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COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 401k Plan overview

Plan NameCOPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN
Plan identification number 501

COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN Benefits

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

401k Sponsoring company profile

TRUSTEES OF COPOLYMER RETIREES TRUST has sponsored the creation of one or more 401k plans.

Company Name:TRUSTEES OF COPOLYMER RETIREES TRUST
Employer identification number (EIN):204982669
NAIC Classification:561110
NAIC Description:Office Administrative Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-09-01
5012020-09-01
5012019-09-01
5012018-09-01
5012017-09-01
5012016-09-01LLOYD J. TABARY II
5012015-09-01LLOYD J. TABARY II
5012014-09-01LLOYD J. TABARY II
5012013-09-01LLOYD J. TABARY II
5012012-09-01LLOYD J. TABARY II
5012011-09-01LLOYD J. TABARY II
5012010-09-01LLOYD J. TABARY II
5012009-09-01LLOYD J. TABARY II

Plan Statistics for COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN

401k plan membership statisitcs for COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN

Measure Date Value
2021: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01237
Total number of active participants reported on line 7a of the Form 55002021-09-01216
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01216
2020: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01244
Total number of active participants reported on line 7a of the Form 55002020-09-01237
Number of retired or separated participants receiving benefits2020-09-010
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01237
2019: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01277
Total number of active participants reported on line 7a of the Form 55002019-09-01244
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-01244
2018: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01309
Total number of active participants reported on line 7a of the Form 55002018-09-01277
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01277
2017: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01330
Total number of active participants reported on line 7a of the Form 55002017-09-01309
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01309
2016: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01348
Total number of active participants reported on line 7a of the Form 55002016-09-01330
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01330
2015: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01358
Total number of active participants reported on line 7a of the Form 55002015-09-01348
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01348
2014: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01376
Total number of active participants reported on line 7a of the Form 55002014-09-01358
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01358
2013: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01396
Total number of active participants reported on line 7a of the Form 55002013-09-01376
Number of retired or separated participants receiving benefits2013-09-010
Number of other retired or separated participants entitled to future benefits2013-09-010
Total of all active and inactive participants2013-09-01376
2012: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01406
Total number of active participants reported on line 7a of the Form 55002012-09-01396
Number of retired or separated participants receiving benefits2012-09-010
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-01396
2011: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01418
Total number of active participants reported on line 7a of the Form 55002011-09-01406
Number of retired or separated participants receiving benefits2011-09-010
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-01406
2010: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-09-01436
Total number of active participants reported on line 7a of the Form 55002010-09-01418
Number of retired or separated participants receiving benefits2010-09-010
Number of other retired or separated participants entitled to future benefits2010-09-010
Total of all active and inactive participants2010-09-01418
2009: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-01481
Total number of active participants reported on line 7a of the Form 55002009-09-01436
Number of retired or separated participants receiving benefits2009-09-010
Number of other retired or separated participants entitled to future benefits2009-09-010
Total of all active and inactive participants2009-09-01436

Financial Data on COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN

Measure Date Value
2022 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-08-31$-565,311
Total unrealized appreciation/depreciation of assets2022-08-31$-565,311
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-08-31$1,450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-08-31$1,450
Total income from all sources (including contributions)2022-08-31$151,289
Total loss/gain on sale of assets2022-08-31$15,906
Total of all expenses incurred2022-08-31$1,591,557
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-08-31$1,190,127
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-08-31$750,046
Value of total assets at end of year2022-08-31$5,820,766
Value of total assets at beginning of year2022-08-31$7,261,034
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-08-31$401,430
Total interest from all sources2022-08-31$161,409
Total dividends received (eg from common stock, registered investment company shares)2022-08-31$88,614
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-08-31$88,614
Administrative expenses professional fees incurred2022-08-31$66,276
Was this plan covered by a fidelity bond2022-08-31Yes
Value of fidelity bond cover2022-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-08-31No
Contributions received from participants2022-08-31$750,046
Assets. Other investments not covered elsewhere at end of year2022-08-31$443,956
Assets. Other investments not covered elsewhere at beginning of year2022-08-31$507,006
Administrative expenses (other) incurred2022-08-31$302,153
Liabilities. Value of operating payables at end of year2022-08-31$1,450
Liabilities. Value of operating payables at beginning of year2022-08-31$1,450
Total non interest bearing cash at end of year2022-08-31$150,156
Total non interest bearing cash at beginning of year2022-08-31$180,667
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-08-31No
Value of net income/loss2022-08-31$-1,440,268
Value of net assets at end of year (total assets less liabilities)2022-08-31$5,819,316
Value of net assets at beginning of year (total assets less liabilities)2022-08-31$7,259,584
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-08-31No
Were any leases to which the plan was party in default or uncollectible2022-08-31No
Investment advisory and management fees2022-08-31$33,001
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-08-31$1,107,139
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-08-31$1,043,307
Interest earned on other investments2022-08-31$1,550
Income. Interest from US Government securities2022-08-31$2,083
Income. Interest from corporate debt instruments2022-08-31$157,681
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-08-31$188,534
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-08-31$821,486
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-08-31$821,486
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-08-31$95
Expenses. Payments to insurance carriers foe the provision of benefits2022-08-31$1,190,127
Asset value of US Government securities at end of year2022-08-31$33,393
Asset value of US Government securities at beginning of year2022-08-31$48,204
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-08-31$-299,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-08-31No
Was there a failure to transmit to the plan any participant contributions2022-08-31No
Has the plan failed to provide any benefit when due under the plan2022-08-31No
Asset. Corporate debt instrument debt (other) at end of year2022-08-31$3,897,588
Asset. Corporate debt instrument debt (other) at beginning of year2022-08-31$4,660,364
Did the plan have assets held for investment2022-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-08-31No
Aggregate proceeds on sale of assets2022-08-31$228,181
Aggregate carrying amount (costs) on sale of assets2022-08-31$212,275
Opinion of an independent qualified public accountant for this plan2022-08-31Unqualified
Accountancy firm name2022-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2022-08-31208410792
2021 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-08-31$-170,989
Total unrealized appreciation/depreciation of assets2021-08-31$-170,989
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-08-31$1,450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-08-31$6,979
Total income from all sources (including contributions)2021-08-31$1,321,388
Total loss/gain on sale of assets2021-08-31$64,102
Total of all expenses incurred2021-08-31$1,657,301
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-08-31$1,271,184
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-08-31$787,213
Value of total assets at end of year2021-08-31$7,261,034
Value of total assets at beginning of year2021-08-31$7,602,476
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-08-31$386,117
Total interest from all sources2021-08-31$175,831
Total dividends received (eg from common stock, registered investment company shares)2021-08-31$60,276
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-08-31$60,276
Administrative expenses professional fees incurred2021-08-31$70,551
Was this plan covered by a fidelity bond2021-08-31Yes
Value of fidelity bond cover2021-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-08-31No
Contributions received from participants2021-08-31$787,213
Assets. Other investments not covered elsewhere at end of year2021-08-31$507,006
Assets. Other investments not covered elsewhere at beginning of year2021-08-31$393,309
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-08-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-08-31$0
Administrative expenses (other) incurred2021-08-31$280,151
Liabilities. Value of operating payables at end of year2021-08-31$1,450
Liabilities. Value of operating payables at beginning of year2021-08-31$6,979
Total non interest bearing cash at end of year2021-08-31$180,667
Total non interest bearing cash at beginning of year2021-08-31$256,284
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-08-31No
Value of net income/loss2021-08-31$-335,913
Value of net assets at end of year (total assets less liabilities)2021-08-31$7,259,584
Value of net assets at beginning of year (total assets less liabilities)2021-08-31$7,595,497
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-08-31No
Were any leases to which the plan was party in default or uncollectible2021-08-31No
Investment advisory and management fees2021-08-31$35,415
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-08-31$1,043,307
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-08-31$1,251,838
Income. Interest from US Government securities2021-08-31$2,730
Income. Interest from corporate debt instruments2021-08-31$173,047
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-08-31$821,486
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-08-31$408,756
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-08-31$408,756
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-08-31$54
Expenses. Payments to insurance carriers foe the provision of benefits2021-08-31$1,271,184
Asset value of US Government securities at end of year2021-08-31$48,204
Asset value of US Government securities at beginning of year2021-08-31$63,246
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-08-31$404,955
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-08-31No
Was there a failure to transmit to the plan any participant contributions2021-08-31No
Has the plan failed to provide any benefit when due under the plan2021-08-31No
Asset. Corporate debt instrument debt (other) at end of year2021-08-31$4,660,364
Asset. Corporate debt instrument debt (other) at beginning of year2021-08-31$5,229,043
Did the plan have assets held for investment2021-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-08-31No
Aggregate proceeds on sale of assets2021-08-31$1,721,742
Aggregate carrying amount (costs) on sale of assets2021-08-31$1,657,640
Opinion of an independent qualified public accountant for this plan2021-08-31Unqualified
Accountancy firm name2021-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2021-08-31208410792
2020 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-08-31$220,036
Total unrealized appreciation/depreciation of assets2020-08-31$220,036
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-08-31$6,979
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-08-31$1,450
Total income from all sources (including contributions)2020-08-31$1,409,486
Total loss/gain on sale of assets2020-08-31$-38,226
Total of all expenses incurred2020-08-31$1,858,360
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-08-31$1,449,456
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-08-31$850,034
Value of total assets at end of year2020-08-31$7,602,476
Value of total assets at beginning of year2020-08-31$8,045,821
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-08-31$408,904
Total interest from all sources2020-08-31$200,809
Total dividends received (eg from common stock, registered investment company shares)2020-08-31$60,474
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-08-31$60,474
Administrative expenses professional fees incurred2020-08-31$86,141
Was this plan covered by a fidelity bond2020-08-31Yes
Value of fidelity bond cover2020-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2020-08-31No
Contributions received from participants2020-08-31$850,034
Assets. Other investments not covered elsewhere at end of year2020-08-31$393,309
Assets. Other investments not covered elsewhere at beginning of year2020-08-31$405,065
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-08-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-08-31$0
Administrative expenses (other) incurred2020-08-31$286,276
Liabilities. Value of operating payables at end of year2020-08-31$6,979
Liabilities. Value of operating payables at beginning of year2020-08-31$1,450
Total non interest bearing cash at end of year2020-08-31$256,284
Total non interest bearing cash at beginning of year2020-08-31$84,082
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-08-31No
Value of net income/loss2020-08-31$-448,874
Value of net assets at end of year (total assets less liabilities)2020-08-31$7,595,497
Value of net assets at beginning of year (total assets less liabilities)2020-08-31$8,044,371
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-08-31No
Were any leases to which the plan was party in default or uncollectible2020-08-31No
Investment advisory and management fees2020-08-31$36,487
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-08-31$1,251,838
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-08-31$1,123,723
Income. Interest from US Government securities2020-08-31$3,623
Income. Interest from corporate debt instruments2020-08-31$195,852
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-08-31$408,756
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-08-31$804,842
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-08-31$804,842
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-08-31$1,334
Expenses. Payments to insurance carriers foe the provision of benefits2020-08-31$1,449,456
Asset value of US Government securities at end of year2020-08-31$63,246
Asset value of US Government securities at beginning of year2020-08-31$86,035
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-08-31$116,359
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-08-31No
Was there a failure to transmit to the plan any participant contributions2020-08-31No
Has the plan failed to provide any benefit when due under the plan2020-08-31No
Asset. Corporate debt instrument debt (other) at end of year2020-08-31$5,229,043
Asset. Corporate debt instrument debt (other) at beginning of year2020-08-31$5,542,074
Did the plan have assets held for investment2020-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-08-31No
Aggregate proceeds on sale of assets2020-08-31$1,210,686
Aggregate carrying amount (costs) on sale of assets2020-08-31$1,248,912
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-08-31Yes
Opinion of an independent qualified public accountant for this plan2020-08-31Disclaimer
Accountancy firm name2020-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2020-08-31208410792
2019 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-08-31$387,326
Total unrealized appreciation/depreciation of assets2019-08-31$387,326
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-08-31$1,450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-08-31$1,450
Total income from all sources (including contributions)2019-08-31$1,355,684
Total loss/gain on sale of assets2019-08-31$-147,175
Total of all expenses incurred2019-08-31$2,049,983
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-08-31$1,661,958
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-08-31$916,743
Value of total assets at end of year2019-08-31$8,045,821
Value of total assets at beginning of year2019-08-31$8,740,120
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-08-31$388,025
Total interest from all sources2019-08-31$192,147
Total dividends received (eg from common stock, registered investment company shares)2019-08-31$159,557
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-08-31$159,557
Administrative expenses professional fees incurred2019-08-31$77,190
Was this plan covered by a fidelity bond2019-08-31Yes
Value of fidelity bond cover2019-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-08-31No
Contributions received from participants2019-08-31$916,743
Assets. Other investments not covered elsewhere at end of year2019-08-31$405,065
Assets. Other investments not covered elsewhere at beginning of year2019-08-31$833,045
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-08-31$-14,950
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-08-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-08-31$0
Administrative expenses (other) incurred2019-08-31$276,101
Liabilities. Value of operating payables at end of year2019-08-31$1,450
Liabilities. Value of operating payables at beginning of year2019-08-31$1,450
Total non interest bearing cash at end of year2019-08-31$84,082
Total non interest bearing cash at beginning of year2019-08-31$242,600
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-08-31No
Value of net income/loss2019-08-31$-694,299
Value of net assets at end of year (total assets less liabilities)2019-08-31$8,044,371
Value of net assets at beginning of year (total assets less liabilities)2019-08-31$8,738,670
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-08-31No
Were any leases to which the plan was party in default or uncollectible2019-08-31No
Investment advisory and management fees2019-08-31$34,734
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-08-31$1,123,723
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-08-31$3,433,938
Income. Interest from US Government securities2019-08-31$5,050
Income. Interest from corporate debt instruments2019-08-31$181,944
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-08-31$804,842
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-08-31$293,825
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-08-31$293,825
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-08-31$5,153
Expenses. Payments to insurance carriers foe the provision of benefits2019-08-31$1,676,908
Asset value of US Government securities at end of year2019-08-31$86,035
Asset value of US Government securities at beginning of year2019-08-31$125,483
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-08-31$-152,914
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-08-31Yes
Was there a failure to transmit to the plan any participant contributions2019-08-31No
Has the plan failed to provide any benefit when due under the plan2019-08-31No
Asset. Corporate debt instrument debt (other) at end of year2019-08-31$5,542,074
Asset. Corporate debt instrument debt (other) at beginning of year2019-08-31$3,811,229
Did the plan have assets held for investment2019-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-08-31No
Aggregate proceeds on sale of assets2019-08-31$923,769
Aggregate carrying amount (costs) on sale of assets2019-08-31$1,070,944
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-08-31Yes
Opinion of an independent qualified public accountant for this plan2019-08-31Disclaimer
Accountancy firm name2019-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2019-08-31208410792
2018 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-08-31$-1,257,257
Total unrealized appreciation/depreciation of assets2018-08-31$-1,257,257
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-08-31$1,450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-08-31$10,504
Total income from all sources (including contributions)2018-08-31$1,585,275
Total loss/gain on sale of assets2018-08-31$-6,984
Total of all expenses incurred2018-08-31$2,869,992
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-08-31$2,363,855
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-08-31$972,002
Value of total assets at end of year2018-08-31$8,740,120
Value of total assets at beginning of year2018-08-31$10,033,891
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-08-31$506,137
Total interest from all sources2018-08-31$255,306
Total dividends received (eg from common stock, registered investment company shares)2018-08-31$61,334
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-08-31$61,334
Administrative expenses professional fees incurred2018-08-31$84,003
Was this plan covered by a fidelity bond2018-08-31Yes
Value of fidelity bond cover2018-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-08-31No
Contributions received from participants2018-08-31$972,002
Assets. Other investments not covered elsewhere at end of year2018-08-31$833,045
Assets. Other investments not covered elsewhere at beginning of year2018-08-31$995,832
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-08-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-08-31$0
Other income not declared elsewhere2018-08-31$10,795
Administrative expenses (other) incurred2018-08-31$327,282
Liabilities. Value of operating payables at end of year2018-08-31$1,450
Liabilities. Value of operating payables at beginning of year2018-08-31$10,504
Total non interest bearing cash at end of year2018-08-31$242,600
Total non interest bearing cash at beginning of year2018-08-31$295,501
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-08-31No
Value of net income/loss2018-08-31$-1,284,717
Value of net assets at end of year (total assets less liabilities)2018-08-31$8,738,670
Value of net assets at beginning of year (total assets less liabilities)2018-08-31$10,023,387
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-08-31No
Were any leases to which the plan was party in default or uncollectible2018-08-31No
Investment advisory and management fees2018-08-31$32,760
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-08-31$3,433,938
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-08-31$3,494,464
Interest earned on other investments2018-08-31$132
Income. Interest from US Government securities2018-08-31$7,453
Income. Interest from corporate debt instruments2018-08-31$247,681
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-08-31$293,825
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-08-31$778,661
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-08-31$778,661
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-08-31$40
Expenses. Payments to insurance carriers foe the provision of benefits2018-08-31$1,853,727
Asset value of US Government securities at end of year2018-08-31$125,483
Asset value of US Government securities at beginning of year2018-08-31$171,748
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-08-31$1,550,079
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-08-31Yes
Was there a failure to transmit to the plan any participant contributions2018-08-31No
Has the plan failed to provide any benefit when due under the plan2018-08-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-08-31$510,128
Asset. Corporate debt instrument debt (other) at end of year2018-08-31$3,811,229
Asset. Corporate debt instrument debt (other) at beginning of year2018-08-31$4,297,685
Contract administrator fees2018-08-31$62,092
Did the plan have assets held for investment2018-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-08-31No
Aggregate proceeds on sale of assets2018-08-31$2,264,187
Aggregate carrying amount (costs) on sale of assets2018-08-31$2,271,171
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-08-31Yes
Opinion of an independent qualified public accountant for this plan2018-08-31Disclaimer
Accountancy firm name2018-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2018-08-31208410792
2017 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-08-31$-16,439
Total unrealized appreciation/depreciation of assets2017-08-31$-16,439
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-08-31$10,504
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-08-31$18,950
Total income from all sources (including contributions)2017-08-31$1,785,350
Total loss/gain on sale of assets2017-08-31$-107,301
Total of all expenses incurred2017-08-31$3,895,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-08-31$3,269,161
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-08-31$977,712
Value of total assets at end of year2017-08-31$10,033,891
Value of total assets at beginning of year2017-08-31$12,152,147
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-08-31$625,999
Total interest from all sources2017-08-31$222,345
Total dividends received (eg from common stock, registered investment company shares)2017-08-31$89,589
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-08-31$89,589
Administrative expenses professional fees incurred2017-08-31$68,453
Was this plan covered by a fidelity bond2017-08-31Yes
Value of fidelity bond cover2017-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-08-31No
Contributions received from participants2017-08-31$977,712
Assets. Other investments not covered elsewhere at end of year2017-08-31$995,832
Assets. Other investments not covered elsewhere at beginning of year2017-08-31$937,225
Other income not declared elsewhere2017-08-31$5,211
Administrative expenses (other) incurred2017-08-31$335,493
Liabilities. Value of operating payables at end of year2017-08-31$10,504
Liabilities. Value of operating payables at beginning of year2017-08-31$18,950
Total non interest bearing cash at end of year2017-08-31$295,501
Total non interest bearing cash at beginning of year2017-08-31$336,642
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-08-31No
Value of net income/loss2017-08-31$-2,109,810
Value of net assets at end of year (total assets less liabilities)2017-08-31$10,023,387
Value of net assets at beginning of year (total assets less liabilities)2017-08-31$12,133,197
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-08-31No
Were any leases to which the plan was party in default or uncollectible2017-08-31No
Investment advisory and management fees2017-08-31$35,853
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-08-31$3,494,464
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-08-31$4,323,476
Interest earned on other investments2017-08-31$839
Income. Interest from US Government securities2017-08-31$10,081
Income. Interest from corporate debt instruments2017-08-31$211,425
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-08-31$778,661
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-08-31$1,069,843
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-08-31$1,069,843
Expenses. Payments to insurance carriers foe the provision of benefits2017-08-31$697,761
Asset value of US Government securities at end of year2017-08-31$171,748
Asset value of US Government securities at beginning of year2017-08-31$240,975
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-08-31$614,233
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-08-31Yes
Was there a failure to transmit to the plan any participant contributions2017-08-31No
Has the plan failed to provide any benefit when due under the plan2017-08-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-08-31$2,571,400
Asset. Corporate debt instrument debt (other) at end of year2017-08-31$4,297,685
Asset. Corporate debt instrument debt (other) at beginning of year2017-08-31$5,243,986
Contract administrator fees2017-08-31$186,200
Did the plan have assets held for investment2017-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-08-31No
Aggregate proceeds on sale of assets2017-08-31$4,183,764
Aggregate carrying amount (costs) on sale of assets2017-08-31$4,291,065
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-08-31Yes
Opinion of an independent qualified public accountant for this plan2017-08-31Disclaimer
Accountancy firm name2017-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2017-08-31208410792
2016 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-08-31$156,422
Total unrealized appreciation/depreciation of assets2016-08-31$156,422
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-08-31$18,950
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-08-31$1,450
Total income from all sources (including contributions)2016-08-31$1,959,813
Total loss/gain on sale of assets2016-08-31$150,635
Total of all expenses incurred2016-08-31$5,716,198
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-08-31$5,045,728
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-08-31$960,395
Value of total assets at end of year2016-08-31$12,152,147
Value of total assets at beginning of year2016-08-31$15,891,032
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-08-31$670,470
Total interest from all sources2016-08-31$312,019
Total dividends received (eg from common stock, registered investment company shares)2016-08-31$110,353
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-08-31$110,353
Administrative expenses professional fees incurred2016-08-31$57,923
Was this plan covered by a fidelity bond2016-08-31Yes
Value of fidelity bond cover2016-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-08-31No
Contributions received from participants2016-08-31$960,395
Assets. Other investments not covered elsewhere at end of year2016-08-31$937,225
Assets. Other investments not covered elsewhere at beginning of year2016-08-31$1,038,341
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-08-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-08-31$2,695,136
Other income not declared elsewhere2016-08-31$4,793
Administrative expenses (other) incurred2016-08-31$369,843
Liabilities. Value of operating payables at end of year2016-08-31$18,950
Liabilities. Value of operating payables at beginning of year2016-08-31$1,450
Total non interest bearing cash at end of year2016-08-31$336,642
Total non interest bearing cash at beginning of year2016-08-31$296,520
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-08-31No
Value of net income/loss2016-08-31$-3,756,385
Value of net assets at end of year (total assets less liabilities)2016-08-31$12,133,197
Value of net assets at beginning of year (total assets less liabilities)2016-08-31$15,889,582
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-08-31No
Were any leases to which the plan was party in default or uncollectible2016-08-31No
Investment advisory and management fees2016-08-31$47,886
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-08-31$4,323,476
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-08-31$5,267,077
Interest earned on other investments2016-08-31$26,062
Income. Interest from US Government securities2016-08-31$14,155
Income. Interest from corporate debt instruments2016-08-31$271,802
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-08-31$1,069,843
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-08-31$459,943
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-08-31$459,943
Expenses. Payments to insurance carriers foe the provision of benefits2016-08-31$2,931,218
Asset value of US Government securities at end of year2016-08-31$240,975
Asset value of US Government securities at beginning of year2016-08-31$329,511
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-08-31$265,196
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-08-31Yes
Was there a failure to transmit to the plan any participant contributions2016-08-31No
Has the plan failed to provide any benefit when due under the plan2016-08-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-08-31$2,114,510
Asset. Corporate debt instrument debt (other) at end of year2016-08-31$5,243,986
Asset. Corporate debt instrument debt (other) at beginning of year2016-08-31$5,804,504
Contract administrator fees2016-08-31$194,818
Did the plan have assets held for investment2016-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-08-31No
Aggregate proceeds on sale of assets2016-08-31$5,112,486
Aggregate carrying amount (costs) on sale of assets2016-08-31$4,961,851
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-08-31Yes
Opinion of an independent qualified public accountant for this plan2016-08-31Disclaimer
Accountancy firm name2016-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2016-08-31208410792
2015 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-08-31$-402,775
Total unrealized appreciation/depreciation of assets2015-08-31$-402,775
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-08-31$1,450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-08-31$1,450
Total income from all sources (including contributions)2015-08-31$1,106,410
Total loss/gain on sale of assets2015-08-31$641,804
Total of all expenses incurred2015-08-31$3,425,067
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-08-31$2,697,684
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-08-31$920,931
Value of total assets at end of year2015-08-31$15,891,032
Value of total assets at beginning of year2015-08-31$18,209,689
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-08-31$727,383
Total interest from all sources2015-08-31$521,995
Total dividends received (eg from common stock, registered investment company shares)2015-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-08-31No
Administrative expenses professional fees incurred2015-08-31$68,068
Was this plan covered by a fidelity bond2015-08-31Yes
Value of fidelity bond cover2015-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-08-31No
Contributions received from participants2015-08-31$920,931
Assets. Other investments not covered elsewhere at end of year2015-08-31$1,038,341
Assets. Other investments not covered elsewhere at beginning of year2015-08-31$1,945,188
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-08-31$2,695,136
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-08-31$1,264,056
Other income not declared elsewhere2015-08-31$43
Administrative expenses (other) incurred2015-08-31$420,772
Liabilities. Value of operating payables at end of year2015-08-31$1,450
Liabilities. Value of operating payables at beginning of year2015-08-31$1,450
Total non interest bearing cash at end of year2015-08-31$296,520
Total non interest bearing cash at beginning of year2015-08-31$169,349
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-08-31No
Value of net income/loss2015-08-31$-2,318,657
Value of net assets at end of year (total assets less liabilities)2015-08-31$15,889,582
Value of net assets at beginning of year (total assets less liabilities)2015-08-31$18,208,239
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-08-31No
Were any leases to which the plan was party in default or uncollectible2015-08-31No
Investment advisory and management fees2015-08-31$38,237
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-08-31$5,267,077
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-08-31$4,925,569
Interest earned on other investments2015-08-31$150,071
Income. Interest from US Government securities2015-08-31$43,133
Income. Interest from corporate debt instruments2015-08-31$328,791
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-08-31$459,943
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-08-31$591,881
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-08-31$591,881
Expenses. Payments to insurance carriers foe the provision of benefits2015-08-31$451,645
Asset value of US Government securities at end of year2015-08-31$329,511
Asset value of US Government securities at beginning of year2015-08-31$1,162,824
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-08-31$-575,588
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-08-31Yes
Was there a failure to transmit to the plan any participant contributions2015-08-31No
Has the plan failed to provide any benefit when due under the plan2015-08-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-08-31$2,246,039
Asset. Corporate debt instrument debt (other) at end of year2015-08-31$5,804,504
Asset. Corporate debt instrument debt (other) at beginning of year2015-08-31$8,150,822
Contract administrator fees2015-08-31$200,306
Did the plan have assets held for investment2015-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-08-31No
Aggregate proceeds on sale of assets2015-08-31$11,008,339
Aggregate carrying amount (costs) on sale of assets2015-08-31$10,366,535
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-08-31Yes
Opinion of an independent qualified public accountant for this plan2015-08-31Disclaimer
Accountancy firm name2015-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2015-08-31208410792
2014 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-08-31$-52,747
Total unrealized appreciation/depreciation of assets2014-08-31$-52,747
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-08-31$1,450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-08-31$0
Total income from all sources (including contributions)2014-08-31$2,915,933
Total loss/gain on sale of assets2014-08-31$93,020
Total of all expenses incurred2014-08-31$3,052,473
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-08-31$2,354,400
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-08-31$918,673
Value of total assets at end of year2014-08-31$18,209,689
Value of total assets at beginning of year2014-08-31$18,344,779
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-08-31$698,073
Total interest from all sources2014-08-31$521,057
Total dividends received (eg from common stock, registered investment company shares)2014-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-08-31No
Administrative expenses professional fees incurred2014-08-31$79,270
Was this plan covered by a fidelity bond2014-08-31Yes
Value of fidelity bond cover2014-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2014-08-31No
Contributions received from participants2014-08-31$918,673
Assets. Other investments not covered elsewhere at end of year2014-08-31$1,945,188
Assets. Other investments not covered elsewhere at beginning of year2014-08-31$1,262,635
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-08-31$1,264,056
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-08-31$1,463,672
Other income not declared elsewhere2014-08-31$217,632
Administrative expenses (other) incurred2014-08-31$351,908
Liabilities. Value of operating payables at end of year2014-08-31$1,450
Liabilities. Value of operating payables at beginning of year2014-08-31$0
Total non interest bearing cash at end of year2014-08-31$169,349
Total non interest bearing cash at beginning of year2014-08-31$126,457
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-08-31No
Value of net income/loss2014-08-31$-136,540
Value of net assets at end of year (total assets less liabilities)2014-08-31$18,208,239
Value of net assets at beginning of year (total assets less liabilities)2014-08-31$18,344,779
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-08-31No
Were any leases to which the plan was party in default or uncollectible2014-08-31No
Investment advisory and management fees2014-08-31$64,090
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-08-31$4,925,569
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-08-31$5,245,404
Interest earned on other investments2014-08-31$59,658
Income. Interest from US Government securities2014-08-31$61,612
Income. Interest from corporate debt instruments2014-08-31$399,787
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-08-31$591,881
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-08-31$1,098,496
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-08-31$1,098,496
Expenses. Payments to insurance carriers foe the provision of benefits2014-08-31$466,410
Asset value of US Government securities at end of year2014-08-31$1,162,824
Asset value of US Government securities at beginning of year2014-08-31$1,510,210
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-08-31$1,218,298
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-08-31Yes
Was there a failure to transmit to the plan any participant contributions2014-08-31No
Has the plan failed to provide any benefit when due under the plan2014-08-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-08-31$1,887,990
Asset. Corporate debt instrument debt (other) at end of year2014-08-31$8,150,822
Asset. Corporate debt instrument debt (other) at beginning of year2014-08-31$7,637,905
Contract administrator fees2014-08-31$202,805
Did the plan have assets held for investment2014-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-08-31No
Aggregate proceeds on sale of assets2014-08-31$5,573,991
Aggregate carrying amount (costs) on sale of assets2014-08-31$5,480,971
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-08-31Yes
Opinion of an independent qualified public accountant for this plan2014-08-31Disclaimer
Accountancy firm name2014-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2014-08-31208410792
2013 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-08-31$-634,047
Total unrealized appreciation/depreciation of assets2013-08-31$-634,047
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-08-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-08-31$0
Total income from all sources (including contributions)2013-08-31$2,071,702
Total loss/gain on sale of assets2013-08-31$102,949
Total of all expenses incurred2013-08-31$3,092,578
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-08-31$2,409,986
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-08-31$935,680
Value of total assets at end of year2013-08-31$18,344,779
Value of total assets at beginning of year2013-08-31$19,365,655
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-08-31$682,592
Total interest from all sources2013-08-31$572,540
Total dividends received (eg from common stock, registered investment company shares)2013-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-08-31No
Administrative expenses professional fees incurred2013-08-31$64,791
Was this plan covered by a fidelity bond2013-08-31Yes
Value of fidelity bond cover2013-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2013-08-31No
Contributions received from participants2013-08-31$935,680
Assets. Other investments not covered elsewhere at end of year2013-08-31$1,262,635
Assets. Other investments not covered elsewhere at beginning of year2013-08-31$1,096,561
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-08-31$1,463,672
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-08-31$1,001,866
Other income not declared elsewhere2013-08-31$8,622
Administrative expenses (other) incurred2013-08-31$347,591
Liabilities. Value of operating payables at end of year2013-08-31$0
Liabilities. Value of operating payables at beginning of year2013-08-31$0
Total non interest bearing cash at end of year2013-08-31$126,457
Total non interest bearing cash at beginning of year2013-08-31$138,607
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-08-31No
Value of net income/loss2013-08-31$-1,020,876
Value of net assets at end of year (total assets less liabilities)2013-08-31$18,344,779
Value of net assets at beginning of year (total assets less liabilities)2013-08-31$19,365,655
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-08-31No
Were any leases to which the plan was party in default or uncollectible2013-08-31No
Investment advisory and management fees2013-08-31$56,024
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-08-31$5,245,404
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-08-31$4,863,468
Interest earned on other investments2013-08-31$72,776
Income. Interest from US Government securities2013-08-31$94,565
Income. Interest from corporate debt instruments2013-08-31$405,199
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-08-31$1,098,496
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-08-31$1,341,435
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-08-31$1,341,435
Expenses. Payments to insurance carriers foe the provision of benefits2013-08-31$2,409,986
Asset value of US Government securities at end of year2013-08-31$1,510,210
Asset value of US Government securities at beginning of year2013-08-31$2,494,034
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-08-31$1,085,958
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-08-31Yes
Was there a failure to transmit to the plan any participant contributions2013-08-31No
Has the plan failed to provide any benefit when due under the plan2013-08-31No
Asset. Corporate debt instrument debt (other) at end of year2013-08-31$7,637,905
Asset. Corporate debt instrument debt (other) at beginning of year2013-08-31$8,429,684
Contract administrator fees2013-08-31$214,186
Did the plan have assets held for investment2013-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-08-31No
Aggregate proceeds on sale of assets2013-08-31$2,859,782
Aggregate carrying amount (costs) on sale of assets2013-08-31$2,756,833
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-08-31Yes
Opinion of an independent qualified public accountant for this plan2013-08-31Disclaimer
Accountancy firm name2013-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2013-08-31208410792
2012 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-08-31$-62,921
Total unrealized appreciation/depreciation of assets2012-08-31$-62,921
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-08-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-08-31$30,481
Total income from all sources (including contributions)2012-08-31$2,237,433
Total loss/gain on sale of assets2012-08-31$120,889
Total of all expenses incurred2012-08-31$3,311,090
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-08-31$2,611,903
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-08-31$947,070
Value of total assets at end of year2012-08-31$19,365,655
Value of total assets at beginning of year2012-08-31$20,469,793
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-08-31$699,187
Total interest from all sources2012-08-31$588,156
Total dividends received (eg from common stock, registered investment company shares)2012-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-08-31No
Administrative expenses professional fees incurred2012-08-31$68,214
Was this plan covered by a fidelity bond2012-08-31Yes
Value of fidelity bond cover2012-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2012-08-31No
Contributions received from participants2012-08-31$947,070
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-08-31$1,001,866
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-08-31$1,262,781
Other income not declared elsewhere2012-08-31$72
Administrative expenses (other) incurred2012-08-31$344,245
Liabilities. Value of operating payables at end of year2012-08-31$0
Liabilities. Value of operating payables at beginning of year2012-08-31$30,481
Total non interest bearing cash at end of year2012-08-31$138,607
Total non interest bearing cash at beginning of year2012-08-31$482,344
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-08-31No
Value of net income/loss2012-08-31$-1,073,657
Value of net assets at end of year (total assets less liabilities)2012-08-31$19,365,655
Value of net assets at beginning of year (total assets less liabilities)2012-08-31$20,439,312
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-08-31No
Were any leases to which the plan was party in default or uncollectible2012-08-31No
Investment advisory and management fees2012-08-31$67,240
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-08-31$5,960,029
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-08-31$6,094,757
Interest earned on other investments2012-08-31$30,598
Income. Interest from US Government securities2012-08-31$161,718
Income. Interest from corporate debt instruments2012-08-31$395,840
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-08-31$1,341,435
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-08-31$1,132,019
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-08-31$1,132,019
Expenses. Payments to insurance carriers foe the provision of benefits2012-08-31$2,611,903
Asset value of US Government securities at end of year2012-08-31$2,494,034
Asset value of US Government securities at beginning of year2012-08-31$4,104,299
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-08-31$644,167
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-08-31Yes
Was there a failure to transmit to the plan any participant contributions2012-08-31No
Has the plan failed to provide any benefit when due under the plan2012-08-31No
Asset. Corporate debt instrument debt (other) at end of year2012-08-31$8,429,684
Asset. Corporate debt instrument debt (other) at beginning of year2012-08-31$7,393,593
Contract administrator fees2012-08-31$219,488
Did the plan have assets held for investment2012-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-08-31No
Aggregate proceeds on sale of assets2012-08-31$4,074,732
Aggregate carrying amount (costs) on sale of assets2012-08-31$3,953,843
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-08-31Yes
Opinion of an independent qualified public accountant for this plan2012-08-31Disclaimer
Accountancy firm name2012-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2012-08-31208410792
2011 : COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-08-31$-115,832
Total unrealized appreciation/depreciation of assets2011-08-31$-115,832
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-08-31$30,481
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-08-31$10,855
Total income from all sources (including contributions)2011-08-31$2,553,395
Total loss/gain on sale of assets2011-08-31$11,221
Total of all expenses incurred2011-08-31$3,410,193
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-08-31$2,701,204
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-08-31$990,254
Value of total assets at end of year2011-08-31$20,469,793
Value of total assets at beginning of year2011-08-31$21,306,965
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-08-31$708,989
Total interest from all sources2011-08-31$641,573
Total dividends received (eg from common stock, registered investment company shares)2011-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-08-31No
Administrative expenses professional fees incurred2011-08-31$90,824
Was this plan covered by a fidelity bond2011-08-31Yes
Value of fidelity bond cover2011-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2011-08-31No
Contributions received from participants2011-08-31$990,254
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-08-31$1,262,781
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-08-31$1,481,247
Other income not declared elsewhere2011-08-31$197
Administrative expenses (other) incurred2011-08-31$342,985
Liabilities. Value of operating payables at end of year2011-08-31$30,481
Liabilities. Value of operating payables at beginning of year2011-08-31$10,855
Total non interest bearing cash at end of year2011-08-31$482,344
Total non interest bearing cash at beginning of year2011-08-31$123,449
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-08-31No
Value of net income/loss2011-08-31$-856,798
Value of net assets at end of year (total assets less liabilities)2011-08-31$20,439,312
Value of net assets at beginning of year (total assets less liabilities)2011-08-31$21,296,110
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-08-31No
Were any leases to which the plan was party in default or uncollectible2011-08-31No
Investment advisory and management fees2011-08-31$48,754
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-08-31$6,094,757
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-08-31$7,110,239
Interest earned on other investments2011-08-31$48,825
Income. Interest from US Government securities2011-08-31$196,609
Income. Interest from corporate debt instruments2011-08-31$396,139
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-08-31$1,132,019
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-08-31$651,967
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-08-31$651,967
Expenses. Payments to insurance carriers foe the provision of benefits2011-08-31$2,701,204
Asset value of US Government securities at end of year2011-08-31$4,104,299
Asset value of US Government securities at beginning of year2011-08-31$4,194,878
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-08-31$1,025,982
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-08-31Yes
Was there a failure to transmit to the plan any participant contributions2011-08-31No
Has the plan failed to provide any benefit when due under the plan2011-08-31No
Asset. Corporate debt instrument debt (other) at end of year2011-08-31$7,393,593
Asset. Corporate debt instrument debt (other) at beginning of year2011-08-31$7,745,185
Contract administrator fees2011-08-31$226,426
Did the plan have assets held for investment2011-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-08-31No
Aggregate proceeds on sale of assets2011-08-31$1,455,721
Aggregate carrying amount (costs) on sale of assets2011-08-31$1,444,500
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-08-31Yes
Opinion of an independent qualified public accountant for this plan2011-08-31Disclaimer
Accountancy firm name2011-08-31STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN2011-08-31208410792

Form 5500 Responses for COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN

2021: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan funding arrangement – TrustYes
2021-09-01Plan benefit arrangement – InsuranceYes
2021-09-01Plan benefit arrangement - TrustYes
2020: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan funding arrangement – TrustYes
2020-09-01Plan benefit arrangement – InsuranceYes
2020-09-01Plan benefit arrangement - TrustYes
2019: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan funding arrangement – TrustYes
2019-09-01Plan benefit arrangement – InsuranceYes
2019-09-01Plan benefit arrangement - TrustYes
2018: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan funding arrangement – TrustYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement - TrustYes
2017: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan funding arrangement – TrustYes
2017-09-01Plan benefit arrangement – InsuranceYes
2017-09-01Plan benefit arrangement - TrustYes
2016: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan funding arrangement – TrustYes
2016-09-01Plan benefit arrangement – InsuranceYes
2016-09-01Plan benefit arrangement - TrustYes
2015: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan funding arrangement – TrustYes
2015-09-01Plan benefit arrangement – InsuranceYes
2015-09-01Plan benefit arrangement - TrustYes
2014: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan funding arrangement – TrustYes
2014-09-01Plan benefit arrangement – InsuranceYes
2014-09-01Plan benefit arrangement - TrustYes
2013: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan funding arrangement – TrustYes
2013-09-01Plan benefit arrangement – InsuranceYes
2013-09-01Plan benefit arrangement - TrustYes
2012: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – TrustYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement - TrustYes
2011: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan funding arrangement – TrustYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-09-01Plan benefit arrangement - TrustYes
2010: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Submission has been amendedNo
2010-09-01This submission is the final filingNo
2010-09-01This return/report is a short plan year return/report (less than 12 months)No
2010-09-01Plan is a collectively bargained planNo
2010-09-01Plan funding arrangement – InsuranceYes
2010-09-01Plan funding arrangement – TrustYes
2010-09-01Plan benefit arrangement – InsuranceYes
2010-09-01Plan benefit arrangement - TrustYes
2009: COPOLYMER RETIREES HEALTH AND LIFE INSURANCE PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan funding arrangement – TrustYes
2009-09-01Plan benefit arrangement – InsuranceYes
2009-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE467161
Policy instance 2
Insurance contract or identification numberAE467161
Number of Individuals Covered283
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $25,075
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $854,952
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,075
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724997
Policy instance 1
Insurance contract or identification number0724997
Number of Individuals Covered8
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $2,030
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $262,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,223
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724997
Policy instance 1
Insurance contract or identification number0724997
Number of Individuals Covered11
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $4,200
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $297,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,200
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE467161
Policy instance 2
Insurance contract or identification numberAE467161
Number of Individuals Covered313
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $27,200
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $928,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,200
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE467161
Policy instance 2
Insurance contract or identification numberAE467161
Number of Individuals Covered332
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $29,155
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,031,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,155
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724997
Policy instance 1
Insurance contract or identification number0724997
Number of Individuals Covered12
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $5,110
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $343,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,110
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724997
Policy instance 1
Insurance contract or identification number0724997
Number of Individuals Covered20
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $8,786
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $424,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,598
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE467161
Policy instance 2
Insurance contract or identification numberAE467161
Number of Individuals Covered336
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $32,640
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,170,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,640
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009236-000
Policy instance 2
Insurance contract or identification number16-009236-000
Number of Individuals Covered323
Insurance policy start date2017-09-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $441
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $33,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0164372
Policy instance 1
Insurance contract or identification number0164372
Number of Individuals Covered266
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,964
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $197,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE467161
Policy instance 4
Insurance contract or identification numberAE467161
Number of Individuals Covered396
Insurance policy start date2018-01-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $56,000
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $905,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724997
Policy instance 3
Insurance contract or identification number0724997
Number of Individuals Covered26
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $4,620
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $284,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009236-000
Policy instance 3
Insurance contract or identification number16-009236-000
Number of Individuals Covered358
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,036
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $104,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1036
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number77970FF4
Policy instance 2
Insurance contract or identification number77970FF4
Number of Individuals Covered353
Insurance policy start date2014-09-01
Insurance policy end date2015-01-01
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0145447
Policy instance 1
Insurance contract or identification number0145447
Number of Individuals Covered288
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $22,500
Total amount of fees paid to insurance companyUSD $645
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,501
Amount paid for insurance broker fees645
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameGROUP RISK SPECIALISTS INC.
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009236-000
Policy instance 3
Insurance contract or identification number16-009236-000
Number of Individuals Covered376
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $110,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number77970FF4
Policy instance 2
Insurance contract or identification number77970FF4
Number of Individuals Covered372
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0145447
Policy instance 1
Insurance contract or identification number0145447
Number of Individuals Covered304
Insurance policy start date2013-09-01
Insurance policy end date2014-08-30
Total amount of commissions paid to insurance brokerUSD $22,500
Total amount of fees paid to insurance companyUSD $613
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,501
Amount paid for insurance broker fees613
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameGROUP RISK SPECIALISTS INC.
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009236-000
Policy instance 2
Insurance contract or identification number16-009236-000
Number of Individuals Covered392
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $251
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $116,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees251
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0145447
Policy instance 3
Insurance contract or identification number0145447
Number of Individuals Covered315
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $43,125
Total amount of fees paid to insurance companyUSD $864
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,543
Amount paid for insurance broker fees864
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameGROUP RISK SPECIALISTS INC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number77970FF4
Policy instance 1
Insurance contract or identification number77970FF4
Number of Individuals Covered369
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0145447
Policy instance 3
Insurance contract or identification number0145447
Number of Individuals Covered329
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $5,434
Total amount of fees paid to insurance companyUSD $487
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number77970FF4
Policy instance 1
Insurance contract or identification number77970FF4
Number of Individuals Covered359
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009236-000
Policy instance 2
Insurance contract or identification number16-009236-000
Number of Individuals Covered406
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $121,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0145447
Policy instance 3
Insurance contract or identification number0145447
Number of Individuals Covered340
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $27,509
Total amount of fees paid to insurance companyUSD $1,100
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009236-000
Policy instance 2
Insurance contract or identification number16-009236-000
Number of Individuals Covered418
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $123,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number77970FF4
Policy instance 1
Insurance contract or identification number77970FF4
Number of Individuals Covered380
Insurance policy start date2010-09-01
Insurance policy end date2011-09-01
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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