UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN
Plan identification number	501

UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Prepaid legal Other welfare benefit cover

401k Sponsoring company profile

BOARD OF TRUSTEES, UNITED FOOD & COMMERCIAL WORKERS LOCAL 152 HEALTH has sponsored the creation of one or more 401k plans.

Company Name:	BOARD OF TRUSTEES, UNITED FOOD & COMMERCIAL WORKERS LOCAL 152 HEALTH
Employer identification number (EIN):	210681336
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	BRIAN STRING	2023-10-16	DANIEL R. DOSENBACH	2023-10-16
501	2021-01-01	BRIAN STRING	2022-10-14	DANIEL R. DOSENBACH	2022-10-14
501	2020-01-01	BRIAN STRING	2021-10-12	DANIEL R. DOSENBACH	2021-10-12
501	2019-01-01	BRIAN STRING	2020-10-05
501	2018-01-01	BRIAN STRING	2019-10-14	DANIEL R. DOSENBACH	2019-10-14
501	2017-01-01
501	2017-01-01
501	2016-01-01
501	2015-01-01	BRIAN STRING
501	2015-01-01
501	2014-01-01	BRIAN STRING
501	2013-01-01
501	2012-01-01	BRIAN STRING		DANIEL R. DOSENBACH	2013-10-15
501	2011-01-01	BRIAN STRING		DANIEL R. DOSENBACH	2012-10-15
501	2010-01-01	BRIAN STRING		DANIEL R. DOSENBACH	2011-10-14
501	2009-01-01	BRIAN STRING		DANIEL R. DOSENBACH	2010-10-15

Plan Statistics for UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN

401k plan membership statisitcs for UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN

Measure	Date	Value
2022: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	9,800
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	9,631
Number of retired or separated participants receiving benefits	2022-01-01	151
Total of all active and inactive participants	2022-01-01	9,782
Number of employers contributing to the scheme	2022-01-01	90
2021: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	11,148
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	9,628
Number of retired or separated participants receiving benefits	2021-01-01	172
Total of all active and inactive participants	2021-01-01	9,800
Number of employers contributing to the scheme	2021-01-01	102
2020: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	11,368
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	10,953
Number of retired or separated participants receiving benefits	2020-01-01	195
Total of all active and inactive participants	2020-01-01	11,148
Number of employers contributing to the scheme	2020-01-01	91
2019: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	11,913
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	11,177
Number of retired or separated participants receiving benefits	2019-01-01	191
Total of all active and inactive participants	2019-01-01	11,368
Number of employers contributing to the scheme	2019-01-01	89
2018: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	12,096
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	11,710
Number of retired or separated participants receiving benefits	2018-01-01	203
Total of all active and inactive participants	2018-01-01	11,913
Number of employers contributing to the scheme	2018-01-01	92
2017: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	12,023
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	11,878
Number of retired or separated participants receiving benefits	2017-01-01	218
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	12,096
Number of employers contributing to the scheme	2017-01-01	87
2016: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	11,929
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	11,816
Number of retired or separated participants receiving benefits	2016-01-01	207
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	12,023
Number of employers contributing to the scheme	2016-01-01	93
2015: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	11,341
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	11,579
Number of retired or separated participants receiving benefits	2015-01-01	350
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	11,929
Number of employers contributing to the scheme	2015-01-01	88
2014: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	11,449
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	10,977
Number of retired or separated participants receiving benefits	2014-01-01	364
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	11,341
Number of employers contributing to the scheme	2014-01-01	91
2013: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	14,725
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	10,977
Number of retired or separated participants receiving benefits	2013-01-01	472
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	11,449
Number of employers contributing to the scheme	2013-01-01	177
2012: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	11,750
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	14,264
Number of retired or separated participants receiving benefits	2012-01-01	461
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	14,725
Number of employers contributing to the scheme	2012-01-01	107
2011: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	11,726
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	11,420
Number of retired or separated participants receiving benefits	2011-01-01	330
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	11,750
Number of employers contributing to the scheme	2011-01-01	106
2010: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	11,763
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	11,364
Number of retired or separated participants receiving benefits	2010-01-01	362
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	11,726
Number of employers contributing to the scheme	2010-01-01	98
2009: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	11,359
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	11,431
Number of retired or separated participants receiving benefits	2009-01-01	332
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	11,763
Number of employers contributing to the scheme	2009-01-01	100

Financial Data on UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN

Measure	Date	Value
2022 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$11,114,692
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$13,495,726
Total income from all sources (including contributions)	2022-12-31	$121,626,177
Total of all expenses incurred	2022-12-31	$112,451,307
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$102,114,323
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$123,902,527
Value of total assets at end of year	2022-12-31	$63,448,584
Value of total assets at beginning of year	2022-12-31	$56,654,748
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$10,336,984
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$357,916
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$357,916
Administrative expenses professional fees incurred	2022-12-31	$231,634
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$878,129
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$6,614,731
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$7,157,795
Other income not declared elsewhere	2022-12-31	$12,909
Administrative expenses (other) incurred	2022-12-31	$136,054
Liabilities. Value of operating payables at end of year	2022-12-31	$474,692
Liabilities. Value of operating payables at beginning of year	2022-12-31	$419,726
Total non interest bearing cash at end of year	2022-12-31	$21,056,009
Total non interest bearing cash at beginning of year	2022-12-31	$23,865,357
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$9,174,870
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$52,333,892
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$43,159,022
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$10,000
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$29,875,442
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$19,214,626
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$687,590
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-2,647,175
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$123,024,398
Employer contributions (assets) at end of year	2022-12-31	$5,902,402
Employer contributions (assets) at beginning of year	2022-12-31	$6,416,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$101,426,733
Contract administrator fees	2022-12-31	$9,959,296
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$10,640,000
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$13,076,000
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	MSPC CERTIFIED PUBLIC ACCOUNTANTS A
Accountancy firm EIN	2022-12-31	222951202
2021 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$13,495,726
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$11,835,704
Expenses. Interest paid	2021-12-31	$1,562
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2021-12-31	$1,562
Total income from all sources (including contributions)	2021-12-31	$126,728,813
Total of all expenses incurred	2021-12-31	$121,416,604
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$111,592,806
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$125,194,267
Value of total assets at end of year	2021-12-31	$56,654,748
Value of total assets at beginning of year	2021-12-31	$49,682,517
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$9,822,236
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$172,481
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$172,481
Administrative expenses professional fees incurred	2021-12-31	$160,343
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$654,940
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$7,157,795
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$8,166,765
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$85,623
Other income not declared elsewhere	2021-12-31	$1,963
Administrative expenses (other) incurred	2021-12-31	$131,791
Liabilities. Value of operating payables at end of year	2021-12-31	$419,726
Liabilities. Value of operating payables at beginning of year	2021-12-31	$547,081
Total non interest bearing cash at end of year	2021-12-31	$23,865,357
Total non interest bearing cash at beginning of year	2021-12-31	$13,118,146
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$5,312,209
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$43,159,022
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$37,846,813
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$19,214,626
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$17,682,054
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$706,088
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,360,102
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$124,539,327
Employer contributions (assets) at end of year	2021-12-31	$6,416,970
Employer contributions (assets) at beginning of year	2021-12-31	$10,715,552
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$110,886,718
Contract administrator fees	2021-12-31	$9,530,102
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$13,076,000
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$11,203,000
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MSPC CERTIFIED PUBLIC ACCOUNTANTS A
Accountancy firm EIN	2021-12-31	222951202
2020 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$11,835,704
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$12,008,124
Expenses. Interest paid	2020-12-31	$21,323
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2020-12-31	$21,323
Total income from all sources (including contributions)	2020-12-31	$132,487,112
Total of all expenses incurred	2020-12-31	$122,701,384
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$111,898,640
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$131,141,199
Value of total assets at end of year	2020-12-31	$49,682,517
Value of total assets at beginning of year	2020-12-31	$40,069,209
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$10,781,421
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$192,152
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$192,152
Administrative expenses professional fees incurred	2020-12-31	$215,220
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$677,323
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$8,141,421
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$6,836,831
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$85,623
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$413,040
Administrative expenses (other) incurred	2020-12-31	$132,427
Liabilities. Value of operating payables at end of year	2020-12-31	$547,081
Liabilities. Value of operating payables at beginning of year	2020-12-31	$486,084
Total non interest bearing cash at end of year	2020-12-31	$13,118,146
Total non interest bearing cash at beginning of year	2020-12-31	$10,945,482
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$9,785,728
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$37,846,813
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$28,061,085
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$17,682,054
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$16,336,176
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$779,754
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,153,761
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$130,463,876
Employer contributions (assets) at end of year	2020-12-31	$10,715,552
Employer contributions (assets) at beginning of year	2020-12-31	$5,926,422
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$111,118,886
Contract administrator fees	2020-12-31	$10,433,774
Liabilities. Value of benefit claims payable at end of year	2020-12-31	$11,203,000
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$11,109,000
Assets. Value of buildings and other operty used in plan operation at end of year	2020-12-31	$25,344
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-12-31	$24,298
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	MSPC CERTIFIED PUBLIC ACCOUNTANTS A
Accountancy firm EIN	2020-12-31	222951202
2019 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$12,008,124
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$12,008,124
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$13,476,009
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$13,476,009
Total income from all sources (including contributions)	2019-12-31	$129,481,286
Total income from all sources (including contributions)	2019-12-31	$129,481,286
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$122,505,759
Total of all expenses incurred	2019-12-31	$122,505,759
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$112,292,976
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$112,292,976
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$127,873,146
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$127,873,146
Value of total assets at end of year	2019-12-31	$40,069,209
Value of total assets at end of year	2019-12-31	$40,069,209
Value of total assets at beginning of year	2019-12-31	$34,561,567
Value of total assets at beginning of year	2019-12-31	$34,561,567
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$10,212,783
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$10,212,783
Total interest from all sources	2019-12-31	$0
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$298,292
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$298,292
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$298,292
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$298,292
Administrative expenses professional fees incurred	2019-12-31	$286,491
Administrative expenses professional fees incurred	2019-12-31	$286,491
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
Value of fidelity bond cover	2019-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$836,508
Contributions received from participants	2019-12-31	$836,508
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$6,836,831
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$6,836,831
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$5,743,545
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$5,743,545
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$413,040
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$413,040
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$1,177,417
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$1,177,417
Administrative expenses (other) incurred	2019-12-31	$5,767,930
Administrative expenses (other) incurred	2019-12-31	$5,767,930
Liabilities. Value of operating payables at end of year	2019-12-31	$486,084
Liabilities. Value of operating payables at end of year	2019-12-31	$486,084
Liabilities. Value of operating payables at beginning of year	2019-12-31	$573,592
Liabilities. Value of operating payables at beginning of year	2019-12-31	$573,592
Total non interest bearing cash at end of year	2019-12-31	$10,945,482
Total non interest bearing cash at end of year	2019-12-31	$10,945,482
Total non interest bearing cash at beginning of year	2019-12-31	$13,775,409
Total non interest bearing cash at beginning of year	2019-12-31	$13,775,409
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$6,975,527
Value of net income/loss	2019-12-31	$6,975,527
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$28,061,085
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$28,061,085
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$21,085,558
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$21,085,558
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$16,336,176
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$16,336,176
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$9,428,037
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$9,428,037
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$5,058,468
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$5,058,468
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,309,848
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,309,848
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$127,036,638
Contributions received in cash from employer	2019-12-31	$127,036,638
Employer contributions (assets) at end of year	2019-12-31	$5,926,422
Employer contributions (assets) at end of year	2019-12-31	$5,926,422
Employer contributions (assets) at beginning of year	2019-12-31	$5,583,074
Employer contributions (assets) at beginning of year	2019-12-31	$5,583,074
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$107,234,508
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$107,234,508
Contract administrator fees	2019-12-31	$4,158,362
Contract administrator fees	2019-12-31	$4,158,362
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$11,109,000
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$11,109,000
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$11,725,000
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$11,725,000
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$24,298
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$24,298
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$31,502
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$31,502
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Accountancy firm name	2019-12-31	WITHUMSMITH & BROWN, P.C.
Accountancy firm name	2019-12-31	WITHUMSMITH & BROWN, P.C.
Accountancy firm EIN	2019-12-31	222027092
Accountancy firm EIN	2019-12-31	222027092
2018 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$13,476,009
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$13,978,499
Total income from all sources (including contributions)	2018-12-31	$119,673,863
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$116,677,911
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$107,087,594
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$119,974,415
Value of total assets at end of year	2018-12-31	$34,561,567
Value of total assets at beginning of year	2018-12-31	$32,068,105
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$9,590,317
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$191,919
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$191,919
Administrative expenses professional fees incurred	2018-12-31	$258,754
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$1,024,007
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$5,743,545
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$4,164,419
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$1,177,417
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$1,545,075
Administrative expenses (other) incurred	2018-12-31	$5,173,018
Liabilities. Value of operating payables at end of year	2018-12-31	$573,592
Liabilities. Value of operating payables at beginning of year	2018-12-31	$853,424
Total non interest bearing cash at end of year	2018-12-31	$13,775,409
Total non interest bearing cash at beginning of year	2018-12-31	$14,474,185
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$2,995,952
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$21,085,558
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$18,089,606
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$9,428,037
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$8,228,589
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$5,595,638
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-492,471
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$118,950,408
Employer contributions (assets) at end of year	2018-12-31	$5,583,074
Employer contributions (assets) at beginning of year	2018-12-31	$5,173,382
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$101,491,956
Contract administrator fees	2018-12-31	$4,158,545
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$11,725,000
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$11,580,000
Assets. Value of buildings and other operty used in plan operation at end of year	2018-12-31	$31,502
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-12-31	$27,530
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	No
Opinion of an independent qualified public accountant for this plan	2018-12-31	Unqualified
Accountancy firm name	2018-12-31	WITHUMSMITH & BROWN, P.C.
Accountancy firm EIN	2018-12-31	222027092
2017 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$13,978,499
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$13,651,670
Total income from all sources (including contributions)	2017-12-31	$120,141,357
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$115,814,257
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$106,217,049
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$119,188,421
Value of total assets at end of year	2017-12-31	$32,068,105
Value of total assets at beginning of year	2017-12-31	$27,414,176
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$9,597,208
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$161,126
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$161,126
Administrative expenses professional fees incurred	2017-12-31	$252,928
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$1,026,082
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$4,164,419
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$4,239,641
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$1,545,075
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$1,980,392
Administrative expenses (other) incurred	2017-12-31	$5,237,179
Liabilities. Value of operating payables at end of year	2017-12-31	$853,424
Liabilities. Value of operating payables at beginning of year	2017-12-31	$1,323,278
Total non interest bearing cash at end of year	2017-12-31	$14,474,185
Total non interest bearing cash at beginning of year	2017-12-31	$10,694,316
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$4,327,100
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$18,089,606
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$13,762,506
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$8,228,589
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$7,290,654
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$5,144,194
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$791,810
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$118,162,339
Employer contributions (assets) at end of year	2017-12-31	$5,173,382
Employer contributions (assets) at beginning of year	2017-12-31	$5,162,525
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$101,072,855
Contract administrator fees	2017-12-31	$4,107,101
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$11,580,000
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$10,348,000
Assets. Value of buildings and other operty used in plan operation at end of year	2017-12-31	$27,530
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-12-31	$27,040
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	WITHUMSMITH & BROWN, P.C.
Accountancy firm EIN	2017-12-31	222027092
2016 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$13,651,670
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$14,384,405
Total income from all sources (including contributions)	2016-12-31	$112,663,666
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$103,705,919
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$94,099,503
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$112,207,141
Value of total assets at end of year	2016-12-31	$27,414,176
Value of total assets at beginning of year	2016-12-31	$19,189,164
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$9,606,416
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$136,153
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$136,153
Administrative expenses professional fees incurred	2016-12-31	$270,218
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$763,888
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$4,239,641
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$5,098,947
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$1,980,392
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$2,324,819
Administrative expenses (other) incurred	2016-12-31	$5,635,329
Liabilities. Value of operating payables at end of year	2016-12-31	$1,323,278
Liabilities. Value of operating payables at beginning of year	2016-12-31	$1,600,586
Total non interest bearing cash at end of year	2016-12-31	$10,694,316
Total non interest bearing cash at beginning of year	2016-12-31	$1,272,511
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$8,957,747
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$13,762,506
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,804,759
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$7,290,654
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$6,834,129
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$4,815,709
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$320,372
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$111,443,253
Employer contributions (assets) at end of year	2016-12-31	$5,162,525
Employer contributions (assets) at beginning of year	2016-12-31	$5,955,907
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$89,283,794
Contract administrator fees	2016-12-31	$3,700,869
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$10,348,000
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$10,459,000
Assets. Value of buildings and other operty used in plan operation at end of year	2016-12-31	$27,040
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$27,670
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	BOND BEEBE, P.C.
Accountancy firm EIN	2016-12-31	521044197
2015 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$14,384,405
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$13,860,202
Total income from all sources (including contributions)	2015-12-31	$111,621,780
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$112,018,425
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$102,306,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$111,615,501
Value of total assets at end of year	2015-12-31	$19,189,164
Value of total assets at beginning of year	2015-12-31	$19,061,606
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$9,711,784
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$120,647
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$120,647
Administrative expenses professional fees incurred	2015-12-31	$288,343
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$694,485
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$5,098,947
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$5,223,941
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$2,324,819
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$2,347,364
Other income not declared elsewhere	2015-12-31	$0
Administrative expenses (other) incurred	2015-12-31	$5,729,061
Liabilities. Value of operating payables at end of year	2015-12-31	$1,600,586
Liabilities. Value of operating payables at beginning of year	2015-12-31	$1,377,838
Total non interest bearing cash at end of year	2015-12-31	$1,272,511
Total non interest bearing cash at beginning of year	2015-12-31	$2,993,688
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-396,645
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,804,759
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,201,404
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$6,834,129
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$6,827,849
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$5,179,349
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-114,368
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$110,921,016
Employer contributions (assets) at end of year	2015-12-31	$5,955,907
Employer contributions (assets) at beginning of year	2015-12-31	$3,959,968
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$97,127,292
Contract administrator fees	2015-12-31	$3,694,380
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$10,459,000
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$10,135,000
Assets. Value of buildings and other operty used in plan operation at end of year	2015-12-31	$27,670
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-12-31	$56,160
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	BOND BEEBE, P.C.
Accountancy firm EIN	2015-12-31	521044197
2014 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$13,860,202
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$17,058,562
Total income from all sources (including contributions)	2014-12-31	$107,758,461
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$106,780,825
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$97,184,471
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$107,182,530
Value of total assets at end of year	2014-12-31	$19,061,606
Value of total assets at beginning of year	2014-12-31	$21,282,330
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$9,596,354
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$121,302
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$121,302
Administrative expenses professional fees incurred	2014-12-31	$338,436
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,001,409
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$5,223,941
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$5,671,066
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$2,347,364
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$2,914,136
Other income not declared elsewhere	2014-12-31	$192,696
Administrative expenses (other) incurred	2014-12-31	$5,801,237
Liabilities. Value of operating payables at end of year	2014-12-31	$1,377,838
Liabilities. Value of operating payables at beginning of year	2014-12-31	$1,112,426
Total non interest bearing cash at end of year	2014-12-31	$2,993,688
Total non interest bearing cash at beginning of year	2014-12-31	$4,068,215
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$977,636
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,201,404
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,223,768
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$6,827,849
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$6,444,614
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$4,783,273
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$261,933
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$106,181,121
Employer contributions (assets) at end of year	2014-12-31	$3,959,968
Employer contributions (assets) at beginning of year	2014-12-31	$5,039,940
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$92,401,198
Contract administrator fees	2014-12-31	$3,456,681
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$10,135,000
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$13,032,000
Assets. Value of buildings and other operty used in plan operation at end of year	2014-12-31	$56,160
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-12-31	$58,495
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	BOND BEEBE, P.C.
Accountancy firm EIN	2014-12-31	521044197
2013 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$17,058,562
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$15,698,940
Total income from all sources (including contributions)	2013-12-31	$106,262,116
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$109,731,490
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$100,811,564
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$103,757,009
Value of total assets at end of year	2013-12-31	$21,282,330
Value of total assets at beginning of year	2013-12-31	$23,392,082
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$8,919,926
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$173,286
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$173,286
Administrative expenses professional fees incurred	2013-12-31	$319,056
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$1,192,670
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$5,671,066
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$3,664,282
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$2,914,136
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$2,223,136
Other income not declared elsewhere	2013-12-31	$1,850,000
Administrative expenses (other) incurred	2013-12-31	$5,120,504
Liabilities. Value of operating payables at end of year	2013-12-31	$1,112,426
Liabilities. Value of operating payables at beginning of year	2013-12-31	$630,804
Total non interest bearing cash at end of year	2013-12-31	$4,068,215
Total non interest bearing cash at beginning of year	2013-12-31	$1,419,117
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-3,469,374
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,223,768
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$7,693,142
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$3,911
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$6,444,614
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$13,689,525
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$909,465
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$481,821
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$102,564,339
Employer contributions (assets) at end of year	2013-12-31	$5,039,940
Employer contributions (assets) at beginning of year	2013-12-31	$4,577,010
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$99,902,099
Contract administrator fees	2013-12-31	$3,476,455
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$13,032,000
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$12,845,000
Assets. Value of buildings and other operty used in plan operation at end of year	2013-12-31	$58,495
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-12-31	$42,148
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	BOND BEEBE, P.C.
Accountancy firm EIN	2013-12-31	521044197
2012 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$15,698,940
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$14,952,745
Total income from all sources (including contributions)	2012-12-31	$100,778,551
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$112,778,949
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$103,894,168
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$100,084,066
Value of total assets at end of year	2012-12-31	$23,392,082
Value of total assets at beginning of year	2012-12-31	$34,646,285
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$8,884,781
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$249,937
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$249,937
Administrative expenses professional fees incurred	2012-12-31	$196,479
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$1,152,093
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$3,664,282
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$3,411,770
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$2,223,136
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$2,385,811
Other income not declared elsewhere	2012-12-31	$1,714
Administrative expenses (other) incurred	2012-12-31	$5,339,758
Liabilities. Value of operating payables at end of year	2012-12-31	$630,804
Liabilities. Value of operating payables at beginning of year	2012-12-31	$1,826,934
Total non interest bearing cash at end of year	2012-12-31	$1,419,117
Total non interest bearing cash at beginning of year	2012-12-31	$2,900,409
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-12,000,398
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$7,693,142
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$19,693,540
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$6,880
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$13,689,525
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$23,996,753
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$1,085,441
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$442,834
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$98,931,973
Employer contributions (assets) at end of year	2012-12-31	$4,577,010
Employer contributions (assets) at beginning of year	2012-12-31	$4,294,238
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$102,808,727
Contract administrator fees	2012-12-31	$3,341,664
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$12,845,000
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$10,740,000
Assets. Value of buildings and other operty used in plan operation at end of year	2012-12-31	$42,148
Assets. Value of buildings and other operty used in plan operation at beginning of year	2012-12-31	$43,115
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	BOND BEEBE, P.C.
Accountancy firm EIN	2012-12-31	521044197
2011 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$14,952,745
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$12,637,827
Total income from all sources (including contributions)	2011-12-31	$94,218,952
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$95,104,496
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$86,321,049
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$93,823,173
Value of total assets at end of year	2011-12-31	$34,646,285
Value of total assets at beginning of year	2011-12-31	$33,216,911
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$8,783,447
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$271,100
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$271,100
Administrative expenses professional fees incurred	2011-12-31	$275,035
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$1,083,816
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$3,411,770
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$4,520,465
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$2,385,811
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$2,536,097
Administrative expenses (other) incurred	2011-12-31	$5,385,161
Liabilities. Value of operating payables at end of year	2011-12-31	$1,826,934
Liabilities. Value of operating payables at beginning of year	2011-12-31	$574,730
Total non interest bearing cash at end of year	2011-12-31	$2,900,409
Total non interest bearing cash at beginning of year	2011-12-31	$2,923,375
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-885,544
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$19,693,540
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$20,579,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$4,902
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$23,996,753
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$22,152,020
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$1,065,492
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$124,679
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$92,739,357
Employer contributions (assets) at end of year	2011-12-31	$4,294,238
Employer contributions (assets) at beginning of year	2011-12-31	$3,568,234
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$85,255,557
Contract administrator fees	2011-12-31	$3,118,349
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$10,740,000
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$9,527,000
Assets. Value of buildings and other operty used in plan operation at end of year	2011-12-31	$43,115
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-31	$52,817
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	BOND BEEBE, P.C.
Accountancy firm EIN	2011-12-31	521044197
2010 : UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$12,637,827
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$12,307,309
Total income from all sources (including contributions)	2010-12-31	$90,717,971
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$86,363,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$77,419,914
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$89,016,976
Value of total assets at end of year	2010-12-31	$33,216,911
Value of total assets at beginning of year	2010-12-31	$28,531,728
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$8,943,392
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$252,640
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$252,640
Administrative expenses professional fees incurred	2010-12-31	$571,564
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$972,872
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$4,520,465
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$1,703,201
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$2,536,097
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$2,674,939
Other income not declared elsewhere	2010-12-31	$1,045,057
Administrative expenses (other) incurred	2010-12-31	$5,316,527
Liabilities. Value of operating payables at end of year	2010-12-31	$574,730
Liabilities. Value of operating payables at beginning of year	2010-12-31	$107,370
Total non interest bearing cash at end of year	2010-12-31	$2,923,375
Total non interest bearing cash at beginning of year	2010-12-31	$3,541,488
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$4,354,665
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$20,579,084
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$16,224,419
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$766
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$22,152,020
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$19,496,692
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$786,458
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$403,298
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$88,044,104
Employer contributions (assets) at end of year	2010-12-31	$3,568,234
Employer contributions (assets) at beginning of year	2010-12-31	$3,743,913
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$76,633,456
Contract administrator fees	2010-12-31	$3,054,535
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$9,527,000
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$9,525,000
Assets. Value of buildings and other operty used in plan operation at end of year	2010-12-31	$52,817
Assets. Value of buildings and other operty used in plan operation at beginning of year	2010-12-31	$46,434
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	BOND BEEBE, P.C.
Accountancy firm EIN	2010-12-31	521044197

Form 5500 Responses for UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN

2022: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Multi-employer plan
2022-01-01	Plan is a collectively bargained plan	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Multi-employer plan
2021-01-01	Plan is a collectively bargained plan	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Multi-employer plan
2020-01-01	Plan is a collectively bargained plan	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Multi-employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Multi-employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Multi-employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Multi-employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Multi-employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Multi-employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Multi-employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Multi-employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Multi-employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Multi-employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: UNITED FOOD AND COMMERCIAL WORKERS LOCAL 152 HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Multi-employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number	18141-0001-001
Policy instance	3
Insurance contract or identification number 18141-0001-001 Number of Individuals Covered 542 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided LEGAL Welfare Benefit Premiums Paid to Carrier USD $26,775 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	30780-33
Policy instance	10
Insurance contract or identification number 30780-33 Number of Individuals Covered 1245 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $47,046 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )
Policy contract number	151595
Policy instance	1
Insurance contract or identification number 151595 Number of Individuals Covered 590 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $37,507 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $246,168 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $37,507 Insurance broker organization code? 3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number	C16AA5FF, A17F-
Policy instance	2
Insurance contract or identification number C16AA5FF, A17F- Number of Individuals Covered 10 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Welfare Benefit Premiums Paid to Carrier USD $47,502 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number	76154
Policy instance	4
Insurance contract or identification number 76154 Number of Individuals Covered 6796 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,678,600 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50035443
Policy instance	5
Insurance contract or identification number 50035443 Number of Individuals Covered 8532 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $22,781 Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $455,620 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 22781 Insurance broker organization code? 3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number	1507
Policy instance	6
Insurance contract or identification number 1507 Number of Individuals Covered 4805 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number	1508
Policy instance	7
Insurance contract or identification number 1508 Number of Individuals Covered 3228 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2646
Policy instance	8
Insurance contract or identification number 2646 Number of Individuals Covered 35 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided RETIREE SUPPLEMENTAL INSURANCE Welfare Benefit Premiums Paid to Carrier USD $111,720 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2604
Policy instance	9
Insurance contract or identification number 2604 Number of Individuals Covered 40 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided RETIREE SUPPLEMENTAL INSURANCE Welfare Benefit Premiums Paid to Carrier USD $134,064 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number	76154
Policy instance	4
Insurance contract or identification number 76154 Number of Individuals Covered 6796 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,537,400 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number	18141
Policy instance	3
Insurance contract or identification number 18141 Number of Individuals Covered 561 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided LEGAL Welfare Benefit Premiums Paid to Carrier USD $29,645 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )
Policy contract number	151595
Policy instance	1
Insurance contract or identification number 151595 Number of Individuals Covered 1704 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $132,723 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $854,129 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $121,257 Insurance broker organization code? 3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number	C16AA5FF, A17F-
Policy instance	2
Insurance contract or identification number C16AA5FF, A17F- Number of Individuals Covered 10 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Welfare Benefit Premiums Paid to Carrier USD $46,440 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50035443
Policy instance	5
Insurance contract or identification number 50035443 Number of Individuals Covered 8896 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $23,231 Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $464,611 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 23231 Insurance broker organization code? 3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number	1507
Policy instance	6
Insurance contract or identification number 1507 Number of Individuals Covered 4966 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	30780-33
Policy instance	10
Insurance contract or identification number 30780-33 Number of Individuals Covered 1196 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $4,784 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $45,296 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,784 Insurance broker organization code? 5
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2604
Policy instance	9
Insurance contract or identification number 2604 Number of Individuals Covered 45 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $8,492 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided RETIREE SUPPLEMENTAL INSURANCE Welfare Benefit Premiums Paid to Carrier USD $150,290 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,492 Insurance broker organization code? 3
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2646
Policy instance	8
Insurance contract or identification number 2646 Number of Individuals Covered 43 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $8,160 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided RETIREE SUPPLEMENTAL INSURANCE Welfare Benefit Premiums Paid to Carrier USD $145,212 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,160 Insurance broker organization code? 3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number	1508
Policy instance	7
Insurance contract or identification number 1508 Number of Individuals Covered 3571 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3
DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )
Policy contract number	151595
Policy instance	1
Insurance contract or identification number 151595 Number of Individuals Covered 762 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $56,526 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $418,354 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $47,105 Insurance broker organization code? 3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number	C16AA5FF, A17F-
Policy instance	2
Insurance contract or identification number C16AA5FF, A17F- Number of Individuals Covered 12 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Welfare Benefit Premiums Paid to Carrier USD $52,440 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number	18141
Policy instance	3
Insurance contract or identification number 18141 Number of Individuals Covered 621 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided LEGAL Welfare Benefit Premiums Paid to Carrier USD $26,383 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number	76154
Policy instance	4
Insurance contract or identification number 76154 Number of Individuals Covered 8049 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,927,949 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50035443
Policy instance	5
Insurance contract or identification number 50035443 Number of Individuals Covered 9917 Insurance policy start date 2019-06-01 Insurance policy end date 2020-05-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $23,157 Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $463,143 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 23157 Insurance broker organization code? 3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number	1507
Policy instance	6
Insurance contract or identification number 1507 Number of Individuals Covered 5247 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number	1508
Policy instance	7
Insurance contract or identification number 1508 Number of Individuals Covered 3989 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2646
Policy instance	8
Insurance contract or identification number 2646 Number of Individuals Covered 51 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $9,290 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided RETIREE SUPPLEMENTAL INSURANCE Welfare Benefit Premiums Paid to Carrier USD $162,024 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $9,290 Insurance broker organization code? 3
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2604
Policy instance	9
Insurance contract or identification number 2604 Number of Individuals Covered 57 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $10,475 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided RETIREE SUPPLEMENTAL INSURANCE Welfare Benefit Premiums Paid to Carrier USD $178,020 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $10,475 Insurance broker organization code? 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	30780-33
Policy instance	10
Insurance contract or identification number 30780-33 Number of Individuals Covered 1550 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $5,949 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $62,030 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,949 Insurance broker organization code? 5
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2604
Policy instance	11
Insurance contract or identification number 2604 Number of Individuals Covered 58 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $11,387 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $182,500 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $11,387 Insurance broker organization code? 3
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2646
Policy instance	12
Insurance contract or identification number 2646 Number of Individuals Covered 58 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $11,525 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $180,307 Commission paid to Insurance Broker USD $11,525 Insurance broker organization code? 3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50035443
Policy instance	13
Insurance contract or identification number 50035443 Number of Individuals Covered 9876 Insurance policy start date 2019-06-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $14,794 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT GROUP TERM LIFE 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 Carrier USD $295,872 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $14,794 Insurance broker organization code? 3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number	1508
Policy instance	14
Insurance contract or identification number 1508 Number of Individuals Covered 3928 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number	1507
Policy instance	15
Insurance contract or identification number 1507 Number of Individuals Covered 5536 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	10
Insurance contract or identification number C4460 Number of Individuals Covered 10055 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $13,685 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	9
Insurance contract or identification number G3187 Number of Individuals Covered 10063 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $232,877 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number	76154
Policy instance	8
Insurance contract or identification number 76154 Number of Individuals Covered 7783 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $3,091,144 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	30780-33
Policy instance	2
Insurance contract or identification number 30780-33 Number of Individuals Covered 1697 Insurance policy start date 2018-11-01 Insurance policy end date 2019-10-31 Total amount of commissions paid to insurance broker USD $6,184 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $61,836 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,184 Insurance broker organization code? 5
ADVANTICA ADMINISTRATIVE SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	11083301
Policy instance	1
Insurance contract or identification number 11083301 Number of Individuals Covered 1816 Insurance policy start date 2019-01-01 Insurance policy end date 2019-03-31 Total amount of commissions paid to insurance broker USD $14,787 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $132,756 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $14,787 Insurance broker organization code? 3
DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )
Policy contract number	151595
Policy instance	3
Insurance contract or identification number 151595 Number of Individuals Covered 830 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $50,759 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $309,277 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $42,299 Insurance broker organization code? 3
DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )
Policy contract number	359636
Policy instance	4
Insurance contract or identification number 359636 Number of Individuals Covered 1115 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $38,850 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $388,497 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $38,850 Insurance broker organization code? 3
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number
Policy instance	5
Number of Individuals Covered 15 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $65,693 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number	18141-0001-001
Policy instance	6
Insurance contract or identification number 18141-0001-001 Number of Individuals Covered 178 Insurance policy start date 2019-01-01 Insurance policy end date 2019-10-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided GROUP LEGAL 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 Carrier USD $11,076 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number	18141-0002-001
Policy instance	7
Insurance contract or identification number 18141-0002-001 Number of Individuals Covered 446 Insurance policy start date 2018-11-01 Insurance policy end date 2019-10-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided GROUP LEGAL 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 Carrier USD $20,619 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2646
Policy instance	10
Insurance contract or identification number 2646 Number of Individuals Covered 65 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $9,583 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $191,678 Commission paid to Insurance Broker USD $9,583 Insurance broker organization code? 3
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2604
Policy instance	9
Insurance contract or identification number 2604 Number of Individuals Covered 63 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $8,790 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $175,801 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,790 Insurance broker organization code? 3
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	8
Insurance contract or identification number C4460 Number of Individuals Covered 9790 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $32,816 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	7
Insurance contract or identification number G3187 Number of Individuals Covered 9798 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $509,162 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number	76154
Policy instance	6
Insurance contract or identification number 76154 Number of Individuals Covered 10216 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $2,815,776 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ADVANTICA ADMINISTRATIVE SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	11083301
Policy instance	1
Insurance contract or identification number 11083301 Number of Individuals Covered 1820 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $52,892 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $539,836 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $52,892 Insurance broker organization code? 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	30780-33
Policy instance	2
Insurance contract or identification number 30780-33 Number of Individuals Covered 1505 Insurance policy start date 2017-09-01 Insurance policy end date 2018-08-31 Total amount of commissions paid to insurance broker USD $5,399 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $53,993 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,399 Insurance broker organization code? 5
DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )
Policy contract number	151595
Policy instance	3
Insurance contract or identification number 151595 Number of Individuals Covered 92 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $57,215 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $309,048 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $46,372 Insurance broker organization code? 3
ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )
Policy contract number	18141-0001-001
Policy instance	4
Insurance contract or identification number 18141-0001-001 Number of Individuals Covered 270 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided GROUP LEGAL 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 Carrier USD $16,695 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14559 )
Policy contract number	18141-0002-001
Policy instance	5
Insurance contract or identification number 18141-0002-001 Number of Individuals Covered 478 Insurance policy start date 2017-11-01 Insurance policy end date 2018-10-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided GROUP LEGAL 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 Carrier USD $29,857 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	30780-33
Policy instance	2
Insurance contract or identification number 30780-33 Number of Individuals Covered 1581 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $5,578 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $55,775 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,578 Insurance broker organization code? 5 Insurance broker name BENEFIT COMMUNICATION SERVICES
ADVANTICA ADMINISTRATIVE SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	11083301
Policy instance	1
Insurance contract or identification number 11083301 Number of Individuals Covered 1922 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $56,798 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $567,979 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $56,798 Insurance broker organization code? 3 Insurance broker name BENEFIT COMMUNICATION SERVICES, INC
DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )
Policy contract number	151595
Policy instance	3
Insurance contract or identification number 151595 Number of Individuals Covered 804 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $56,221 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $321,044 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $48,157 Insurance broker organization code? 3 Insurance broker name KENNETH B. JOHNSON
GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14559 )
Policy contract number	18141-0001-001
Policy instance	4
Insurance contract or identification number 18141-0001-001 Number of Individuals Covered 358 Insurance policy start date 2016-11-01 Insurance policy end date 2017-10-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided GROUP LEGAL 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 Carrier USD $20,898 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14559 )
Policy contract number	18141-0002-001
Policy instance	5
Insurance contract or identification number 18141-0002-001 Number of Individuals Covered 528 Insurance policy start date 2016-11-01 Insurance policy end date 2017-10-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided GROUP LEGAL 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 Carrier USD $23,697 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number	76154
Policy instance	6
Insurance contract or identification number 76154 Number of Individuals Covered 8394 Insurance policy start date 2016-09-01 Insurance policy end date 2017-08-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $3,157,357 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	7
Insurance contract or identification number G3187 Number of Individuals Covered 10103 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $537,430 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	8
Insurance contract or identification number C4460 Number of Individuals Covered 10090 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $34,614 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number	2604
Policy instance	9
Insurance contract or identification number 2604 Number of Individuals Covered 75 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $25,937 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $220,114 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $25,937 Insurance broker name UFCW LOCAL 152 H&W FUND
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number	01GDS05
Policy instance	2
Insurance contract or identification number 01GDS05 Number of Individuals Covered 957 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $152,634 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ADVANTICA ADMINISTRATIVE SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	ADVANTICA-L152
Policy instance	1
Insurance contract or identification number ADVANTICA-L152 Number of Individuals Covered 1651 Insurance policy start date 2014-11-01 Insurance policy end date 2015-10-31 Total amount of commissions paid to insurance broker USD $4,050 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $46,744 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,050 Insurance broker organization code? 1 Insurance broker name ALPHA OMEGA
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	3
Insurance contract or identification number G3187 Number of Individuals Covered 9176 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $379,190 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	4
Insurance contract or identification number C4460 Number of Individuals Covered 9146 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $34,422 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	2
Insurance contract or identification number G3187 Number of Individuals Covered 8838 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $344,459 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	3
Insurance contract or identification number C4460 Number of Individuals Covered 8826 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $36,290 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	PA6191
Policy instance	1
Insurance contract or identification number PA6191 Number of Individuals Covered 2 Insurance policy start date 2013-11-01 Insurance policy end date 2014-10-31 Total amount of commissions paid to insurance broker USD $9,260 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $2,179,681 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $9,260 Insurance broker organization code? 3 Insurance broker name DELAWARE VALLEY HEALTH CARE COALITI
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	3
Insurance contract or identification number C4460 Number of Individuals Covered 9317 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $37,487 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	2
Insurance contract or identification number G3187 Number of Individuals Covered 9331 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $356,237 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	PA6191
Policy instance	1
Insurance contract or identification number PA6191 Number of Individuals Covered 14396 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $14,453 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $3,262,032 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $14,453 Insurance broker organization code? 3 Insurance broker name DELAWARE VALLEY HEALTH CARE COALITI
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	PA6191
Policy instance	1
Insurance contract or identification number PA6191 Number of Individuals Covered 14914 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $16,393 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $3,603,164 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $16,393 Insurance broker organization code? 3 Insurance broker name DELAWARE VALLEY HEALTH CARE COALITI
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	2
Insurance contract or identification number G3187 Number of Individuals Covered 9031 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $351,608 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	3
Insurance contract or identification number C4460 Number of Individuals Covered 9016 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $36,939 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	3
Insurance contract or identification number C4460 Number of Individuals Covered 9514 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $37,656 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	2
Insurance contract or identification number G3187 Number of Individuals Covered 9529 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $358,400 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	PA6191
Policy instance	1
Insurance contract or identification number PA6191 Number of Individuals Covered 9572 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $17,046 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $2,503,200 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	C4460
Policy instance	3
Insurance contract or identification number C4460 Number of Individuals Covered 8500 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT 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 Carrier USD $35,433 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	PA6191
Policy instance	1
Insurance contract or identification number PA6191 Number of Individuals Covered 9409 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $16,580 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $2,414,355 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number	G3187
Policy instance	2
Insurance contract or identification number G3187 Number of Individuals Covered 8519 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $337,506 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No

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