UAW GROUP HEALTH AND WELFARE PLAN has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan UAW GROUP HEALTH AND WELFARE PLAN
| Measure | Date | Value |
|---|
| 2022 : UAW GROUP HEALTH AND WELFARE PLAN 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-37,295 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-37,295 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $2,869,276 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $3,073,393 |
| Total income from all sources (including contributions) | 2022-12-31 | $16,282,896 |
| Total loss/gain on sale of assets | 2022-12-31 | $-12,649 |
| Total of all expenses incurred | 2022-12-31 | $16,747,402 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $15,509,113 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $15,422,019 |
| Value of total assets at end of year | 2022-12-31 | $11,055,789 |
| Value of total assets at beginning of year | 2022-12-31 | $11,724,412 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $1,238,289 |
| Total interest from all sources | 2022-12-31 | $53,594 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $56,578 |
| 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 | $56,578 |
| Administrative expenses professional fees incurred | 2022-12-31 | $312,083 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $1,302,193 |
| Participant contributions at end of year | 2022-12-31 | $112,114 |
| Participant contributions at beginning of year | 2022-12-31 | $125,794 |
| Assets. Other investments not covered elsewhere at end of year | 2022-12-31 | $573,840 |
| Assets. Other investments not covered elsewhere at beginning of year | 2022-12-31 | $559,591 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $1,710,179 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $929,684 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2022-12-31 | $819,853 |
| Administrative expenses (other) incurred | 2022-12-31 | $625,094 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $562,800 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $165,882 |
| Total non interest bearing cash at end of year | 2022-12-31 | $314,406 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $2,063,001 |
| 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 | $-464,506 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $8,186,513 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $8,651,019 |
| 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 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $4,938,252 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $4,901,251 |
| Interest earned on other investments | 2022-12-31 | $14,248 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $2,879,224 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $2,514,327 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $2,514,327 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $39,346 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $737,795 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-19,204 |
| 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 | $14,119,826 |
| Employer contributions (assets) at end of year | 2022-12-31 | $527,774 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $254,944 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $14,771,318 |
| Asset. Corporate debt instrument debt (other) at end of year | 2022-12-31 | $0 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2022-12-31 | $375,820 |
| Contract administrator fees | 2022-12-31 | $301,112 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $1,256,476 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $1,857,511 |
| 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 |
| Aggregate proceeds on sale of assets | 2022-12-31 | $2,577,395 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $2,590,044 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2022-12-31 | 611436956 |
| 2021 : UAW GROUP HEALTH AND WELFARE PLAN 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $-35,109 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $-35,109 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $3,073,393 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $2,141,940 |
| Total income from all sources (including contributions) | 2021-12-31 | $16,291,116 |
| Total loss/gain on sale of assets | 2021-12-31 | $-15,341 |
| Total of all expenses incurred | 2021-12-31 | $17,209,008 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $16,147,539 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $16,258,320 |
| Value of total assets at end of year | 2021-12-31 | $11,724,412 |
| Value of total assets at beginning of year | 2021-12-31 | $11,710,851 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $1,061,469 |
| Total interest from all sources | 2021-12-31 | $66,369 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $2,854 |
| 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 | $2,854 |
| Administrative expenses professional fees incurred | 2021-12-31 | $156,327 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $1,564,877 |
| Participant contributions at end of year | 2021-12-31 | $125,794 |
| Participant contributions at beginning of year | 2021-12-31 | $117,136 |
| Assets. Other investments not covered elsewhere at end of year | 2021-12-31 | $559,591 |
| Assets. Other investments not covered elsewhere at beginning of year | 2021-12-31 | $543,280 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $929,684 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $940,010 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2021-12-31 | $21,205 |
| Administrative expenses (other) incurred | 2021-12-31 | $570,290 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $165,882 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $215,901 |
| Total non interest bearing cash at end of year | 2021-12-31 | $2,063,001 |
| Total non interest bearing cash at beginning of year | 2021-12-31 | $2,562,739 |
| 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 | $-917,892 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $8,651,019 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $9,568,911 |
| 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 | $4,901,251 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $4,156,130 |
| Interest earned on other investments | 2021-12-31 | $16,311 |
| Income. Interest from corporate debt instruments | 2021-12-31 | $8,064 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $2,514,327 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $2,023,852 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $2,023,852 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $41,994 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $855,725 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $-7,182 |
| 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 | $14,693,443 |
| Employer contributions (assets) at end of year | 2021-12-31 | $254,944 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $506,566 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $15,291,814 |
| Asset. Corporate debt instrument debt (other) at end of year | 2021-12-31 | $375,820 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2021-12-31 | $861,138 |
| Contract administrator fees | 2021-12-31 | $334,852 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $1,857,511 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $876,039 |
| 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 |
| Aggregate proceeds on sale of assets | 2021-12-31 | $1,475,000 |
| Aggregate carrying amount (costs) on sale of assets | 2021-12-31 | $1,490,341 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2021-12-31 | 611436956 |
| 2020 : UAW GROUP HEALTH AND WELFARE PLAN 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $31,635 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $31,635 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $2,141,940 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $2,153,029 |
| Total income from all sources (including contributions) | 2020-12-31 | $16,613,219 |
| Total loss/gain on sale of assets | 2020-12-31 | $-5,108 |
| Total of all expenses incurred | 2020-12-31 | $16,192,251 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $15,217,994 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $16,437,445 |
| Value of total assets at end of year | 2020-12-31 | $11,710,851 |
| Value of total assets at beginning of year | 2020-12-31 | $11,300,972 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $974,257 |
| Total interest from all sources | 2020-12-31 | $115,392 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $7,733 |
| 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 | $7,733 |
| Administrative expenses professional fees incurred | 2020-12-31 | $195,219 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $1,290,439 |
| Participant contributions at end of year | 2020-12-31 | $117,136 |
| Participant contributions at beginning of year | 2020-12-31 | $126,597 |
| Assets. Other investments not covered elsewhere at end of year | 2020-12-31 | $543,280 |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-12-31 | $527,049 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $940,010 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $1,380,471 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2020-12-31 | $29,724 |
| Administrative expenses (other) incurred | 2020-12-31 | $514,824 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $215,901 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $66,165 |
| Total non interest bearing cash at end of year | 2020-12-31 | $2,562,739 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $2,592,913 |
| 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 | $420,968 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $9,568,911 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $9,147,943 |
| 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 | $4,156,130 |
| Interest earned on other investments | 2020-12-31 | $18,380 |
| Income. Interest from corporate debt instruments | 2020-12-31 | $22,494 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $2,023,852 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $5,319,694 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $5,319,694 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $74,518 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $860,173 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $-3,602 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| 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 | $15,147,006 |
| Employer contributions (assets) at end of year | 2020-12-31 | $506,566 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $291,324 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $14,357,821 |
| Asset. Corporate debt instrument debt (other) at end of year | 2020-12-31 | $861,138 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2020-12-31 | $1,062,924 |
| Contract administrator fees | 2020-12-31 | $264,214 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $876,039 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $1,036,864 |
| 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 |
| Aggregate proceeds on sale of assets | 2020-12-31 | $3,400,000 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $3,405,108 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2020-12-31 | 611436956 |
| 2019 : UAW GROUP HEALTH AND WELFARE PLAN 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $95,189 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $95,189 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $2,153,029 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $1,517,922 |
| Total income from all sources (including contributions) | 2019-12-31 | $17,853,914 |
| Total loss/gain on sale of assets | 2019-12-31 | $8,246 |
| Total of all expenses incurred | 2019-12-31 | $16,399,590 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $15,513,487 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $17,560,701 |
| Value of total assets at end of year | 2019-12-31 | $11,300,972 |
| Value of total assets at beginning of year | 2019-12-31 | $9,211,541 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $886,103 |
| Total interest from all sources | 2019-12-31 | $160,469 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Administrative expenses professional fees incurred | 2019-12-31 | $125,180 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $1,869,902 |
| Participant contributions at end of year | 2019-12-31 | $126,597 |
| Participant contributions at beginning of year | 2019-12-31 | $131,744 |
| Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $527,049 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $510,963 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $1,380,471 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $1,358,841 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2019-12-31 | $29,309 |
| Administrative expenses (other) incurred | 2019-12-31 | $592,288 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $66,165 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $106,922 |
| Total non interest bearing cash at end of year | 2019-12-31 | $2,592,913 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $509,441 |
| 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 | $1,454,324 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $9,147,943 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $7,693,619 |
| 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 leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Interest earned on other investments | 2019-12-31 | $17,194 |
| Income. Interest from corporate debt instruments | 2019-12-31 | $30,963 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $5,319,694 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $5,031,561 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $5,031,561 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $112,312 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $836,706 |
| 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 |
| 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 | $15,690,799 |
| Employer contributions (assets) at end of year | 2019-12-31 | $291,324 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $547,257 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $14,676,781 |
| Asset. Corporate debt instrument debt (other) at end of year | 2019-12-31 | $1,062,924 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-12-31 | $1,121,734 |
| Contract administrator fees | 2019-12-31 | $168,635 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $1,036,864 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $361,000 |
| 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 |
| 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 |
| Aggregate proceeds on sale of assets | 2019-12-31 | $2,900,000 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $2,891,754 |
| 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 |
| Accountancy firm name | 2019-12-31 | NOVAK FRANCELLA LLC |
| Accountancy firm EIN | 2019-12-31 | 611436956 |
| 2018 : UAW GROUP HEALTH AND WELFARE PLAN 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-44,667 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-44,667 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $1,517,922 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $1,786,197 |
| Total income from all sources (including contributions) | 2018-12-31 | $18,973,461 |
| Total loss/gain on sale of assets | 2018-12-31 | $-18,691 |
| Total of all expenses incurred | 2018-12-31 | $20,202,239 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $19,819,437 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $18,838,584 |
| Value of total assets at end of year | 2018-12-31 | $9,211,541 |
| Value of total assets at beginning of year | 2018-12-31 | $10,708,594 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $382,802 |
| Total interest from all sources | 2018-12-31 | $139,060 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Administrative expenses professional fees incurred | 2018-12-31 | $155,864 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $1,956,650 |
| Participant contributions at end of year | 2018-12-31 | $131,744 |
| Participant contributions at beginning of year | 2018-12-31 | $155,073 |
| Assets. Other investments not covered elsewhere at end of year | 2018-12-31 | $510,963 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-12-31 | $519,496 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $1,358,841 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $1,330,030 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2018-12-31 | $59,175 |
| Administrative expenses (other) incurred | 2018-12-31 | $58,026 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $106,922 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $102,510 |
| Total non interest bearing cash at end of year | 2018-12-31 | $509,441 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $2,018,668 |
| 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 | $-1,228,778 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $7,693,619 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $8,922,397 |
| 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 |
| Interest earned on other investments | 2018-12-31 | $10,963 |
| Income. Interest from corporate debt instruments | 2018-12-31 | $48,874 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $5,031,561 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $5,076,861 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $5,076,861 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $79,223 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $640,490 |
| 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 | $16,881,934 |
| Employer contributions (assets) at end of year | 2018-12-31 | $547,257 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $618,359 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $18,659,451 |
| Asset. Corporate debt instrument debt (other) at end of year | 2018-12-31 | $1,121,734 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2018-12-31 | $1,509,603 |
| Contract administrator fees | 2018-12-31 | $168,912 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $361,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $633,687 |
| 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 |
| Aggregate proceeds on sale of assets | 2018-12-31 | $2,491,913 |
| Aggregate carrying amount (costs) on sale of assets | 2018-12-31 | $2,510,604 |
| 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 | Disclaimer |
| Accountancy firm name | 2018-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2018-12-31 | 611436956 |
| 2017 : UAW GROUP HEALTH AND WELFARE PLAN 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $-29,192 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $-29,192 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $1,786,197 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $2,309,867 |
| Total income from all sources (including contributions) | 2017-12-31 | $18,820,556 |
| Total loss/gain on sale of assets | 2017-12-31 | $-6,851 |
| Total of all expenses incurred | 2017-12-31 | $16,773,900 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $16,460,459 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $18,768,306 |
| Value of total assets at end of year | 2017-12-31 | $10,708,594 |
| Value of total assets at beginning of year | 2017-12-31 | $9,185,608 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $313,441 |
| Total interest from all sources | 2017-12-31 | $66,197 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Administrative expenses professional fees incurred | 2017-12-31 | $83,018 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $2,126,839 |
| Participant contributions at end of year | 2017-12-31 | $155,073 |
| Participant contributions at beginning of year | 2017-12-31 | $188,269 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-12-31 | $565,932 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $1,330,030 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $1,310,260 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2017-12-31 | $22,096 |
| Administrative expenses (other) incurred | 2017-12-31 | $56,363 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $102,510 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $102,968 |
| Total non interest bearing cash at end of year | 2017-12-31 | $2,018,668 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $2,386,853 |
| 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 | $2,046,656 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $8,922,397 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $6,875,741 |
| 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 |
| Income. Interest from corporate debt instruments | 2017-12-31 | $19,886 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $5,076,861 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $4,127,236 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $4,127,236 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $46,311 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $644,410 |
| 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 | $16,641,467 |
| Employer contributions (assets) at end of year | 2017-12-31 | $618,359 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $730,088 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $15,250,117 |
| Asset. Corporate debt instrument debt (other) at end of year | 2017-12-31 | $1,509,603 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2017-12-31 | $442,902 |
| Contract administrator fees | 2017-12-31 | $174,060 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $633,687 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $1,156,899 |
| 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 |
| Aggregate proceeds on sale of assets | 2017-12-31 | $1,500,000 |
| Aggregate carrying amount (costs) on sale of assets | 2017-12-31 | $1,506,851 |
| 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 | Disclaimer |
| Accountancy firm name | 2017-12-31 | NOVAK FRANCELLA LLC |
| Accountancy firm EIN | 2017-12-31 | 611436956 |
| 2016 : UAW GROUP HEALTH AND WELFARE PLAN 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $21,556 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $21,556 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $2,309,867 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $2,393,520 |
| Total income from all sources (including contributions) | 2016-12-31 | $18,408,511 |
| Total loss/gain on sale of assets | 2016-12-31 | $-1,433 |
| Total of all expenses incurred | 2016-12-31 | $16,592,543 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $16,178,920 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $18,321,300 |
| Value of total assets at end of year | 2016-12-31 | $9,185,608 |
| Value of total assets at beginning of year | 2016-12-31 | $7,453,293 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $413,623 |
| Total interest from all sources | 2016-12-31 | $41,424 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Administrative expenses professional fees incurred | 2016-12-31 | $96,615 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $2,177,912 |
| Participant contributions at end of year | 2016-12-31 | $188,269 |
| Participant contributions at beginning of year | 2016-12-31 | $204,604 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-12-31 | $509,822 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $1,310,260 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $1,300,461 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2016-12-31 | $25,664 |
| Administrative expenses (other) incurred | 2016-12-31 | $135,892 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $102,968 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $71,734 |
| Total non interest bearing cash at end of year | 2016-12-31 | $2,386,853 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $3,419,198 |
| 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 | $1,815,968 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $6,875,741 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $5,059,773 |
| 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 bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $4,127,236 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $2,018,746 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $2,018,746 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $41,424 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $560,340 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| 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 | $16,143,388 |
| Employer contributions (assets) at end of year | 2016-12-31 | $730,088 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $510,284 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $15,108,758 |
| Asset. Corporate debt instrument debt (other) at end of year | 2016-12-31 | $442,902 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2016-12-31 | $0 |
| Contract administrator fees | 2016-12-31 | $181,116 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $1,156,899 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $1,271,786 |
| 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 |
| Aggregate proceeds on sale of assets | 2016-12-31 | $750,000 |
| Aggregate carrying amount (costs) on sale of assets | 2016-12-31 | $751,433 |
| 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 | Disclaimer |
| Accountancy firm name | 2016-12-31 | NOVAK FRANCELLA LLC |
| Accountancy firm EIN | 2016-12-31 | 611436956 |
| 2015 : UAW GROUP HEALTH AND WELFARE PLAN 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $7,846 |
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $7,846 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $2,393,520 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $2,532,180 |
| Total income from all sources (including contributions) | 2015-12-31 | $18,370,656 |
| Total loss/gain on sale of assets | 2015-12-31 | $-52 |
| Total of all expenses incurred | 2015-12-31 | $16,628,003 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $15,916,267 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $18,329,224 |
| Value of total assets at end of year | 2015-12-31 | $7,453,293 |
| Value of total assets at beginning of year | 2015-12-31 | $5,849,300 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $711,736 |
| Total interest from all sources | 2015-12-31 | $20,708 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Administrative expenses professional fees incurred | 2015-12-31 | $198,696 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $2,414,286 |
| Participant contributions at end of year | 2015-12-31 | $204,604 |
| Participant contributions at beginning of year | 2015-12-31 | $215,056 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2015-12-31 | $471,698 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $1,300,461 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $1,690,608 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2015-12-31 | $12,930 |
| Administrative expenses (other) incurred | 2015-12-31 | $321,172 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $71,734 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $73,641 |
| Total non interest bearing cash at end of year | 2015-12-31 | $3,419,198 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $1,326,593 |
| 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 | $1,742,653 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $5,059,773 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $3,317,120 |
| 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 bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $2,018,746 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $1,989,853 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $1,989,853 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $20,708 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $527,413 |
| 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 | $15,914,938 |
| Employer contributions (assets) at end of year | 2015-12-31 | $510,284 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $627,190 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $14,917,156 |
| Contract administrator fees | 2015-12-31 | $191,868 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $1,271,786 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $1,408,539 |
| 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 |
| Aggregate proceeds on sale of assets | 2015-12-31 | $500,000 |
| Aggregate carrying amount (costs) on sale of assets | 2015-12-31 | $500,052 |
| 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 | Disclaimer |
| Accountancy firm name | 2015-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2015-12-31 | 611436956 |
| 2014 : UAW GROUP HEALTH AND WELFARE PLAN 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $-10,148 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $-10,148 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $2,532,180 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $2,236,243 |
| Total income from all sources (including contributions) | 2014-12-31 | $19,553,584 |
| Total of all expenses incurred | 2014-12-31 | $18,365,235 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $17,325,408 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $19,560,934 |
| Value of total assets at end of year | 2014-12-31 | $5,849,300 |
| Value of total assets at beginning of year | 2014-12-31 | $4,365,014 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $1,039,827 |
| Total interest from all sources | 2014-12-31 | $2,798 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Administrative expenses professional fees incurred | 2014-12-31 | $168,202 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $2,576,958 |
| Participant contributions at end of year | 2014-12-31 | $215,056 |
| Participant contributions at beginning of year | 2014-12-31 | $198,027 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-12-31 | $542,089 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $1,690,608 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $1,764,908 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-12-31 | $1,050,000 |
| Administrative expenses (other) incurred | 2014-12-31 | $678,051 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $73,641 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $90,560 |
| Total non interest bearing cash at end of year | 2014-12-31 | $1,326,593 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $1,910,203 |
| 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 | $1,188,349 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $3,317,120 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $2,128,771 |
| 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 bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $1,989,853 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $2,798 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $614,494 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| 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 | $16,983,976 |
| Employer contributions (assets) at end of year | 2014-12-31 | $627,190 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $491,876 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $16,168,825 |
| Contract administrator fees | 2014-12-31 | $193,574 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $1,408,539 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $1,095,683 |
| 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 | Disclaimer |
| Accountancy firm name | 2014-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2014-12-31 | 611436956 |
| 2013 : UAW GROUP HEALTH AND WELFARE PLAN 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $2,236,243 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $3,158,831 |
| Total income from all sources (including contributions) | 2013-12-31 | $20,969,784 |
| Total of all expenses incurred | 2013-12-31 | $18,524,999 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $18,101,776 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $20,960,087 |
| Value of total assets at end of year | 2013-12-31 | $4,365,014 |
| Value of total assets at beginning of year | 2013-12-31 | $2,842,817 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $423,223 |
| Total interest from all sources | 2013-12-31 | $9,697 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Administrative expenses professional fees incurred | 2013-12-31 | $181,882 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $3,081,703 |
| Participant contributions at end of year | 2013-12-31 | $198,027 |
| Participant contributions at beginning of year | 2013-12-31 | $115,181 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2013-12-31 | $256,200 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-12-31 | $578,820 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $1,764,908 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $1,648,055 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-12-31 | $1,050,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-12-31 | $1,050,000 |
| Administrative expenses (other) incurred | 2013-12-31 | $56,921 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $90,560 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $352,311 |
| Total non interest bearing cash at end of year | 2013-12-31 | $1,910,203 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $589,065 |
| 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 | $2,444,785 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $2,128,771 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $-316,014 |
| 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 |
| Interest earned on other investments | 2013-12-31 | $9,697 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $910,863 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| 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 | $17,622,184 |
| Employer contributions (assets) at end of year | 2013-12-31 | $491,876 |
| Employer contributions (assets) at beginning of year | 2013-12-31 | $490,516 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $16,612,093 |
| Contract administrator fees | 2013-12-31 | $184,420 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $1,095,683 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $1,756,520 |
| Did the plan have assets held for investment | 2013-12-31 | 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 | 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 | Disclaimer |
| Accountancy firm name | 2013-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2013-12-31 | 611436956 |
| 2012 : UAW GROUP HEALTH AND WELFARE PLAN 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $3,158,831 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $2,442,839 |
| Total income from all sources (including contributions) | 2012-12-31 | $21,282,546 |
| Total of all expenses incurred | 2012-12-31 | $20,931,300 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $20,533,494 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $21,264,843 |
| Value of total assets at end of year | 2012-12-31 | $2,842,817 |
| Value of total assets at beginning of year | 2012-12-31 | $1,775,579 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $397,806 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Administrative expenses professional fees incurred | 2012-12-31 | $130,222 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | Yes |
| Amount of non-exempt transactions with any party-in-interest | 2012-12-31 | $898,055 |
| Contributions received from participants | 2012-12-31 | $2,627,419 |
| Participant contributions at end of year | 2012-12-31 | $115,181 |
| Participant contributions at beginning of year | 2012-12-31 | $197,541 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-12-31 | $300,000 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-12-31 | $640,133 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $1,648,055 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $1,197,259 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-12-31 | $1,050,000 |
| Other income not declared elsewhere | 2012-12-31 | $17,703 |
| Administrative expenses (other) incurred | 2012-12-31 | $52,044 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $352,311 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $162,665 |
| Total non interest bearing cash at end of year | 2012-12-31 | $589,065 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $47,366 |
| 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 | $351,246 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $-316,014 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $-667,260 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $787,786 |
| 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 | $18,337,424 |
| Employer contributions (assets) at end of year | 2012-12-31 | $490,516 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $333,118 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $19,105,575 |
| Contract administrator fees | 2012-12-31 | $215,540 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $1,756,520 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $2,280,174 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2012-12-31 | $0 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-12-31 | $295 |
| Did the plan have assets held for investment | 2012-12-31 | 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 | 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 | Disclaimer |
| Accountancy firm name | 2012-12-31 | NOVAK FRANCELLA LLC |
| Accountancy firm EIN | 2012-12-31 | 611436956 |
| 2011 : UAW GROUP HEALTH AND WELFARE PLAN 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $2,442,839 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $742,535 |
| Total income from all sources (including contributions) | 2011-12-31 | $23,071,846 |
| Total of all expenses incurred | 2011-12-31 | $24,378,313 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $24,075,622 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $22,893,214 |
| Value of total assets at end of year | 2011-12-31 | $1,775,579 |
| Value of total assets at beginning of year | 2011-12-31 | $1,381,742 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $302,691 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Administrative expenses professional fees incurred | 2011-12-31 | $88,525 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | Yes |
| Amount of non-exempt transactions with any party-in-interest | 2011-12-31 | $447,259 |
| Contributions received from participants | 2011-12-31 | $553,391 |
| Participant contributions at end of year | 2011-12-31 | $197,541 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-12-31 | $416,335 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $1,197,259 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $3,723 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-12-31 | $22,210 |
| Other income not declared elsewhere | 2011-12-31 | $178,632 |
| Administrative expenses (other) incurred | 2011-12-31 | $195,626 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $162,665 |
| Total non interest bearing cash at end of year | 2011-12-31 | $47,366 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $514,416 |
| 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 | $-1,306,467 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $-667,260 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $639,207 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $12,096,933 |
| 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 | $22,339,823 |
| Employer contributions (assets) at end of year | 2011-12-31 | $333,118 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $862,521 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $11,562,354 |
| Contract administrator fees | 2011-12-31 | $18,540 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $2,280,174 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $720,325 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2011-12-31 | $295 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-12-31 | $1,082 |
| Did the plan have assets held for investment | 2011-12-31 | 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 | 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 | NOVAK FRANCELLA LLC |
| Accountancy firm EIN | 2011-12-31 | 611436956 |
| 2010 : UAW GROUP HEALTH AND WELFARE PLAN 2010 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $742,535 |
| Total income from all sources (including contributions) | 2010-12-31 | $15,250,509 |
| Total of all expenses incurred | 2010-12-31 | $15,178,413 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $15,004,648 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $15,250,509 |
| Value of total assets at end of year | 2010-12-31 | $1,381,742 |
| Value of total assets at beginning of year | 2010-12-31 | $567,111 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $111,087 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Administrative expenses professional fees incurred | 2010-12-31 | $21,466 |
| Was this plan covered by a fidelity bond | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $13,851 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2010-12-31 | $193,175 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $3,723 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $3,723 |
| Administrative expenses (other) incurred | 2010-12-31 | $77,371 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $742,535 |
| Total non interest bearing cash at end of year | 2010-12-31 | $514,416 |
| Total non interest bearing cash at beginning of year | 2010-12-31 | $162,245 |
| 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 | $72,096 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $639,207 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $567,111 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $15,004,648 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
| 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 | $15,043,483 |
| Employer contributions (assets) at end of year | 2010-12-31 | $862,521 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $399,074 |
| Contract administrator fees | 2010-12-31 | $12,250 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2010-12-31 | $1,082 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2010-12-31 | $2,069 |
| Did the plan have assets held for investment | 2010-12-31 | 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 | 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 | BACHELER & COMPANY PC |
| Accountancy firm EIN | 2010-12-31 | 232978066 |
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 1 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 121 | | 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 $76,192 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 2 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 39 | | 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 $28,120 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 3 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 87 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,139 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,394 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,139 |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | SL10367 |
| Policy instance | 4 |
| Insurance contract or identification number | SL10367 | | Number of Individuals Covered | 934 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | 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 $369,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
| Policy contract number | 00851F4 |
| Policy instance | 5 |
| Insurance contract or identification number | 00851F4 | | Number of Individuals Covered | 932 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | 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 $117,826 | | 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 | 851P8 |
| Policy instance | 6 |
| Insurance contract or identification number | 851P8 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | 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 $160,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 805755G |
| Policy instance | 7 |
| Insurance contract or identification number | 805755G | | Number of Individuals Covered | 394 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,397 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $30,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,397 |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 2 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 47 | | 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 $18,418 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 3 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 99 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,817 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,172 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,817 | | Insurance broker organization code? | 3 |
|
| HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
| Policy contract number | 00851F4 |
| Policy instance | 5 |
| Insurance contract or identification number | 00851F4 | | Number of Individuals Covered | 932 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | 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 $128,502 | | 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 | SL10367 |
| Policy instance | 4 |
| Insurance contract or identification number | SL10367 | | Number of Individuals Covered | 1010 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 $366,314 | | 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 | 851P8 |
| Policy instance | 6 |
| Insurance contract or identification number | 851P8 | | Number of Individuals Covered | 269 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 $264,032 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 805755G |
| Policy instance | 7 |
| Insurance contract or identification number | 805755G | | Number of Individuals Covered | 436 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,492 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $29,636 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,492 | | Insurance broker organization code? | 3 |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 1 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 128 | | 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 $48,311 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 2 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 62 | | 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 $124,755 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 0702903 | | Number of Individuals Covered | 819 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $1,581 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $32,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,581 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 5 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 120 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,798 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,978 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,798 | | Insurance broker organization code? | 3 |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | SL10367 |
| Policy instance | 6 |
| Insurance contract or identification number | SL10367 | | Number of Individuals Covered | 1111 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | 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 $356,899 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 4 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 120 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,388 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,882 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,388 | | Insurance broker organization code? | 3 |
|
| HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
| Policy contract number | 00851F4 |
| Policy instance | 7 |
| Insurance contract or identification number | 00851F4 | | Number of Individuals Covered | 1118 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | 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 $138,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHCARE DENTAL, INC. (National Association of Insurance Commissioners NAIC id number: 11146 ) |
| Policy contract number | 851P8-01 |
| Policy instance | 8 |
| Insurance contract or identification number | 851P8-01 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 $135,457 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 3 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 0 | | 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 $25,630 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 805755G |
| Policy instance | 9 |
| Insurance contract or identification number | 805755G | | Number of Individuals Covered | 400 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $651 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $10,830 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $651 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 4 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 132 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,844 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,438 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,844 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 5 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 132 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,141 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,415 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,141 | | Insurance broker organization code? | 3 |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | SL10367 |
| Policy instance | 6 |
| Insurance contract or identification number | SL10367 | | Number of Individuals Covered | 1175 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | 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 $330,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 702903 | | Number of Individuals Covered | 435 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,641 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $32,910 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,641 | | Insurance broker organization code? | 3 |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 2 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 410 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $230,625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 3 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 82 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,465 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
| Policy contract number | 00851F4 |
| Policy instance | 7 |
| Insurance contract or identification number | 00851F4 | | Number of Individuals Covered | 1098 | | Insurance policy start date | 2019-04-01 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $116,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 2 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 396 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $230,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 4 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 157 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $3,121 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,215 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,121 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 5 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 157 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,351 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,512 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,351 | | Insurance broker organization code? | 3 |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GB00221NJ |
| Policy instance | 6 |
| Insurance contract or identification number | GB00221NJ | | Number of Individuals Covered | 1233 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $3,080 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | STOP LOSS | | Welfare Benefit Premiums Paid to Carrier | USD $154,025 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,080 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 702903 | | Number of Individuals Covered | 417 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $32,237 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 3 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 89 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,572 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 5 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 151 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,083 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,083 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GB00221NJ |
| Policy instance | 6 |
| Insurance contract or identification number | GB00221NJ | | Number of Individuals Covered | 1258 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,079 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $303,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,079 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 4 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 151 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,927 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,274 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,927 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 3 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 90 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,491 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 2 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 396 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $208,483 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 702903 | | Number of Individuals Covered | 352 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-06-30 | | Total amount of commissions paid to insurance broker | USD $1,573 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $30,693 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,573 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 702903 | | Number of Individuals Covered | 412 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $1,408 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $26,805 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,408 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GB00221NJ |
| Policy instance | 7 |
| Insurance contract or identification number | GB00221NJ | | Number of Individuals Covered | 1306 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $8,612 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $430,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,612 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-357 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-357 | | Number of Individuals Covered | 2 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $759 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 6 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 162 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $2,150 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,497 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,150 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 5 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 162 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $2,982 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,824 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,982 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 3 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 68 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 2 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 382 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $226,099 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GB0021NJ-01 |
| Policy instance | 7 |
| Insurance contract or identification number | GB0021NJ-01 | | Number of Individuals Covered | 1483 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $13,508 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $675,375 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,508 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 6 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 162 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,818 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,176 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,818 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 5 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 162 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,351 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,351 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GRP INS.BROKERAGE |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 2 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 418 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $257,915 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 702903 | | Number of Individuals Covered | 393 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $1,311 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $26,021 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,311 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 3 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,312 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-357 |
| Policy instance | 4 |
| Insurance contract or identification number | GG-357 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 8 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 162 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,012 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,012 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AP5W |
| Policy instance | 9 |
| Insurance contract or identification number | G000AP5W | | Number of Individuals Covered | 162 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,370 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,703 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,370 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GB0021NJ-01 |
| Policy instance | 10 |
| Insurance contract or identification number | GB0021NJ-01 | | Number of Individuals Covered | 1483 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $6,830 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $341,515 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,830 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 5 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $72,858 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-357 |
| Policy instance | 6 |
| Insurance contract or identification number | GG-357 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,458 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 4 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 422 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $234,902 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGD601804 |
| Policy instance | 2 |
| Insurance contract or identification number | SGD601804 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-03-01 | | Total amount of commissions paid to insurance broker | USD $157 | | Total amount of fees paid to insurance company | USD $68 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,056 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $157 | | Amount paid for insurance broker fees | 68 | | Additional information about fees paid to insurance broker | SALES & SERVICE | | Insurance broker name | SAVOY ASSOCIATES |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 702903 | | Number of Individuals Covered | 429 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $1,849 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $39,338 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,849 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GROUP INSURANCE |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGD601803 |
| Policy instance | 3 |
| Insurance contract or identification number | SGD601803 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-03-01 | | Total amount of commissions paid to insurance broker | USD $112 | | Total amount of fees paid to insurance company | USD $56 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,944 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $112 | | Amount paid for insurance broker fees | 56 | | Additional information about fees paid to insurance broker | SALES & SERVICE | | Insurance broker name | SAVOY ASSOCIATES |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 949-1612 |
| Policy instance | 7 |
| Insurance contract or identification number | 949-1612 | | Number of Individuals Covered | 1567 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $8,706 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,706 | | Insurance broker organization code? | 3 | | Insurance broker name | LAKESHORE BENEFIT GRP INS.BROKERAGE |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 949-1306 |
| Policy instance | 8 |
| Insurance contract or identification number | 949-1306 | | Number of Individuals Covered | 1793 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-357 |
| Policy instance | 7 |
| Insurance contract or identification number | GG-357 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 5 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 448 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $245,192 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 6 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $69,392 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | SAVOY ASSOCIATES |
|
| DENTAL SERVICES ORGANIZATION (National Association of Insurance Commissioners NAIC id number: 11234 ) |
| Policy contract number | 85A182 |
| Policy instance | 4 |
| Insurance contract or identification number | 85A182 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $114,735 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGD601803 |
| Policy instance | 3 |
| Insurance contract or identification number | SGD601803 | | Number of Individuals Covered | 1653 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-03-01 | | Total amount of commissions paid to insurance broker | USD $1,204 | | Total amount of fees paid to insurance company | USD $2,629 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,038 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,204 | | Amount paid for insurance broker fees | 2027 | | Insurance broker organization code? | 3 | | Insurance broker name | SAVOY ASSOCIATES |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGD601804 |
| Policy instance | 2 |
| Insurance contract or identification number | SGD601804 | | Number of Individuals Covered | 1653 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-03-01 | | Total amount of commissions paid to insurance broker | USD $2,184 | | Total amount of fees paid to insurance company | USD $999 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,558 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,184 | | Amount paid for insurance broker fees | 271 | | Insurance broker organization code? | 3 | | Insurance broker name | SAVOY ASSOCIATES |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 702903 | | Number of Individuals Covered | 686 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $50,605 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-358 |
| Policy instance | 8 |
| Insurance contract or identification number | GG-358 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | GJ2158 |
| Policy instance | 7 |
| Insurance contract or identification number | GJ2158 | | Number of Individuals Covered | 444 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $233,752 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTAL SERVICES ORGANIZATION (National Association of Insurance Commissioners NAIC id number: 11234 ) |
| Policy contract number | 85A182 |
| Policy instance | 6 |
| Insurance contract or identification number | 85A182 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $114,735 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGD601803 |
| Policy instance | 5 |
| Insurance contract or identification number | SGD601803 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-03-01 | | Total amount of commissions paid to insurance broker | USD $1,345 | | Total amount of fees paid to insurance company | USD $615 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,454 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGD601804 |
| Policy instance | 4 |
| Insurance contract or identification number | SGD601804 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-03-01 | | Total amount of commissions paid to insurance broker | USD $2,383 | | Total amount of fees paid to insurance company | USD $741 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,332 | | 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 | 86970 |
| Policy instance | 3 |
| Insurance contract or identification number | 86970 | | Number of Individuals Covered | 2075 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $118,465 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,965,255 | | 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 | 86970 |
| Policy instance | 2 |
| Insurance contract or identification number | 86970 | | Number of Individuals Covered | 2075 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $36,438 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,447,719 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 702903 |
| Policy instance | 1 |
| Insurance contract or identification number | 702903 | | Number of Individuals Covered | 686 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $2,909 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $55,566 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DENTCARE DELIVERY SYSTEMS (National Association of Insurance Commissioners NAIC id number: 47112 ) |
| Policy contract number | GG-357 |
| Policy instance | 9 |
| Insurance contract or identification number | GG-357 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,812 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 702903-10-0001 |
| Policy instance | 3 |
| Insurance contract or identification number | 702903-10-0001 | | Number of Individuals Covered | 686 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 1769 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,680,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| INTERNATIONAL HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 11173 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 460 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $268,090 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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