (total assets less liabilities)2011-03-31$500
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-03-31No
Were any leases to which the plan was party in default or uncollectible2011-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-03-31$1,761,807
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-03-31No
Was there a failure to transmit to the plan any participant contributions2011-03-31No
Has the plan failed to provide any benefit when due under the plan2011-03-31No
Contributions received in cash from employer2011-03-31$1,761,807
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-03-31No
Did the plan have assets held for investment2011-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-03-31No
Opinion of an independent qualified public accountant for this plan2011-03-31Unqualified
Accountancy firm name2011-03-31NUSSBAUM YATES BERG KLEIN & WOLPOW
Accountancy firm EIN2011-03-31260221653

Form 5500 Responses for SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION

2022: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – TrustYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement - TrustYes
2021: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – TrustYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement - TrustYes
2020: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – TrustYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement - TrustYes
2019: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes
2018: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement - TrustYes
2017: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – TrustYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement - TrustYes
2016: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – TrustYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement - TrustYes
2015: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Plan funding arrangement – TrustYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement - TrustYes
2014: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Plan funding arrangement – TrustYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement - TrustYes
2013: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Plan funding arrangement – TrustYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement - TrustYes
2012: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Plan funding arrangement – TrustYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement - TrustYes
2011: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Plan funding arrangement – TrustYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement - TrustYes
2009: SID HARVEY INDUSTRIES, INC. VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01This submission is the final filingNo
2009-04-01Plan funding arrangement – TrustYes
2009-04-01Plan benefit arrangement – InsuranceYes
2009-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number10106225
Policy instance 3
Insurance contract or identification number10106225
Number of Individuals Covered55
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $404,769
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 number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered0
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00
Policy instance 2
Insurance contract or identification number05-56497-00
Number of Individuals Covered47
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number300457
Policy instance 4
Insurance contract or identification number300457
Number of Individuals Covered437
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
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,259,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA DENTAL HEALTH PLAN OF COLORADO, INC. (National Association of Insurance Commissioners NAIC id number: 11175 )
Policy contract number3214388
Policy instance 5
Insurance contract or identification number3214388
Number of Individuals Covered4
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA DENTAL HEALTH OF DELAWARE, INC. (National Association of Insurance Commissioners NAIC id number: 95380 )
Policy contract number3214388
Policy instance 6
Insurance contract or identification number3214388
Number of Individuals Covered1
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $906
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA DENTAL HEALTH OF KENTUCKY, INC. (National Association of Insurance Commissioners NAIC id number: 52108 )
Policy contract number3214388
Policy instance 7
Insurance contract or identification number3214388
Number of Individuals Covered4
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 )
Policy contract number3214388
Policy instance 8
Insurance contract or identification number3214388
Number of Individuals Covered14
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA DENTAL HEALTH OF NORTH CAROLINA, INC. (National Association of Insurance Commissioners NAIC id number: 95179 )
Policy contract number3214388
Policy instance 9
Insurance contract or identification number3214388
Number of Individuals Covered3
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47041 )
Policy contract number3214388
Policy instance 10
Insurance contract or identification number3214388
Number of Individuals Covered20
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3214388
Policy instance 11
Insurance contract or identification number3214388
Number of Individuals Covered8
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number928007
Policy instance 12
Insurance contract or identification number928007
Number of Individuals Covered498
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $5,941
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,767,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,941
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered259
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number10106225
Policy instance 3
Insurance contract or identification number10106225
Number of Individuals Covered63
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $429,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number300457
Policy instance 4
Insurance contract or identification number300457
Number of Individuals Covered389
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $7,140
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,414,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees7140
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00
Policy instance 2
Insurance contract or identification number05-56497-00
Number of Individuals Covered34
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $2,106
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,106
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered250
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00
Policy instance 2
Insurance contract or identification number05-56497-00
Number of Individuals Covered32
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $1,251
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,251
Insurance broker organization code?3
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number10106225
Policy instance 3
Insurance contract or identification number10106225
Number of Individuals Covered77
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $401,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number71-31799
Policy instance 4
Insurance contract or identification number71-31799
Number of Individuals Covered231
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL34172
Policy instance 5
Insurance contract or identification numberHCL34172
Number of Individuals Covered253
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $506,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CORESOURCE (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberSHM834
Policy instance 6
Insurance contract or identification numberSHM834
Number of Individuals Covered242
Insurance policy start date2019-07-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00
Policy instance 2
Insurance contract or identification number05-56497-00
Number of Individuals Covered30
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $1,216
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,216
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered217
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL34172
Policy instance 5
Insurance contract or identification numberHCL34172
Number of Individuals Covered222
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $370,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number71-31799
Policy instance 6
Insurance contract or identification number71-31799
Number of Individuals Covered233
Insurance policy start date2019-06-01
Insurance policy end date2019-07-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number71-31799
Policy instance 4
Insurance contract or identification number71-31799
Number of Individuals Covered222
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number10106225
Policy instance 3
Insurance contract or identification number10106225
Number of Individuals Covered40
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $367,546
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 number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered207
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number106225
Policy instance 3
Insurance contract or identification number106225
Number of Individuals Covered75
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $345,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST SYMETRA NATIONAL LIFE INS CO OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 78417 )
Policy contract number16-013142-000
Policy instance 5
Insurance contract or identification number16-013142-000
Number of Individuals Covered204
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $348,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00
Policy instance 2
Insurance contract or identification number05-56497-00
Number of Individuals Covered27
Insurance policy start date2017-08-01
Insurance policy end date2018-08-01
Total amount of commissions paid to insurance brokerUSD $387
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $387
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number71-31799-99
Policy instance 4
Insurance contract or identification number71-31799-99
Number of Individuals Covered204
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST SYMETRA NATIONAL LIFE INS CO OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 78417 )
Policy contract number16-013142-000
Policy instance 5
Insurance contract or identification number16-013142-000
Number of Individuals Covered198
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $342,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number71-31799-99
Policy instance 4
Insurance contract or identification number71-31799-99
Number of Individuals Covered198
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number106225
Policy instance 3
Insurance contract or identification number106225
Number of Individuals Covered63
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $341,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00
Policy instance 2
Insurance contract or identification number05-56497-00
Number of Individuals Covered31
Insurance policy start date2016-08-01
Insurance policy end date2017-08-01
Total amount of commissions paid to insurance brokerUSD $1,199
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,199
Insurance broker organization code?3
Insurance broker nameJOSEPH SCHAUB
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered205
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number106225
Policy instance 3
Insurance contract or identification number106225
Number of Individuals Covered21
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $309,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00
Policy instance 2
Insurance contract or identification number05-56497-00
Number of Individuals Covered21
Insurance policy start date2014-08-01
Insurance policy end date2015-08-01
Total amount of commissions paid to insurance brokerUSD $1,366
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,366
Insurance broker organization code?3
Insurance broker nameJOSEPH SCHAUB
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered208
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number70-31799-00
Policy instance 4
Insurance contract or identification number70-31799-00
Number of Individuals Covered204
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00
Policy instance 2
Insurance contract or identification number05-56497-00
Number of Individuals Covered29
Insurance policy start date2013-08-01
Insurance policy end date2014-08-01
Total amount of commissions paid to insurance brokerUSD $1,661
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,661
Insurance broker organization code?3
Insurance broker nameJOSEPH SCHAUB
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number106225
Policy instance 3
Insurance contract or identification number106225
Number of Individuals Covered59
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $280,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number70-31799-00
Policy instance 4
Insurance contract or identification number70-31799-00
Number of Individuals Covered203
Insurance policy start date2013-06-01
Insurance policy end date2014-06-01
Total amount of commissions paid to insurance brokerUSD $54,845
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,845
Insurance broker organization code?3
Insurance broker nameALPINE AGENCY
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered201
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $65
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees65
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered204
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $126
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees126
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number106225
Policy instance 3
Insurance contract or identification number106225
Number of Individuals Covered60
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $258,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number70-31799-00
Policy instance 4
Insurance contract or identification number70-31799-00
Number of Individuals Covered215
Insurance policy start date2012-06-01
Insurance policy end date2013-06-01
Total amount of commissions paid to insurance brokerUSD $55,796
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,796
Insurance broker organization code?3
Insurance broker nameALPINE AGENCY
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number055649700
Policy instance 2
Insurance contract or identification number055649700
Number of Individuals Covered30
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $1,980
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,980
Insurance broker organization code?3
Insurance broker nameJOSEPH SCHAUB
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number70-31799-00
Policy instance 4
Insurance contract or identification number70-31799-00
Number of Individuals Covered209
Insurance policy start date2011-06-01
Insurance policy end date2012-06-01
Total amount of commissions paid to insurance brokerUSD $48,935
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,935
Insurance broker organization code?3
Insurance broker nameALPINE AGENCY
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number106225
Policy instance 3
Insurance contract or identification number106225
Number of Individuals Covered54
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $224,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497
Policy instance 2
Insurance contract or identification number05-56497
Number of Individuals Covered49
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $1,380
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,380
Insurance broker organization code?3
Insurance broker nameALPINE AGENCY
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered188
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $143
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Other welfare benefits providedPREPAID DENTAL
Welfare Benefit Premiums Paid to CarrierUSD $77,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees143
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number70-31799-00
Policy instance 4
Insurance contract or identification number70-31799-00
Number of Individuals Covered206
Insurance policy start date2010-06-01
Insurance policy end date2011-06-01
Total amount of commissions paid to insurance brokerUSD $45,223
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number106225
Policy instance 3
Insurance contract or identification number106225
Number of Individuals Covered58
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $190,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497
Policy instance 2
Insurance contract or identification number05-56497
Number of Individuals Covered46
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $1,432
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered181
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $85
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3214388
Policy instance 1
Insurance contract or identification number3214388
Number of Individuals Covered158
Insurance policy start date2009-06-01
Insurance policy end date2010-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number05-56497-00-2
Policy instance 2
Insurance contract or identification number05-56497-00-2
Number of Individuals Covered56
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $1,485
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number106225
Policy instance 3
Insurance contract or identification number106225
Number of Individuals Covered53
Insurance policy start date2009-06-01
Insurance policy end date2010-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $152,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number70-31799-00
Policy instance 4
Insurance contract or identification number70-31799-00
Number of Individuals Covered202
Insurance policy start date2009-06-01
Insurance policy end date2010-06-01
Total amount of commissions paid to insurance brokerUSD $42,970
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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