401k Plan data: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN plan

NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN
Plan identification number	520

NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Other welfare benefit cover

401k Sponsoring company profile

NORTHTOWN AUTOMOTIVE COMPANIES, INC. has sponsored the creation of one or more 401k plans.

Company Name: NORTHTOWN AUTOMOTIVE COMPANIES, INC.

Employer identification number (EIN): 160970381

NAIC Classification: 441110
NAIC Description: New Car Dealers

Additional information about NORTHTOWN AUTOMOTIVE COMPANIES, INC.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1969-12-31

Company Identification Number: 286754

Legal Registered Office Address: 1135 MILLERSPORT HIGHWAY
Erie
AMHERST
United States of America (USA)
14226

More information about NORTHTOWN AUTOMOTIVE COMPANIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
520 2022-01-01 KYLE ROOKEY 2023-10-11 KYLE ROOKEY 2023-10-11
520 2021-01-01 KYLE ROOKEY 2022-10-14 KYLE ROOKEY 2022-10-14
520 2020-01-01 KYLE ROOKEY 2021-06-16
520 2019-01-01 KYLE ROOKEY 2020-07-24
520 2018-01-01 KYLE ROOKEY 2019-10-31
520 2017-01-01
520 2016-01-01
520 2015-01-01
520 2014-01-01
520 2013-01-01
520 2012-01-01 HAROLD B. ERBACHER
520 2011-01-01 HAROLD B. ERBACHER
520 2010-01-01 HAROLD B. ERBACHER
520 2009-01-01 JENNIFER ACETI
520 2008-01-01 HAROLD B. ERBACHER
520 2007-01-01 HAROLD B. ERBACHER
520 2006-01-01 HAROLD B. ERBACHER
520 2005-01-01 HAROLD B. ERBACHER
520 2004-01-01 HAROLD B. ERBACHER
520 2003-01-01 HAROLD B. ERBACHER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
520	2022-01-01	KYLE ROOKEY	2023-10-11	KYLE ROOKEY	2023-10-11
520	2021-01-01	KYLE ROOKEY	2022-10-14	KYLE ROOKEY	2022-10-14
520	2020-01-01	KYLE ROOKEY	2021-06-16
520	2019-01-01	KYLE ROOKEY	2020-07-24
520	2018-01-01	KYLE ROOKEY	2019-10-31
520	2017-01-01
520	2016-01-01
520	2015-01-01
520	2014-01-01
520	2013-01-01
520	2012-01-01	HAROLD B. ERBACHER
520	2011-01-01	HAROLD B. ERBACHER
520	2010-01-01	HAROLD B. ERBACHER
520	2009-01-01	JENNIFER ACETI
520	2008-01-01	HAROLD B. ERBACHER
520	2007-01-01	HAROLD B. ERBACHER
520	2006-01-01	HAROLD B. ERBACHER
520	2005-01-01	HAROLD B. ERBACHER
520	2004-01-01	HAROLD B. ERBACHER
520	2003-01-01	HAROLD B. ERBACHER

Plan Statistics for NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN

Measure Date Value
2022: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 384
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 364
Number of retired or separated participants receiving benefits 2022-01-01 6
Total of all active and inactive participants 2022-01-01 370
2021: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 389
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 378
Number of retired or separated participants receiving benefits 2021-01-01 6
Total of all active and inactive participants 2021-01-01 384
2020: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 412
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 384
Number of retired or separated participants receiving benefits 2020-01-01 5
Total of all active and inactive participants 2020-01-01 389
2019: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 361
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 406
Number of retired or separated participants receiving benefits 2019-01-01 6
Total of all active and inactive participants 2019-01-01 412
2018: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 345
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 357
Number of retired or separated participants receiving benefits 2018-01-01 4
Total of all active and inactive participants 2018-01-01 361
2017: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 332
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 342
Number of retired or separated participants receiving benefits 2017-01-01 4
Total of all active and inactive participants 2017-01-01 346
2016: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 325
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 328
Number of retired or separated participants receiving benefits 2016-01-01 4
Total of all active and inactive participants 2016-01-01 332
2015: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 309
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 320
Number of retired or separated participants receiving benefits 2015-01-01 5
Total of all active and inactive participants 2015-01-01 325
2014: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 289
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 306
Number of retired or separated participants receiving benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 309
2013: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 281
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 286
Number of retired or separated participants receiving benefits 2013-01-01 3
Total of all active and inactive participants 2013-01-01 289
2012: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 322
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 274
Number of retired or separated participants receiving benefits 2012-01-01 7
Total of all active and inactive participants 2012-01-01 281
2011: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 336
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 318
Number of retired or separated participants receiving benefits 2011-01-01 4
Total of all active and inactive participants 2011-01-01 322
2010: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 349
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 330
Number of retired or separated participants receiving benefits 2010-01-01 6
Total of all active and inactive participants 2010-01-01 336
2009: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 363
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 344
Number of retired or separated participants receiving benefits 2009-01-01 5
Total of all active and inactive participants 2009-01-01 349
2008: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 370
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 356
Number of retired or separated participants receiving benefits 2008-01-01 7
Total of all active and inactive participants 2008-01-01 363
2007: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 344
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 363
Number of retired or separated participants receiving benefits 2007-01-01 7
Total of all active and inactive participants 2007-01-01 370
2006: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 334
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 336
Number of retired or separated participants receiving benefits 2006-01-01 8
Total of all active and inactive participants 2006-01-01 344
2005: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2005 401k membership
Total participants, beginning-of-year 2005-01-01 324
Total number of active participants reported on line 7a of the Form 5500 2005-01-01 323
Number of retired or separated participants receiving benefits 2005-01-01 11
Total of all active and inactive participants 2005-01-01 334
2004: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2004 401k membership
Total participants, beginning-of-year 2004-01-01 340
Total number of active participants reported on line 7a of the Form 5500 2004-01-01 315
Number of retired or separated participants receiving benefits 2004-01-01 9
Total of all active and inactive participants 2004-01-01 324
2003: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2003 401k membership
Total participants, beginning-of-year 2003-01-01 337
Total number of active participants reported on line 7a of the Form 5500 2003-01-01 329
Number of retired or separated participants receiving benefits 2003-01-01 11
Total of all active and inactive participants 2003-01-01 340

Measure	Date	Value
2022: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	384
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	364
Number of retired or separated participants receiving benefits	2022-01-01	6
Total of all active and inactive participants	2022-01-01	370
2021: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	389
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	378
Number of retired or separated participants receiving benefits	2021-01-01	6
Total of all active and inactive participants	2021-01-01	384
2020: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	412
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	384
Number of retired or separated participants receiving benefits	2020-01-01	5
Total of all active and inactive participants	2020-01-01	389
2019: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	361
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	406
Number of retired or separated participants receiving benefits	2019-01-01	6
Total of all active and inactive participants	2019-01-01	412
2018: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	345
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	357
Number of retired or separated participants receiving benefits	2018-01-01	4
Total of all active and inactive participants	2018-01-01	361
2017: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	332
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	342
Number of retired or separated participants receiving benefits	2017-01-01	4
Total of all active and inactive participants	2017-01-01	346
2016: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	325
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	328
Number of retired or separated participants receiving benefits	2016-01-01	4
Total of all active and inactive participants	2016-01-01	332
2015: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	309
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	320
Number of retired or separated participants receiving benefits	2015-01-01	5
Total of all active and inactive participants	2015-01-01	325
2014: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	289
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	306
Number of retired or separated participants receiving benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	309
2013: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	281
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	286
Number of retired or separated participants receiving benefits	2013-01-01	3
Total of all active and inactive participants	2013-01-01	289
2012: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	322
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	274
Number of retired or separated participants receiving benefits	2012-01-01	7
Total of all active and inactive participants	2012-01-01	281
2011: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	336
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	318
Number of retired or separated participants receiving benefits	2011-01-01	4
Total of all active and inactive participants	2011-01-01	322
2010: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	349
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	330
Number of retired or separated participants receiving benefits	2010-01-01	6
Total of all active and inactive participants	2010-01-01	336
2009: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	363
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	344
Number of retired or separated participants receiving benefits	2009-01-01	5
Total of all active and inactive participants	2009-01-01	349
2008: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	370
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	356
Number of retired or separated participants receiving benefits	2008-01-01	7
Total of all active and inactive participants	2008-01-01	363
2007: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	344
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	363
Number of retired or separated participants receiving benefits	2007-01-01	7
Total of all active and inactive participants	2007-01-01	370
2006: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	334
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	336
Number of retired or separated participants receiving benefits	2006-01-01	8
Total of all active and inactive participants	2006-01-01	344
2005: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2005 401k membership
Total participants, beginning-of-year	2005-01-01	324
Total number of active participants reported on line 7a of the Form 5500	2005-01-01	323
Number of retired or separated participants receiving benefits	2005-01-01	11
Total of all active and inactive participants	2005-01-01	334
2004: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2004 401k membership
Total participants, beginning-of-year	2004-01-01	340
Total number of active participants reported on line 7a of the Form 5500	2004-01-01	315
Number of retired or separated participants receiving benefits	2004-01-01	9
Total of all active and inactive participants	2004-01-01	324
2003: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2003 401k membership
Total participants, beginning-of-year	2003-01-01	337
Total number of active participants reported on line 7a of the Form 5500	2003-01-01	329
Number of retired or separated participants receiving benefits	2003-01-01	11
Total of all active and inactive participants	2003-01-01	340

Form 5500 Responses for NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN

2022: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2008: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2007: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Plan funding arrangement – Insurance	Yes
2007-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2007-01-01	Plan benefit arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2006: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Plan funding arrangement – Insurance	Yes
2006-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2006-01-01	Plan benefit arrangement – Insurance	Yes
2006-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2005: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2005 form 5500 responses
2005-01-01	Type of plan entity	Single employer plan
2005-01-01	Plan funding arrangement – Insurance	Yes
2005-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2005-01-01	Plan benefit arrangement – Insurance	Yes
2005-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2004: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2004 form 5500 responses
2004-01-01	Type of plan entity	Single employer plan
2004-01-01	Plan funding arrangement – Insurance	Yes
2004-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2004-01-01	Plan benefit arrangement – Insurance	Yes
2004-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2003: NORTHTOWN AUTOMOTIVE COMPANIES, INC. EMPLOYEE BENEFITS PLAN 2003 form 5500 responses
2003-01-01	Type of plan entity	Single employer plan
2003-01-01	Plan funding arrangement – Insurance	Yes
2003-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2003-01-01	Plan benefit arrangement – Insurance	Yes
2003-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

11450764

Policy instance

Insurance contract or identification number	11450764
Number of Individuals Covered	667
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $45,804
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	POS
Welfare Benefit Premiums Paid to Carrier	USD $3,564,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $45,804
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	30
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $575
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	UNIVERSAL LIFE
Welfare Benefit Premiums Paid to Carrier	USD $17,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $221
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	28
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,484
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $20,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $761
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	51
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $687
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $16,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $239
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	63
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,109
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $27,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $571
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	125
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $25,220
Total amount of fees paid to insurance company	USD $2,150
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $178,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,734
Amount paid for insurance broker fees	1466
Insurance broker organization code?	3

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

22414

Policy instance

Insurance contract or identification number	22414
Number of Individuals Covered	379
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $20,004
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	POS
Welfare Benefit Premiums Paid to Carrier	USD $3,161,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,004
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	80
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,410
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $35,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $746
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	58
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $761
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $18,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $258
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	37
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,750
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $24,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $946
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	37
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $917
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	UNIVERSAL LIFE
Welfare Benefit Premiums Paid to Carrier	USD $20,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $385
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	133
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $45,530
Total amount of fees paid to insurance company	USD $3,087
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $149,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,805
Amount paid for insurance broker fees	2105
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	110
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,376
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $52,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,720
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	3
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $468
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	70
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $716
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $332
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	49
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $3,301
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $35,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,421
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	39
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,313
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $857
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	151
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $51,169
Total amount of fees paid to insurance company	USD $48
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $122,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,631
Amount paid for insurance broker fees	34
Insurance broker organization code?	3

HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

11445512

Policy instance

Insurance contract or identification number	11445512
Number of Individuals Covered	777
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $47,836
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	POS
Welfare Benefit Premiums Paid to Carrier	USD $3,234,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $47,836
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	49
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $4,125
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,411
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	97
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $10,804
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $62,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,396
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	15
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $275
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $166
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	208
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $13,163
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $96,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,517
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	120
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $43,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	135
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $11,512
Total amount of fees paid to insurance company	USD $70
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $43,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,781
Amount paid for insurance broker fees	34
Insurance broker organization code?	3

HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

11445512

Policy instance

Insurance contract or identification number	11445512
Number of Individuals Covered	752
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	POS
Welfare Benefit Premiums Paid to Carrier	USD $2,927,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	16
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,893
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $574
Insurance broker organization code?	3

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

22414

Policy instance

Insurance contract or identification number	22414
Number of Individuals Covered	687
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,672,629
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	66
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $4,800
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $34,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,980
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	132
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $9,944
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $54,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,335
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	162
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $4,133
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $41,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,426
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	21
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $279
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $169
Insurance broker organization code?	3

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	297
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $12,029
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $89,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,319
Insurance broker organization code?	3

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

2249531

Policy instance

Insurance contract or identification number	2249531
Number of Individuals Covered	4
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

22414

Policy instance

Insurance contract or identification number	22414
Number of Individuals Covered	698
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,416,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

2249531

Policy instance

Insurance contract or identification number	2249531
Number of Individuals Covered	4
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	182
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $12,226
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $77,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,214
Insurance broker organization code?	3
Amount paid for insurance broker fees	0
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	18
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $291
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $176
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ORANGE FINANCIAL SERVICES

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	105
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,666
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $38,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,696
Insurance broker organization code?	3
Amount paid for insurance broker fees	0
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	83
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,402
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $45,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,958
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	43
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,613
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $32,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,098
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

52-0807803

Policy instance

Insurance contract or identification number	52-0807803
Number of Individuals Covered	16
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,679
Total amount of fees paid to insurance company	USD $28
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $580
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	KEVIN MURPHY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	69
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,065
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $43,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,237
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN257

Policy instance

Insurance contract or identification number	GN257
Number of Individuals Covered	46
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,140
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,877
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $905
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN258

Policy instance

Insurance contract or identification number	GN258
Number of Individuals Covered	26
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,193
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,114
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN259

Policy instance

Insurance contract or identification number	GN259
Number of Individuals Covered	17
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,098
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $604
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN261

Policy instance

Insurance contract or identification number	GN261
Number of Individuals Covered	11
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $803
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $375
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN255

Policy instance

Insurance contract or identification number	GN255
Number of Individuals Covered	24
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,099
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,179
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN260

Policy instance

Insurance contract or identification number	GN260
Number of Individuals Covered	3
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $180
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $97
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAUL MOLEY

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

2249531

Policy instance

Insurance contract or identification number	2249531
Number of Individuals Covered	5
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

22414

Policy instance

Insurance contract or identification number	22414
Number of Individuals Covered	649
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,308,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN260

Policy instance

Insurance contract or identification number	GN260
Number of Individuals Covered	5
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,171
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,317
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ORANGE FINANCIAL SERVICES

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

2249531

Policy instance

Insurance contract or identification number	2249531
Number of Individuals Covered	7
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509E

Policy instance

Insurance contract or identification number	19509E
Number of Individuals Covered	17
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $104,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509V

Policy instance

Insurance contract or identification number	19509V
Number of Individuals Covered	604
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,982,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN228

Policy instance

Insurance contract or identification number	GN228
Number of Individuals Covered	24
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $17,712
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,039
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ORANGE FINANCIAL SERVICES

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN257

Policy instance

Insurance contract or identification number	GN257
Number of Individuals Covered	10
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $7,504
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,673
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ORANGE FINANCIAL SERVICES

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN258

Policy instance

Insurance contract or identification number	GN258
Number of Individuals Covered	8
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $8,778
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,463
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ORANGE FINANCIAL SERVICES

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN259

Policy instance

Insurance contract or identification number	GN259
Number of Individuals Covered	6
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,223
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,112
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,956
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	CHARLOTTE SANTA CRUZ

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN261

Policy instance

Insurance contract or identification number	GN261
Number of Individuals Covered	6
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,719
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,693
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ORANGE FINANCIAL SERVICES

ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )

Policy contract number

GN255

Policy instance

Insurance contract or identification number	GN255
Number of Individuals Covered	14
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $6,293
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,919
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ORANGE FINANCIAL SERVICES

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B2930M-07

Policy instance

Insurance contract or identification number	B2930M-07
Number of Individuals Covered	7
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $30,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509V-01

Policy instance

Insurance contract or identification number	19509V-01
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509V

Policy instance

Insurance contract or identification number	19509V
Number of Individuals Covered	601
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,038,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509E

Policy instance

Insurance contract or identification number	19509E
Number of Individuals Covered	19
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $105,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

NK768

Policy instance

Insurance contract or identification number	NK768
Number of Individuals Covered	117
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $19,748
Total amount of fees paid to insurance company	USD $603
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $135,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,487
Amount paid for insurance broker fees	377
Insurance broker organization code?	3
Insurance broker name	CONSTANCE V. SNELL

THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 )

Policy contract number

E3748639

Policy instance

Insurance contract or identification number	E3748639
Number of Individuals Covered	68
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $18,299
Total amount of fees paid to insurance company	USD $992
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $95,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,520
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	AMY YOCKEY

THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 )

Policy contract number

E3748639

Policy instance

Insurance contract or identification number	E3748639
Number of Individuals Covered	67
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $48,250
Total amount of fees paid to insurance company	USD $5,975
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $86,729
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,602
Amount paid for insurance broker fees	709
Insurance broker name	ADAM BENATOVICH

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B2930M-07

Policy instance

Insurance contract or identification number	B2930M-07
Number of Individuals Covered	7
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $27,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509V

Policy instance

Insurance contract or identification number	19509V
Number of Individuals Covered	261
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,951,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

NK768

Policy instance

Insurance contract or identification number	NK768
Number of Individuals Covered	150
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $20,511
Total amount of fees paid to insurance company	USD $126
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $149,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,773
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LISA A. WENDE

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509E

Policy instance

Insurance contract or identification number	19509E
Number of Individuals Covered	9
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $110,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509V-01

Policy instance

Insurance contract or identification number	19509V-01
Number of Individuals Covered	4
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,023
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

NK768

Policy instance

Insurance contract or identification number	NK768
Number of Individuals Covered	125
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $184,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B2930M07

Policy instance

Insurance contract or identification number	B2930M07
Number of Individuals Covered	7
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509V01

Policy instance

Insurance contract or identification number	19509V01
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509E

Policy instance

Insurance contract or identification number	19509E
Number of Individuals Covered	9
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $122,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

19509V

Policy instance

Insurance contract or identification number	19509V
Number of Individuals Covered	305
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,123,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

B1657E

Policy instance

Insurance contract or identification number	B1657E
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984N

Policy instance

Insurance contract or identification number	B1984N
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $367,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984E

Policy instance

Insurance contract or identification number	B1984E
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B2930M07

Policy instance

Insurance contract or identification number	B2930M07
Number of Individuals Covered	8
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BERKLEY HEALTH AND LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 52413 )

Policy contract number

C1003

Policy instance

Insurance contract or identification number	C1003
Number of Individuals Covered	328
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $871,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

NK768

Policy instance

Insurance contract or identification number	NK768
Number of Individuals Covered	138
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $178,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

B1657E

Policy instance

Insurance contract or identification number	B1657E
Number of Individuals Covered	7
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $45,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B2930M07

Policy instance

Insurance contract or identification number	B2930M07
Number of Individuals Covered	6
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B2367M04

Policy instance

Insurance contract or identification number	B2367M04
Number of Individuals Covered	0
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984N

Policy instance

Insurance contract or identification number	B1984N
Number of Individuals Covered	342
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,974,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984E

Policy instance

Insurance contract or identification number	B1984E
Number of Individuals Covered	8
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $281,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984L

Policy instance

Insurance contract or identification number	B1984L
Number of Individuals Covered	0
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $103,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

NK768

Policy instance

Insurance contract or identification number	NK768
Number of Individuals Covered	146
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $102,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

B1657E

Policy instance

Insurance contract or identification number	B1657E
Number of Individuals Covered	8
Insurance policy start date	2007-01-01
Insurance policy end date	2007-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1657M

Policy instance

Insurance contract or identification number	B1657M
Number of Individuals Covered	0
Insurance policy start date	2007-01-01
Insurance policy end date	2007-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,944
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984E

Policy instance

Insurance contract or identification number	B1984E
Number of Individuals Covered	241
Insurance policy start date	2007-01-01
Insurance policy end date	2007-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $952,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984L

Policy instance

Insurance contract or identification number	B1984L
Number of Individuals Covered	121
Insurance policy start date	2007-01-01
Insurance policy end date	2007-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $449,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

NK768

Policy instance

Insurance contract or identification number	NK768
Number of Individuals Covered	88
Insurance policy start date	2007-01-01
Insurance policy end date	2007-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $44,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

NK768

Policy instance

Insurance contract or identification number	NK768
Number of Individuals Covered	76
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $33,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984E

Policy instance

Insurance contract or identification number	B1984E
Number of Individuals Covered	234
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,305,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B2367M04

Policy instance

Insurance contract or identification number	B2367M04
Number of Individuals Covered	0
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1657M

Policy instance

Insurance contract or identification number	B1657M
Number of Individuals Covered	2
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

B1657E

Policy instance

Insurance contract or identification number	B1657E
Number of Individuals Covered	7
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984L

Policy instance

Insurance contract or identification number	B1984L
Number of Individuals Covered	101
Insurance policy start date	2006-01-01
Insurance policy end date	2006-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $451,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

B1657E

Policy instance

Insurance contract or identification number	B1657E
Number of Individuals Covered	7
Insurance policy start date	2005-01-01
Insurance policy end date	2005-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984E

Policy instance

Insurance contract or identification number	B1984E
Number of Individuals Covered	324
Insurance policy start date	2005-01-01
Insurance policy end date	2005-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,537,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

NK768

Policy instance

Insurance contract or identification number	NK768
Number of Individuals Covered	55
Insurance policy start date	2005-01-01
Insurance policy end date	2005-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $22,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B2367M04

Policy instance

Insurance contract or identification number	B2367M04
Number of Individuals Covered	3
Insurance policy start date	2005-01-01
Insurance policy end date	2005-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1984E

Policy instance

Insurance contract or identification number	B1984E
Number of Individuals Covered	316
Insurance policy start date	2004-01-01
Insurance policy end date	2004-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,422,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1657M

Policy instance

Insurance contract or identification number	B1657M
Number of Individuals Covered	1
Insurance policy start date	2004-01-01
Insurance policy end date	2004-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

B1657E

Policy instance

Insurance contract or identification number	B1657E
Number of Individuals Covered	7
Insurance policy start date	2004-01-01
Insurance policy end date	2004-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $27,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )

Policy contract number

B1657E

Policy instance

Insurance contract or identification number	B1657E
Number of Individuals Covered	7
Insurance policy start date	2003-01-01
Insurance policy end date	2003-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1657P

Policy instance

Insurance contract or identification number	B1657P
Number of Individuals Covered	331
Insurance policy start date	2003-01-01
Insurance policy end date	2003-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,331,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )

Policy contract number

B1657M

Policy instance

Insurance contract or identification number	B1657M
Number of Individuals Covered	2
Insurance policy start date	2003-01-01
Insurance policy end date	2003-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	NORTHTOWN AUTOMOTIVE COMPANIES, INC.
Employer identification number (EIN):	160970381
NAIC Classification:	441110
NAIC Description:	New Car Dealers

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1969-12-31
Company Identification Number:	286754
Legal Registered Office Address:	1135 MILLERSPORT HIGHWAY Erie AMHERST United States of America (USA) 14226