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IBEW EASTERN STATES HEALTH & BENEFITS FUND 401k Plan overview

Plan NameIBEW EASTERN STATES HEALTH & BENEFITS FUND
Plan identification number 501

IBEW EASTERN STATES HEALTH & BENEFITS FUND Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)
  • Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

BOARD OF TRUSTEES OF IBEW has sponsored the creation of one or more 401k plans.

Company Name:BOARD OF TRUSTEES OF IBEW
Employer identification number (EIN):146030541
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IBEW EASTERN STATES HEALTH & BENEFITS FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01STEVEN T. SCHLAPP
5012016-01-01STEVEN T. SCHLAPP
5012016-01-01STEVEN T. SCHLAPP
5012015-01-01STEVEN T. SCHLAPP
5012014-01-01STEVEN T. SCHLAPP
5012013-01-01STEVEN T. SCHLAPP
5012012-01-01STEVEN T SCHLAPP
5012011-01-01STEVEN T SCHLAPP
5012009-01-01STEVEN T SCHLAPP
5012009-01-01STEVEN T SCHLAPP

Plan Statistics for IBEW EASTERN STATES HEALTH & BENEFITS FUND

401k plan membership statisitcs for IBEW EASTERN STATES HEALTH & BENEFITS FUND

Measure Date Value
2022: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2022 401k membership
Total participants, beginning-of-year2022-01-018
Total number of active participants reported on line 7a of the Form 55002022-01-017
Total of all active and inactive participants2022-01-017
Total participants2022-01-017
2021: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2021 401k membership
Total participants, beginning-of-year2021-01-019
Total number of active participants reported on line 7a of the Form 55002021-01-018
Total of all active and inactive participants2021-01-018
Total participants2021-01-018
2020: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2020 401k membership
Total participants, beginning-of-year2020-01-0110
Total number of active participants reported on line 7a of the Form 55002020-01-019
Total of all active and inactive participants2020-01-019
Total participants2020-01-019
2019: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2019 401k membership
Total participants, beginning-of-year2019-01-016
Total number of active participants reported on line 7a of the Form 55002019-01-0110
Total of all active and inactive participants2019-01-0110
Total participants2019-01-0110
2018: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2018 401k membership
Total participants, beginning-of-year2018-01-0136
Total number of active participants reported on line 7a of the Form 55002018-01-015
Number of retired or separated participants receiving benefits2018-01-011
Total of all active and inactive participants2018-01-016
Total participants2018-01-016
2017: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2017 401k membership
Total participants, beginning-of-year2017-01-0142
Total number of active participants reported on line 7a of the Form 55002017-01-0136
Total of all active and inactive participants2017-01-0136
Total participants2017-01-0136
2016: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2016 401k membership
Total participants, beginning-of-year2016-01-0161
Total number of active participants reported on line 7a of the Form 55002016-01-0142
Total of all active and inactive participants2016-01-0142
Total participants2016-01-0142
Number of employers contributing to the scheme2016-01-014
2015: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2015 401k membership
Total participants, beginning-of-year2015-01-0172
Total number of active participants reported on line 7a of the Form 55002015-01-0161
Total of all active and inactive participants2015-01-0161
Total participants2015-01-010
Number of employers contributing to the scheme2015-01-015
2014: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2014 401k membership
Total participants, beginning-of-year2014-01-01107
Total number of active participants reported on line 7a of the Form 55002014-01-0172
Total of all active and inactive participants2014-01-0172
Total participants2014-01-010
Number of employers contributing to the scheme2014-01-0110
2013: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2013 401k membership
Total participants, beginning-of-year2013-01-01107
Total number of active participants reported on line 7a of the Form 55002013-01-01107
Total of all active and inactive participants2013-01-01107
Total participants2013-01-010
Number of employers contributing to the scheme2013-01-0113
2012: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2012 401k membership
Total participants, beginning-of-year2012-01-01120
Total number of active participants reported on line 7a of the Form 55002012-01-01104
Number of retired or separated participants receiving benefits2012-01-013
Total of all active and inactive participants2012-01-01107
Total participants2012-01-010
Number of employers contributing to the scheme2012-01-0113
2011: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2011 401k membership
Total participants, beginning-of-year2011-01-01126
Total number of active participants reported on line 7a of the Form 55002011-01-01118
Number of retired or separated participants receiving benefits2011-01-012
Total of all active and inactive participants2011-01-01120
Total participants2011-01-01120
Number of employers contributing to the scheme2011-01-0113
2009: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2009 401k membership
Total participants, beginning-of-year2009-01-01148
Total number of active participants reported on line 7a of the Form 55002009-01-01127
Number of retired or separated participants receiving benefits2009-01-016
Total of all active and inactive participants2009-01-01133
Total participants2009-01-01133
Number of employers contributing to the scheme2009-01-0116

Financial Data on IBEW EASTERN STATES HEALTH & BENEFITS FUND

Measure Date Value
2022 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2022 401k financial data
Total plan liabilities at end of year2022-12-31$83,823
Total plan liabilities at beginning of year2022-12-31$88,897
Total income from all sources2022-12-31$-4,827
Expenses. Total of all expenses incurred2022-12-31$174,819
Benefits paid (including direct rollovers)2022-12-31$117,372
Total plan assets at end of year2022-12-31$1,113,056
Total plan assets at beginning of year2022-12-31$1,297,776
Value of fidelity bond covering the plan2022-12-31$250,000
Total contributions received or receivable from participants2022-12-31$11,188
Expenses. Other expenses not covered elsewhere2022-12-31$41,247
Other income received2022-12-31$-103,465
Net income (gross income less expenses)2022-12-31$-179,646
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,029,233
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,208,879
Total contributions received or receivable from employer(s)2022-12-31$87,450
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$16,200
2021 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2021 401k financial data
Total plan liabilities at end of year2021-12-31$88,897
Total plan liabilities at beginning of year2021-12-31$107,466
Total income from all sources2021-12-31$203,297
Expenses. Total of all expenses incurred2021-12-31$170,721
Benefits paid (including direct rollovers)2021-12-31$109,752
Total plan assets at end of year2021-12-31$1,297,776
Total plan assets at beginning of year2021-12-31$1,283,769
Value of fidelity bond covering the plan2021-12-31$250,000
Total contributions received or receivable from participants2021-12-31$831
Expenses. Other expenses not covered elsewhere2021-12-31$44,769
Other income received2021-12-31$112,105
Net income (gross income less expenses)2021-12-31$32,576
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,208,879
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,176,303
Total contributions received or receivable from employer(s)2021-12-31$90,361
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$16,200
2020 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2020 401k financial data
Total plan liabilities at end of year2020-12-31$107,466
Total plan liabilities at beginning of year2020-12-31$109,578
Total income from all sources2020-12-31$186,330
Expenses. Total of all expenses incurred2020-12-31$157,632
Benefits paid (including direct rollovers)2020-12-31$103,732
Total plan assets at end of year2020-12-31$1,283,769
Total plan assets at beginning of year2020-12-31$1,257,183
Value of fidelity bond covering the plan2020-12-31$250,000
Expenses. Other expenses not covered elsewhere2020-12-31$37,700
Other income received2020-12-31$102,984
Net income (gross income less expenses)2020-12-31$28,698
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,176,303
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,147,605
Total contributions received or receivable from employer(s)2020-12-31$83,346
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$16,200
2019 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2019 401k financial data
Total plan liabilities at end of year2019-12-31$109,578
Total plan liabilities at beginning of year2019-12-31$128,439
Total income from all sources2019-12-31$215,947
Expenses. Total of all expenses incurred2019-12-31$144,070
Benefits paid (including direct rollovers)2019-12-31$77,541
Total plan assets at end of year2019-12-31$1,257,183
Total plan assets at beginning of year2019-12-31$1,204,167
Total contributions received or receivable from participants2019-12-31$721
Expenses. Other expenses not covered elsewhere2019-12-31$49,860
Other income received2019-12-31$147,317
Net income (gross income less expenses)2019-12-31$71,877
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,147,605
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,075,728
Total contributions received or receivable from employer(s)2019-12-31$67,909
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$16,669
2018 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2018 401k financial data
Total plan liabilities at end of year2018-12-31$128,439
Total plan liabilities at beginning of year2018-12-31$140,457
Total income from all sources2018-12-31$32,904
Expenses. Total of all expenses incurred2018-12-31$155,172
Benefits paid (including direct rollovers)2018-12-31$100,003
Total plan assets at end of year2018-12-31$1,204,167
Total plan assets at beginning of year2018-12-31$1,338,453
Total contributions received or receivable from participants2018-12-31$1,367
Expenses. Other expenses not covered elsewhere2018-12-31$55,169
Other income received2018-12-31$-31,266
Net income (gross income less expenses)2018-12-31$-122,268
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,075,728
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,197,996
Total contributions received or receivable from employer(s)2018-12-31$62,803
2017 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2017 401k financial data
Total plan liabilities at end of year2017-12-31$140,457
Total plan liabilities at beginning of year2017-12-31$135,402
Total income from all sources2017-12-31$581,582
Expenses. Total of all expenses incurred2017-12-31$521,514
Benefits paid (including direct rollovers)2017-12-31$468,324
Total plan assets at end of year2017-12-31$1,338,453
Total plan assets at beginning of year2017-12-31$1,273,330
Expenses. Other expenses not covered elsewhere2017-12-31$4,482
Other income received2017-12-31$117,517
Net income (gross income less expenses)2017-12-31$60,068
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,197,996
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,137,928
Total contributions received or receivable from employer(s)2017-12-31$464,065
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$48,708
2016 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2016 401k financial data
Total plan liabilities at end of year2016-12-31$33,922
Total plan liabilities at beginning of year2016-12-31$29,880
Total income from all sources2016-12-31$686,149
Expenses. Total of all expenses incurred2016-12-31$686,058
Benefits paid (including direct rollovers)2016-12-31$634,485
Total plan assets at end of year2016-12-31$1,273,330
Total plan assets at beginning of year2016-12-31$1,269,197
Value of fidelity bond covering the plan2016-12-31$500,000
Expenses. Other expenses not covered elsewhere2016-12-31$6,793
Other income received2016-12-31$67,451
Net income (gross income less expenses)2016-12-31$91
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,239,408
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,239,317
Total contributions received or receivable from employer(s)2016-12-31$618,698
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$44,780
2015 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2015 401k financial data
Total plan liabilities at end of year2015-12-31$29,880
Total plan liabilities at beginning of year2015-12-31$17,696
Total income from all sources2015-12-31$902,723
Expenses. Total of all expenses incurred2015-12-31$908,973
Benefits paid (including direct rollovers)2015-12-31$850,168
Total plan assets at end of year2015-12-31$1,269,197
Total plan assets at beginning of year2015-12-31$1,263,263
Value of fidelity bond covering the plan2015-12-31$500,000
Expenses. Other expenses not covered elsewhere2015-12-31$58,805
Other income received2015-12-31$970
Net income (gross income less expenses)2015-12-31$-6,250
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,239,317
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,245,567
Total contributions received or receivable from employer(s)2015-12-31$901,753
2014 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$17,696
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$136,211
Total income from all sources (including contributions)2014-12-31$1,115,584
Total loss/gain on sale of assets2014-12-31$33,919
Total of all expenses incurred2014-12-31$1,103,221
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,047,362
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,042,562
Value of total assets at end of year2014-12-31$1,263,263
Value of total assets at beginning of year2014-12-31$1,369,415
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$55,859
Total interest from all sources2014-12-31$1,596
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$22,196
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$12,270
Administrative expenses professional fees incurred2014-12-31$27,557
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$1,345
Administrative expenses (other) incurred2014-12-31$6,844
Liabilities. Value of operating payables at end of year2014-12-31$17,696
Liabilities. Value of operating payables at beginning of year2014-12-31$29,868
Total non interest bearing cash at end of year2014-12-31$49,510
Total non interest bearing cash at beginning of year2014-12-31$36,378
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$12,363
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,245,567
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,233,204
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$7,318
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$958,070
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$116,095
Income. Interest from US Government securities2014-12-31$1,245
Income. Interest from corporate debt instruments2014-12-31$335
Value of interest in common/collective trusts at end of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$185,910
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$52,095
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$52,095
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$16
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$1,047,362
Asset value of US Government securities at beginning of year2014-12-31$207,689
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$15,311
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$1,042,562
Employer contributions (assets) at end of year2014-12-31$67,958
Employer contributions (assets) at beginning of year2014-12-31$163,970
Income. Dividends from common stock2014-12-31$9,926
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$44,287
Contract administrator fees2014-12-31$14,140
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$746,803
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$106,343
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$1,815
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$753
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$1,201,260
Aggregate carrying amount (costs) on sale of assets2014-12-31$1,167,341
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31GOULD KOBRICK & SCHLAPP PC
Accountancy firm EIN2014-12-31133082707
2013 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$78,807
Total unrealized appreciation/depreciation of assets2013-12-31$78,807
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$136,211
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$35,818
Total income from all sources (including contributions)2013-12-31$1,426,988
Total loss/gain on sale of assets2013-12-31$58,751
Total of all expenses incurred2013-12-31$1,290,805
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,231,811
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,261,169
Value of total assets at end of year2013-12-31$1,369,415
Value of total assets at beginning of year2013-12-31$1,132,839
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$58,994
Total interest from all sources2013-12-31$6,124
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$25,857
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$10,025
Administrative expenses professional fees incurred2013-12-31$25,216
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$3,992
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$1,345
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$1,385
Other income not declared elsewhere2013-12-31$5,474
Administrative expenses (other) incurred2013-12-31$9,169
Liabilities. Value of operating payables at end of year2013-12-31$29,868
Liabilities. Value of operating payables at beginning of year2013-12-31$35,818
Total non interest bearing cash at end of year2013-12-31$36,378
Total non interest bearing cash at beginning of year2013-12-31$31,327
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$136,183
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,233,204
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,097,021
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$11,409
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$116,095
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$117,629
Income. Interest from US Government securities2013-12-31$4,451
Income. Interest from corporate debt instruments2013-12-31$1,673
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$52,095
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$24,813
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$24,813
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$1,231,811
Asset value of US Government securities at end of year2013-12-31$207,689
Asset value of US Government securities at beginning of year2013-12-31$221,881
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$-9,194
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$1,257,177
Employer contributions (assets) at end of year2013-12-31$163,970
Employer contributions (assets) at beginning of year2013-12-31$78,764
Income. Dividends from common stock2013-12-31$15,832
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$44,287
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$44,712
Contract administrator fees2013-12-31$13,200
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$746,803
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$610,960
Liabilities. Value of benefit claims payable at end of year2013-12-31$106,343
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$753
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$1,368
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$413,025
Aggregate carrying amount (costs) on sale of assets2013-12-31$354,274
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31GOULD KOBRICK & SCHLAPP PC
Accountancy firm EIN2013-12-31133082707
2012 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$42,991
Total unrealized appreciation/depreciation of assets2012-12-31$42,991
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$35,818
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$120,905
Total income from all sources (including contributions)2012-12-31$1,339,462
Total loss/gain on sale of assets2012-12-31$32,371
Total of all expenses incurred2012-12-31$1,334,929
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,244,620
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,225,198
Value of total assets at end of year2012-12-31$1,132,839
Value of total assets at beginning of year2012-12-31$1,213,393
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$90,309
Total interest from all sources2012-12-31$7,123
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$21,755
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$5,884
Administrative expenses professional fees incurred2012-12-31$28,709
Was this plan covered by a fidelity bond2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$10,035
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$1,385
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$24,204
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$104,204
Other income not declared elsewhere2012-12-31$36
Administrative expenses (other) incurred2012-12-31$37,039
Liabilities. Value of operating payables at end of year2012-12-31$35,818
Liabilities. Value of operating payables at beginning of year2012-12-31$16,701
Total non interest bearing cash at end of year2012-12-31$31,327
Total non interest bearing cash at beginning of year2012-12-31$192,312
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$4,533
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,097,021
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,092,488
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$11,361
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$117,629
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$110,486
Income. Interest from US Government securities2012-12-31$5,217
Income. Interest from corporate debt instruments2012-12-31$1,906
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$24,813
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$32,082
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$32,082
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$1,244,620
Asset value of US Government securities at end of year2012-12-31$221,881
Asset value of US Government securities at beginning of year2012-12-31$211,297
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$9,988
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,215,163
Employer contributions (assets) at end of year2012-12-31$78,764
Employer contributions (assets) at beginning of year2012-12-31$62,746
Income. Dividends from common stock2012-12-31$15,871
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$44,712
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$39,446
Contract administrator fees2012-12-31$13,200
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$610,960
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$538,838
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$1,368
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$1,982
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$563,298
Aggregate carrying amount (costs) on sale of assets2012-12-31$530,927
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31GOULD KOBRICK & SCHLAPP PC
Accountancy firm EIN2012-12-31133082707
2011 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-52,864
Total unrealized appreciation/depreciation of assets2011-12-31$-52,864
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$120,905
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$18,250
Total income from all sources (including contributions)2011-12-31$1,225,320
Total loss/gain on sale of assets2011-12-31$23,913
Total of all expenses incurred2011-12-31$1,259,537
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,199,150
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,224,938
Value of total assets at end of year2011-12-31$1,213,393
Value of total assets at beginning of year2011-12-31$1,144,955
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$60,387
Total interest from all sources2011-12-31$8,193
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$16,286
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$6,576
Administrative expenses professional fees incurred2011-12-31$25,513
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$9,209
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$24,204
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$18,163
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$104,204
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$1,547
Other income not declared elsewhere2011-12-31$4,960
Administrative expenses (other) incurred2011-12-31$10,275
Liabilities. Value of operating payables at end of year2011-12-31$16,701
Liabilities. Value of operating payables at beginning of year2011-12-31$16,703
Total non interest bearing cash at end of year2011-12-31$192,312
Total non interest bearing cash at beginning of year2011-12-31$79,563
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-34,217
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,092,488
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,126,705
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$11,328
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$110,486
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$99,488
Income. Interest from US Government securities2011-12-31$6,304
Income. Interest from corporate debt instruments2011-12-31$1,858
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$32,082
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$25,866
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$25,866
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$31
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$1,199,150
Asset value of US Government securities at end of year2011-12-31$211,297
Asset value of US Government securities at beginning of year2011-12-31$218,970
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-106
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$1,215,729
Employer contributions (assets) at end of year2011-12-31$62,746
Employer contributions (assets) at beginning of year2011-12-31$64,359
Income. Dividends from common stock2011-12-31$9,710
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$39,446
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$43,197
Contract administrator fees2011-12-31$13,271
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$538,838
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$594,847
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$1,982
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$502
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$553,762
Aggregate carrying amount (costs) on sale of assets2011-12-31$529,849
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31GOULD KOBRICK & SCHLAPP PC
Accountancy firm EIN2011-12-31133082707
2010 : IBEW EASTERN STATES HEALTH & BENEFITS FUND 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$45,172
Total unrealized appreciation/depreciation of assets2010-12-31$45,172
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$18,250
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$24,885
Total income from all sources (including contributions)2010-12-31$1,296,663
Total loss/gain on sale of assets2010-12-31$57,879
Total of all expenses incurred2010-12-31$1,339,381
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,275,827
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,150,223
Value of total assets at end of year2010-12-31$1,144,955
Value of total assets at beginning of year2010-12-31$1,194,308
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$63,554
Total interest from all sources2010-12-31$10,793
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$20,712
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$11,149
Administrative expenses professional fees incurred2010-12-31$25,229
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$22,774
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$18,163
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$54,426
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$1,547
Other income not declared elsewhere2010-12-31$4,504
Administrative expenses (other) incurred2010-12-31$13,515
Liabilities. Value of operating payables at end of year2010-12-31$16,703
Liabilities. Value of operating payables at beginning of year2010-12-31$24,250
Total non interest bearing cash at end of year2010-12-31$79,563
Total non interest bearing cash at beginning of year2010-12-31$2,356
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-42,718
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,126,705
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,169,423
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$11,610
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$99,488
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$91,784
Interest earned on other investments2010-12-31$54
Income. Interest from US Government securities2010-12-31$7,124
Income. Interest from corporate debt instruments2010-12-31$3,603
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$25,866
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$56,567
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$56,567
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$12
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$1,275,827
Asset value of US Government securities at end of year2010-12-31$218,970
Asset value of US Government securities at beginning of year2010-12-31$228,334
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$7,380
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$1,127,449
Employer contributions (assets) at end of year2010-12-31$64,359
Employer contributions (assets) at beginning of year2010-12-31$89,588
Income. Dividends from common stock2010-12-31$9,563
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$43,197
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$52,072
Contract administrator fees2010-12-31$13,200
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$594,847
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$617,492
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$635
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$502
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$1,689
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$576,451
Aggregate carrying amount (costs) on sale of assets2010-12-31$518,572
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31GOULD KOBRICK & SCHLAPP PC
Accountancy firm EIN2010-12-31133082707

Form 5500 Responses for IBEW EASTERN STATES HEALTH & BENEFITS FUND

2022: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Submission has been amendedYes
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: IBEW EASTERN STATES HEALTH & BENEFITS FUND 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract numberA67483
Policy instance 1
Insurance contract or identification numberA67483
Number of Individuals Covered8
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,716
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $117,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,716
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract numberA67483
Policy instance 1
Insurance contract or identification numberA67483
Number of Individuals Covered8
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,368
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $109,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,368
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract numberA67483
Policy instance 1
Insurance contract or identification numberA67483
Number of Individuals Covered9
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,140
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,140
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract numberA67483
Policy instance 1
Insurance contract or identification numberA67483
Number of Individuals Covered12
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,902
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,902
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract numberA67483
Policy instance 1
Insurance contract or identification numberA67483
Number of Individuals Covered16
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,713
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,713
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract numberA67483
Policy instance 2
Insurance contract or identification numberA67483
Number of Individuals Covered35
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $21,320
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $502,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,320
Insurance broker organization code?3
Insurance broker nameBPAS ACTUARIAL AND PENSION SERVICES
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFNYH893235
Policy instance 3
Insurance contract or identification numberFNYH893235
Number of Individuals Covered45
Insurance policy start date2017-04-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $466
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD,DEPSP
Welfare Benefit Premiums Paid to CarrierUSD $3,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees466
Insurance broker organization code?3
Insurance broker nameWINSTON FINANCIAL SERVICES INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFNYH893235
Policy instance 1
Insurance contract or identification numberFNYH893235
Number of Individuals Covered42
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of fees paid to insurance companyUSD $664
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD,DEPSP
Welfare Benefit Premiums Paid to CarrierUSD $4,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees664
Insurance broker organization code?3
Insurance broker nameWINSTON FINANCIAL SERVICES INC
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00041139
Policy instance 2
Insurance contract or identification number00041139
Number of Individuals Covered61
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $36,241
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $841,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees36241
Insurance broker organization code?3
Insurance broker nameHARBRIDGE CONSULTING GROUP LLC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFNYH893235
Policy instance 3
Insurance contract or identification numberFNYH893235
Number of Individuals Covered66
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $969
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD,DEPSP,LIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $6,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $969
Insurance broker organization code?3
Insurance broker nameWINSTON FINANCIAL SERVICES INC
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberC3908
Policy instance 1
Insurance contract or identification numberC3908
Number of Individuals Covered2
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberC3908
Policy instance 1
Insurance contract or identification numberC3908
Number of Individuals Covered14
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number680106G
Policy instance 3
Insurance contract or identification number680106G
Number of Individuals Covered24
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFNYH893235
Policy instance 4
Insurance contract or identification numberFNYH893235
Number of Individuals Covered128
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $1,329
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD,DEPSP,LIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $10,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,329
Insurance broker organization code?3
Insurance broker nameWINSTON FINANCIAL SERVICES INC
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00041139
Policy instance 2
Insurance contract or identification number00041139
Number of Individuals Covered70
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $46,647
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,023,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,647
Insurance broker organization code?3
Insurance broker nameHARBRIDGE CONSULTING GROUP LLC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFNYH893235
Policy instance 4
Insurance contract or identification numberFNYH893235
Number of Individuals Covered155
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $1,250
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD,DEPSP,LIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $9,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,250
Insurance broker organization code?3
Insurance broker nameWINSTON FINANCIAL SERVICES INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number680106G
Policy instance 3
Insurance contract or identification number680106G
Number of Individuals Covered16
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00041139
Policy instance 2
Insurance contract or identification number00041139
Number of Individuals Covered109
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $40,417
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,203,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,417
Insurance broker organization code?3
Insurance broker nameHARBRIDGE CONSULTING GROUP LLC
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberC3908
Policy instance 1
Insurance contract or identification numberC3908
Number of Individuals Covered40
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number680106G
Policy instance 2
Insurance contract or identification number680106G
Number of Individuals Covered17
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00041139
Policy instance 3
Insurance contract or identification number00041139
Number of Individuals Covered107
Total amount of commissions paid to insurance brokerUSD $46,924
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,207,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,924
Insurance broker organization code?3
Insurance broker nameHARBRIDGE CONSULTING GROUP LLC
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberC-3908
Policy instance 4
Insurance contract or identification numberC-3908
Number of Individuals Covered46
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFNYH893235
Policy instance 1
Insurance contract or identification numberFNYH893235
Number of Individuals Covered165
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of fees paid to insurance companyUSD $1,245
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD,DEPSP,LIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $9,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1245
Insurance broker organization code?3
Insurance broker nameWINSTON FINANCIAL SERVICES INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFNYH893235
Policy instance 1
Insurance contract or identification numberFNYH893235
Number of Individuals Covered168
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $1,223
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD,DEPSP,LIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $8,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number680106G
Policy instance 2
Insurance contract or identification number680106G
Number of Individuals Covered17
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00041139
Policy instance 3
Insurance contract or identification number00041139
Number of Individuals Covered119
Total amount of commissions paid to insurance brokerUSD $39,734
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberC-3908
Policy instance 4
Insurance contract or identification numberC-3908
Number of Individuals Covered45
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number680106G
Policy instance 2
Insurance contract or identification number680106G
Number of Individuals Covered16
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $254
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00603
Policy instance 3
Insurance contract or identification number00603
Number of Individuals Covered226
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $24,858
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberC-3908
Policy instance 4
Insurance contract or identification numberC-3908
Number of Individuals Covered46
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFNYH893235
Policy instance 1
Insurance contract or identification numberFNYH893235
Number of Individuals Covered171
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,217
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD,DEPSP,LIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $8,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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