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THE BURDICK COMPANIES MEDICAL TRUST 401k Plan overview

Plan NameTHE BURDICK COMPANIES MEDICAL TRUST
Plan identification number 503

THE BURDICK COMPANIES MEDICAL TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

DRIVERS VILLAGE, INC. has sponsored the creation of one or more 401k plans.

Company Name:DRIVERS VILLAGE, INC.
Employer identification number (EIN):161614967
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE BURDICK COMPANIES MEDICAL TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01
5032021-01-01
5032020-01-01
5032019-01-01
5032018-01-01
5032017-01-01ROBYN FINSEL2018-10-10 ROGER L. BURDICK2018-10-10
5032016-01-01ROBYN FINSEL2017-09-26 ROGER L. BURDICK2017-09-26
5032015-01-01ROBYN FINSEL2016-10-13 ROGER L. BURDICK2016-10-13
5032014-01-01ROBYN FINSEL2015-10-13 ROGER L. BURDICK2015-10-13
5032013-01-01ROBYN FINSEL2014-10-15 ROGER L. BURDICK2014-10-15
5032012-01-01ROGER L. BURDICK2013-10-15 ROGER L. BURDICK2013-10-15
5032011-01-01ROGER L. BURDICK2012-10-15 ROGER L. BURDICK2012-10-15
5032010-01-01ROGER L. BURDICK2011-10-06 ROGER L. BURDICK2011-10-06
5032009-01-01MICHAEL J. REILLY ROGER L. BURDICK2010-10-15

Plan Statistics for THE BURDICK COMPANIES MEDICAL TRUST

401k plan membership statisitcs for THE BURDICK COMPANIES MEDICAL TRUST

Measure Date Value
2022: THE BURDICK COMPANIES MEDICAL TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-01226
Total number of active participants reported on line 7a of the Form 55002022-01-01232
Number of retired or separated participants receiving benefits2022-01-012
Total of all active and inactive participants2022-01-01234
2021: THE BURDICK COMPANIES MEDICAL TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-01256
Total number of active participants reported on line 7a of the Form 55002021-01-01222
Number of retired or separated participants receiving benefits2021-01-014
Total of all active and inactive participants2021-01-01226
2020: THE BURDICK COMPANIES MEDICAL TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-01263
Total number of active participants reported on line 7a of the Form 55002020-01-01252
Number of retired or separated participants receiving benefits2020-01-014
Total of all active and inactive participants2020-01-01256
2019: THE BURDICK COMPANIES MEDICAL TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-01247
Total number of active participants reported on line 7a of the Form 55002019-01-01262
Number of retired or separated participants receiving benefits2019-01-011
Total of all active and inactive participants2019-01-01263
2018: THE BURDICK COMPANIES MEDICAL TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-01252
Total number of active participants reported on line 7a of the Form 55002018-01-01246
Number of retired or separated participants receiving benefits2018-01-011
Total of all active and inactive participants2018-01-01247
2017: THE BURDICK COMPANIES MEDICAL TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-01252
Total number of active participants reported on line 7a of the Form 55002017-01-01252
Total of all active and inactive participants2017-01-01252
2016: THE BURDICK COMPANIES MEDICAL TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-01253
Total number of active participants reported on line 7a of the Form 55002016-01-01255
Total of all active and inactive participants2016-01-01255
2015: THE BURDICK COMPANIES MEDICAL TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-01253
Total number of active participants reported on line 7a of the Form 55002015-01-01251
Number of retired or separated participants receiving benefits2015-01-012
Total of all active and inactive participants2015-01-01253
2014: THE BURDICK COMPANIES MEDICAL TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-01246
Total number of active participants reported on line 7a of the Form 55002014-01-01251
Number of retired or separated participants receiving benefits2014-01-012
Total of all active and inactive participants2014-01-01253
2013: THE BURDICK COMPANIES MEDICAL TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-01245
Total number of active participants reported on line 7a of the Form 55002013-01-01242
Number of retired or separated participants receiving benefits2013-01-014
Total of all active and inactive participants2013-01-01246
2012: THE BURDICK COMPANIES MEDICAL TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-01249
Total number of active participants reported on line 7a of the Form 55002012-01-01245
Number of retired or separated participants receiving benefits2012-01-010
Total of all active and inactive participants2012-01-01245
2011: THE BURDICK COMPANIES MEDICAL TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-01249
Total number of active participants reported on line 7a of the Form 55002011-01-01293
Number of retired or separated participants receiving benefits2011-01-014
Total of all active and inactive participants2011-01-01297
2010: THE BURDICK COMPANIES MEDICAL TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-01230
Total number of active participants reported on line 7a of the Form 55002010-01-01243
Number of retired or separated participants receiving benefits2010-01-016
Total of all active and inactive participants2010-01-01249
2009: THE BURDICK COMPANIES MEDICAL TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-01209
Total number of active participants reported on line 7a of the Form 55002009-01-01224
Number of retired or separated participants receiving benefits2009-01-016
Total of all active and inactive participants2009-01-01230

Financial Data on THE BURDICK COMPANIES MEDICAL TRUST

Measure Date Value
2022 : THE BURDICK COMPANIES MEDICAL TRUST 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$189,557
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$175,173
Total income from all sources (including contributions)2022-12-31$2,442,264
Total of all expenses incurred2022-12-31$2,249,812
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,067,385
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,442,264
Value of total assets at end of year2022-12-31$2,364,557
Value of total assets at beginning of year2022-12-31$2,157,721
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$182,427
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$200,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$678,497
Assets. Other investments not covered elsewhere at end of year2022-12-31$28,000
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$33,700
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$363,679
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$14,384
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$372,367
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$66,120
Administrative expenses (other) incurred2022-12-31$58,901
Total non interest bearing cash at end of year2022-12-31$1,964,190
Total non interest bearing cash at beginning of year2022-12-31$2,057,901
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$192,452
Value of net assets at end of year (total assets less liabilities)2022-12-31$2,175,000
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,982,548
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$13,454
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$219,271
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,400,088
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,833,730
Contract administrator fees2022-12-31$110,072
Liabilities. Value of benefit claims payable at end of year2022-12-31$189,557
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$175,173
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2022-12-31330996661
2021 : THE BURDICK COMPANIES MEDICAL TRUST 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$175,173
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$70,300
Total income from all sources (including contributions)2021-12-31$2,064,166
Total of all expenses incurred2021-12-31$1,861,289
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,705,816
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,064,166
Value of total assets at end of year2021-12-31$2,157,721
Value of total assets at beginning of year2021-12-31$1,849,971
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$155,473
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$200,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$678,137
Assets. Other investments not covered elsewhere at end of year2021-12-31$33,700
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$33,700
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$59,598
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$104,873
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$66,120
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$11,652
Administrative expenses (other) incurred2021-12-31$32,228
Total non interest bearing cash at end of year2021-12-31$2,057,901
Total non interest bearing cash at beginning of year2021-12-31$1,804,619
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$202,877
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,982,548
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,779,671
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$14,652
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$250,026
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,326,431
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,350,917
Contract administrator fees2021-12-31$108,593
Liabilities. Value of benefit claims payable at end of year2021-12-31$175,173
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$70,300
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2021-12-31330996661
2020 : THE BURDICK COMPANIES MEDICAL TRUST 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$70,300
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$179,254
Total income from all sources (including contributions)2020-12-31$2,368,276
Total of all expenses incurred2020-12-31$2,413,892
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$2,258,146
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,368,276
Value of total assets at end of year2020-12-31$1,849,971
Value of total assets at beginning of year2020-12-31$2,004,541
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$155,746
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$200,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$692,979
Assets. Other investments not covered elsewhere at end of year2020-12-31$33,700
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$271,536
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$-108,954
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$11,652
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$3,579
Administrative expenses (other) incurred2020-12-31$22,858
Total non interest bearing cash at end of year2020-12-31$1,804,619
Total non interest bearing cash at beginning of year2020-12-31$2,000,962
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-45,616
Value of net assets at end of year (total assets less liabilities)2020-12-31$1,779,671
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,825,287
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$19,140
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$258,652
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,403,761
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$2,108,448
Contract administrator fees2020-12-31$113,748
Liabilities. Value of benefit claims payable at end of year2020-12-31$70,300
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$179,254
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2020-12-31330996661
2019 : THE BURDICK COMPANIES MEDICAL TRUST 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$179,254
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$179,254
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$176,016
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$176,016
Total income from all sources (including contributions)2019-12-31$2,224,286
Total of all expenses incurred2019-12-31$1,975,396
Total of all expenses incurred2019-12-31$1,975,396
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,826,310
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,826,310
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,224,286
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,224,286
Value of total assets at end of year2019-12-31$2,004,541
Value of total assets at end of year2019-12-31$2,004,541
Value of total assets at beginning of year2019-12-31$1,752,413
Value of total assets at beginning of year2019-12-31$1,752,413
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$149,086
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$149,086
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$200,000
Value of fidelity bond cover2019-12-31$200,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$739,436
Contributions received from participants2019-12-31$739,436
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$4,883
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$3,238
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$3,238
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$3,579
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$3,579
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$13,526
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$13,526
Administrative expenses (other) incurred2019-12-31$18,005
Administrative expenses (other) incurred2019-12-31$18,005
Total non interest bearing cash at end of year2019-12-31$2,000,962
Total non interest bearing cash at end of year2019-12-31$2,000,962
Total non interest bearing cash at beginning of year2019-12-31$1,738,887
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$248,890
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,825,287
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,576,397
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,576,397
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$19,416
Investment advisory and management fees2019-12-31$19,416
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$259,004
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$259,004
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$1,479,967
Contributions received in cash from employer2019-12-31$1,479,967
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,564,068
Contract administrator fees2019-12-31$111,665
Contract administrator fees2019-12-31$111,665
Liabilities. Value of benefit claims payable at end of year2019-12-31$179,254
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$176,016
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$176,016
Did the plan have assets held for investment2019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31DANNIBLE & MCKEE, LLP
Accountancy firm name2019-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2019-12-31330996661
Accountancy firm EIN2019-12-31330996661
2018 : THE BURDICK COMPANIES MEDICAL TRUST 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$176,016
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$175,465
Total income from all sources (including contributions)2018-12-31$2,135,717
Total of all expenses incurred2018-12-31$2,024,569
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,883,637
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$2,135,717
Value of total assets at end of year2018-12-31$1,752,413
Value of total assets at beginning of year2018-12-31$1,640,714
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$140,932
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$200,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$692,561
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$22,054
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$65,832
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$551
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$13,526
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$82,288
Administrative expenses (other) incurred2018-12-31$16,833
Total non interest bearing cash at end of year2018-12-31$1,738,887
Total non interest bearing cash at beginning of year2018-12-31$1,536,372
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$111,148
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,576,397
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,465,249
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$16,791
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$239,916
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$1,377,324
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,643,170
Contract administrator fees2018-12-31$107,308
Liabilities. Value of benefit claims payable at end of year2018-12-31$176,016
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$175,465
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2018-12-31330996661
2017 : THE BURDICK COMPANIES MEDICAL TRUST 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$175,465
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$274,509
Total income from all sources (including contributions)2017-12-31$2,329,899
Total of all expenses incurred2017-12-31$1,787,240
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,643,207
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,329,899
Value of total assets at end of year2017-12-31$1,640,714
Value of total assets at beginning of year2017-12-31$1,197,099
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$144,033
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$200,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$741,220
Assets. Other investments not covered elsewhere at end of year2017-12-31$22,054
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$166,436
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$-99,044
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$82,288
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$27,625
Administrative expenses (other) incurred2017-12-31$20,520
Total non interest bearing cash at end of year2017-12-31$1,536,372
Total non interest bearing cash at beginning of year2017-12-31$1,169,474
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$542,659
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,465,249
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$922,590
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$14,032
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$279,023
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,422,243
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,463,228
Contract administrator fees2017-12-31$109,481
Liabilities. Value of benefit claims payable at end of year2017-12-31$175,465
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$274,509
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2017-12-31330996661
2016 : THE BURDICK COMPANIES MEDICAL TRUST 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$274,509
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$606,800
Total income from all sources (including contributions)2016-12-31$2,551,113
Total of all expenses incurred2016-12-31$2,269,333
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$2,127,123
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,551,113
Value of total assets at end of year2016-12-31$1,197,099
Value of total assets at beginning of year2016-12-31$1,247,610
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$142,210
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$100,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$748,868
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$374,595
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$271,186
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$27,625
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$135,428
Administrative expenses (other) incurred2016-12-31$33,025
Total non interest bearing cash at end of year2016-12-31$1,169,474
Total non interest bearing cash at beginning of year2016-12-31$1,112,182
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$281,780
Value of net assets at end of year (total assets less liabilities)2016-12-31$922,590
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$640,810
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$5,077
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$235,325
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,427,650
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,620,612
Contract administrator fees2016-12-31$104,108
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$274,509
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$606,800
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2016-12-31330996661
2015 : THE BURDICK COMPANIES MEDICAL TRUST 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$606,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$79,346
Total income from all sources (including contributions)2015-12-31$2,453,645
Total of all expenses incurred2015-12-31$2,496,165
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,345,202
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$2,453,645
Value of total assets at end of year2015-12-31$1,247,610
Value of total assets at beginning of year2015-12-31$762,676
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$150,963
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$100,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$639,541
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$216,826
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$527,454
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$135,428
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$56,627
Administrative expenses (other) incurred2015-12-31$49,501
Total non interest bearing cash at end of year2015-12-31$1,112,182
Total non interest bearing cash at beginning of year2015-12-31$706,049
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-42,520
Value of net assets at end of year (total assets less liabilities)2015-12-31$640,810
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$683,330
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$5,989
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$239,169
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$1,597,278
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,578,579
Contract administrator fees2015-12-31$95,473
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$606,800
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$79,346
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2015-12-31330996661
2014 : THE BURDICK COMPANIES MEDICAL TRUST 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$79,346
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$151,492
Total income from all sources (including contributions)2014-12-31$2,241,138
Total of all expenses incurred2014-12-31$1,947,949
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,820,698
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$2,241,138
Value of total assets at end of year2014-12-31$762,676
Value of total assets at beginning of year2014-12-31$541,633
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$127,251
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$100,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$812,022
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$36,623
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$-72,146
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$56,627
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$60,513
Administrative expenses (other) incurred2014-12-31$42,929
Total non interest bearing cash at end of year2014-12-31$706,049
Total non interest bearing cash at beginning of year2014-12-31$481,120
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$293,189
Value of net assets at end of year (total assets less liabilities)2014-12-31$683,330
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$390,141
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$5,059
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$251,144
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$1,392,493
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,641,700
Contract administrator fees2014-12-31$79,263
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$79,346
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$151,492
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2014-12-31330996661
2013 : THE BURDICK COMPANIES MEDICAL TRUST 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$151,492
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$118,595
Total income from all sources (including contributions)2013-12-31$2,183,937
Total of all expenses incurred2013-12-31$1,825,245
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,724,057
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$2,183,937
Value of total assets at end of year2013-12-31$541,633
Value of total assets at beginning of year2013-12-31$150,044
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$101,188
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$50,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$750,796
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$111,246
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$32,897
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$60,513
Administrative expenses (other) incurred2013-12-31$20,108
Total non interest bearing cash at end of year2013-12-31$481,120
Total non interest bearing cash at beginning of year2013-12-31$150,044
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$358,692
Value of net assets at end of year (total assets less liabilities)2013-12-31$390,141
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$31,449
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$4,897
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$235,958
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$1,321,895
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,455,202
Contract administrator fees2013-12-31$76,183
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$151,492
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$118,595
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2013-12-31330996661
2012 : THE BURDICK COMPANIES MEDICAL TRUST 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$118,595
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$194,827
Total income from all sources (including contributions)2012-12-31$2,218,270
Total of all expenses incurred2012-12-31$2,297,867
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$2,188,314
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$2,218,270
Value of total assets at end of year2012-12-31$150,044
Value of total assets at beginning of year2012-12-31$229,641
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$109,553
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$10,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$785,913
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$148,949
Administrative expenses (other) incurred2012-12-31$20,819
Total non interest bearing cash at end of year2012-12-31$150,044
Total non interest bearing cash at beginning of year2012-12-31$229,641
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-79,597
Value of net assets at end of year (total assets less liabilities)2012-12-31$31,449
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$34,814
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$6,446
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$246,565
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,283,408
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,941,749
Contract administrator fees2012-12-31$82,288
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$118,595
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$194,827
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2012-12-31330996661
2011 : THE BURDICK COMPANIES MEDICAL TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$194,827
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$116,327
Total income from all sources (including contributions)2011-12-31$1,828,086
Total of all expenses incurred2011-12-31$1,867,175
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,761,156
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,828,086
Value of total assets at end of year2011-12-31$229,641
Value of total assets at beginning of year2011-12-31$268,730
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$106,019
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$10,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$754,878
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$205,376
Administrative expenses (other) incurred2011-12-31$19,643
Total non interest bearing cash at end of year2011-12-31$229,641
Total non interest bearing cash at beginning of year2011-12-31$268,730
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-39,089
Value of net assets at end of year (total assets less liabilities)2011-12-31$34,814
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$152,403
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$6,761
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$232,147
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$867,832
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,529,009
Contract administrator fees2011-12-31$79,615
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$194,827
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$116,327
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2011-12-31330996661
2010 : THE BURDICK COMPANIES MEDICAL TRUST 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$116,327
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$450,191
Total income from all sources (including contributions)2010-12-31$1,278,086
Total of all expenses incurred2010-12-31$1,586,899
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,506,915
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,278,086
Value of total assets at end of year2010-12-31$268,730
Value of total assets at beginning of year2010-12-31$577,543
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$79,984
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$10,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$604,412
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$90,036
Administrative expenses (other) incurred2010-12-31$15,492
Total non interest bearing cash at end of year2010-12-31$268,730
Total non interest bearing cash at beginning of year2010-12-31$218,518
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-308,813
Value of net assets at end of year (total assets less liabilities)2010-12-31$152,403
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$127,352
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$2,641
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$169,773
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$583,638
Employer contributions (assets) at end of year2010-12-31$0
Employer contributions (assets) at beginning of year2010-12-31$359,025
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,337,142
Contract administrator fees2010-12-31$61,851
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Liabilities. Value of benefit claims payable at end of year2010-12-31$116,327
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$450,191
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31DANNIBLE & MCKEE, LLP
Accountancy firm EIN2010-12-31330996661

Form 5500 Responses for THE BURDICK COMPANIES MEDICAL TRUST

2022: THE BURDICK COMPANIES MEDICAL TRUST 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: THE BURDICK COMPANIES MEDICAL TRUST 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: THE BURDICK COMPANIES MEDICAL TRUST 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: THE BURDICK COMPANIES MEDICAL TRUST 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: THE BURDICK COMPANIES MEDICAL TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: THE BURDICK COMPANIES MEDICAL TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: THE BURDICK COMPANIES MEDICAL TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: THE BURDICK COMPANIES MEDICAL TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: THE BURDICK COMPANIES MEDICAL TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: THE BURDICK COMPANIES MEDICAL TRUST 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: THE BURDICK COMPANIES MEDICAL TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: THE BURDICK COMPANIES MEDICAL TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: THE BURDICK COMPANIES MEDICAL TRUST 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: THE BURDICK COMPANIES MEDICAL TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number17576
Policy instance 2
Insurance contract or identification number17576
Number of Individuals Covered244
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,745
Total amount of fees paid to insurance companyUSD $17,650
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,745
Amount paid for insurance broker fees17650
Insurance broker organization code?3
FIDELITY SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract numberELN30002
Policy instance 1
Insurance contract or identification numberELN30002
Number of Individuals Covered235
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $37,276
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $219,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,276
Insurance broker organization code?3
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number17576
Policy instance 2
Insurance contract or identification number17576
Number of Individuals Covered220
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $3,077
Total amount of fees paid to insurance companyUSD $16,813
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,077
Amount paid for insurance broker fees16813
Insurance broker organization code?3
FIDELITY SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract numberELN30002
Policy instance 1
Insurance contract or identification numberELN30002
Number of Individuals Covered213
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $42,504
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $250,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,504
Insurance broker organization code?3
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number17576
Policy instance 2
Insurance contract or identification number17576
Number of Individuals Covered232
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $3,372
Total amount of fees paid to insurance companyUSD $18,132
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,372
Amount paid for insurance broker fees18132
Insurance broker organization code?3
FIDELITY SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract numberELN30002
Policy instance 1
Insurance contract or identification numberELN30002
Number of Individuals Covered229
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $43,971
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $258,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,971
Insurance broker organization code?3
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number17576
Policy instance 2
Insurance contract or identification number17576
Number of Individuals Covered276
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $3,598
Total amount of fees paid to insurance companyUSD $17,773
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,598
Amount paid for insurance broker fees17773
Insurance broker organization code?3
FIDELITY SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract numberELN30002
Policy instance 1
Insurance contract or identification numberELN30002
Number of Individuals Covered256
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $44,031
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $259,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,031
Insurance broker organization code?3
FIDELITY SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract numberELN30002
Policy instance 1
Insurance contract or identification numberELN30002
Number of Individuals Covered236
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $40,786
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $239,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,786
Insurance broker organization code?3
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number17576
Policy instance 2
Insurance contract or identification number17576
Number of Individuals Covered265
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $3,430
Total amount of fees paid to insurance companyUSD $16,671
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,430
Amount paid for insurance broker fees16671
Insurance broker organization code?3
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number17576
Policy instance 2
Insurance contract or identification number17576
Number of Individuals Covered257
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $3,549
Total amount of fees paid to insurance companyUSD $16,634
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,549
Amount paid for insurance broker fees16634
Insurance broker organization code?3
Insurance broker nameENV INSURANCE AGENCY
HM LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60213 )
Policy contract number4064020010SSL
Policy instance 1
Insurance contract or identification number4064020010SSL
Number of Individuals Covered252
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $40,803
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $272,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,803
Insurance broker organization code?3
Insurance broker nameENV INSURANCE AGENCY
NIAGARA LIFE & HEALTH INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 12285 )
Policy contract numberSXTN1024
Policy instance 1
Insurance contract or identification numberSXTN1024
Number of Individuals Covered251
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $34,707
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $231,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,707
Insurance broker organization code?3
Insurance broker nameENV INSURANCE AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV571 & RV573
Policy instance 1
Insurance contract or identification numberRV571 & RV573
Number of Individuals Covered387
Insurance policy start date2014-01-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $7,721
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $4,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,366
Insurance broker organization code?3
Insurance broker nameROBERT A. DERRENBACKER
NIAGARA LIFE & HEALTH INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 12285 )
Policy contract numberSXTN1012
Policy instance 2
Insurance contract or identification numberSXTN1012
Number of Individuals Covered251
Insurance policy start date2014-02-14
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $36,959
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $246,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,959
Insurance broker organization code?3
Insurance broker nameENV INSURANCE AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV571 & RV573
Policy instance 1
Insurance contract or identification numberRV571 & RV573
Number of Individuals Covered373
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $29,610
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $235,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,559
Insurance broker organization code?3
Insurance broker nameROBERT A. DERRENBACKER
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberSLC687 & SLC747
Policy instance 1
Insurance contract or identification numberSLC687 & SLC747
Number of Individuals Covered245
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $33,981
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $246,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,981
Insurance broker organization code?3
Insurance broker nameEBS - RMSCO, INC.
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberSLC687 & SLC747
Policy instance 1
Insurance contract or identification numberSLC687 & SLC747
Number of Individuals Covered297
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $33,953
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $232,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberSLC687 & SLC747
Policy instance 1
Insurance contract or identification numberSLC687 & SLC747
Number of Individuals Covered249
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $17,280
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $169,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,280
Insurance broker organization code?3
Insurance broker nameEBS - RMSCO, INC.

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