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IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 401k Plan overview

Plan NameIRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE
Plan identification number 502

IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE Benefits

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

401k Sponsoring company profile

IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE FUND has sponsored the creation of one or more 401k plans.

Company Name:IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE FUND
Employer identification number (EIN):223867031
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-07-01
5022020-07-01
5022019-07-01
5022018-07-01KEVIN C. BOYLE2020-04-01 SUSAN DACHOWSKI2020-03-31
5022017-07-01KEVIN C. BOYLE2019-04-12 SUSAN DACHOWSKI2019-04-12
5022016-07-01
5022015-07-01STEPHEN SWEENEY
5022014-07-01STEPHEN SWEENEY SUSAN DACHOWSKI2016-04-04
5022013-07-01
5022012-07-01CHRISTOPHER PROPHET SUSAN DACHOWSKI2014-02-10
5022011-07-01CHRISTOPHER PROPHET SUSAN DACHOWSKI2013-04-12
5022009-07-01CHARLES ROBERTS SUSAN DACHOWSKI2011-03-09

Plan Statistics for IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE

401k plan membership statisitcs for IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE

Measure Date Value
2021: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2021 401k membership
Total participants, beginning-of-year2021-07-01359
Total number of active participants reported on line 7a of the Form 55002021-07-01350
Total of all active and inactive participants2021-07-01350
Number of employers contributing to the scheme2021-07-0196
2020: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2020 401k membership
Total participants, beginning-of-year2020-07-01345
Total number of active participants reported on line 7a of the Form 55002020-07-01359
Total of all active and inactive participants2020-07-01359
2019: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2019 401k membership
Total participants, beginning-of-year2019-07-01743
Total number of active participants reported on line 7a of the Form 55002019-07-01345
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01345
Number of employers contributing to the scheme2019-07-0198
2018: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2018 401k membership
Total participants, beginning-of-year2018-07-01792
Total number of active participants reported on line 7a of the Form 55002018-07-01743
Total of all active and inactive participants2018-07-01743
Number of employers contributing to the scheme2018-07-01120
2017: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2017 401k membership
Total participants, beginning-of-year2017-07-01714
Total number of active participants reported on line 7a of the Form 55002017-07-01792
Total of all active and inactive participants2017-07-01792
Number of employers contributing to the scheme2017-07-01120
2016: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2016 401k membership
Total participants, beginning-of-year2016-07-01628
Total number of active participants reported on line 7a of the Form 55002016-07-01714
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01714
Number of employers contributing to the scheme2016-07-01118
2015: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2015 401k membership
Total participants, beginning-of-year2015-07-01661
Total number of active participants reported on line 7a of the Form 55002015-07-01628
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01628
2014: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2014 401k membership
Total participants, beginning-of-year2014-07-01669
Total number of active participants reported on line 7a of the Form 55002014-07-01661
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01661
2013: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2013 401k membership
Total participants, beginning-of-year2013-07-01693
Total number of active participants reported on line 7a of the Form 55002013-07-01669
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01669
2012: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2012 401k membership
Total participants, beginning-of-year2012-07-01598
Total number of active participants reported on line 7a of the Form 55002012-07-01693
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01693
2011: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2011 401k membership
Total participants, beginning-of-year2011-07-01736
Total number of active participants reported on line 7a of the Form 55002011-07-01598
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01598
2009: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2009 401k membership
Total participants, beginning-of-year2009-07-01879
Total number of active participants reported on line 7a of the Form 55002009-07-01736
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01736

Financial Data on IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE

Measure Date Value
2022 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-06-30$-46,813
Total unrealized appreciation/depreciation of assets2022-06-30$-46,813
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$5,250
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$15,976
Total income from all sources (including contributions)2022-06-30$1,293,629
Total loss/gain on sale of assets2022-06-30$55
Total of all expenses incurred2022-06-30$1,159,108
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$1,117,359
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$1,317,006
Value of total assets at end of year2022-06-30$3,598,551
Value of total assets at beginning of year2022-06-30$3,474,756
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$41,749
Total interest from all sources2022-06-30$23,381
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Administrative expenses professional fees incurred2022-06-30$4,718
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2022-06-30$36,405
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-06-30$31
Administrative expenses (other) incurred2022-06-30$37,031
Liabilities. Value of operating payables at end of year2022-06-30$4,000
Liabilities. Value of operating payables at beginning of year2022-06-30$4,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$134,521
Value of net assets at end of year (total assets less liabilities)2022-06-30$3,593,301
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$3,458,780
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-06-30$779,791
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-06-30$813,398
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-06-30$2,765,861
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-06-30$2,621,761
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-06-30$2,621,761
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-06-30$23,381
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$1,280,601
Employer contributions (assets) at end of year2022-06-30$51,949
Employer contributions (assets) at beginning of year2022-06-30$37,903
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$1,117,359
Liabilities. Value of benefit claims payable at end of year2022-06-30$1,250
Liabilities. Value of benefit claims payable at beginning of year2022-06-30$11,976
Assets. Value of buildings and other operty used in plan operation at end of year2022-06-30$950
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-06-30$1,663
Did the plan have assets held for investment2022-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Aggregate proceeds on sale of assets2022-06-30$291,000
Aggregate carrying amount (costs) on sale of assets2022-06-30$290,945
Opinion of an independent qualified public accountant for this plan2022-06-30Unqualified
Accountancy firm name2022-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2022-06-30232247478
2021 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-06-30$4,203
Total unrealized appreciation/depreciation of assets2021-06-30$4,203
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$15,976
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$27,358
Total income from all sources (including contributions)2021-06-30$1,394,968
Total loss/gain on sale of assets2021-06-30$49
Total of all expenses incurred2021-06-30$1,278,532
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$1,236,618
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$1,374,065
Value of total assets at end of year2021-06-30$3,474,756
Value of total assets at beginning of year2021-06-30$3,369,702
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$41,914
Total interest from all sources2021-06-30$16,651
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Administrative expenses professional fees incurred2021-06-30$6,007
Was this plan covered by a fidelity bond2021-06-30Yes
Value of fidelity bond cover2021-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2021-06-30$37,500
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-06-30$31
Administrative expenses (other) incurred2021-06-30$35,907
Liabilities. Value of operating payables at end of year2021-06-30$4,000
Liabilities. Value of operating payables at beginning of year2021-06-30$6,211
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$116,436
Value of net assets at end of year (total assets less liabilities)2021-06-30$3,458,780
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$3,342,344
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-06-30$813,398
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-06-30$794,351
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-06-30$2,621,761
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-06-30$2,512,332
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-06-30$2,512,332
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-06-30$16,651
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30No
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$1,336,565
Employer contributions (assets) at end of year2021-06-30$37,903
Employer contributions (assets) at beginning of year2021-06-30$63,019
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-06-30$1,236,618
Liabilities. Value of benefit claims payable at end of year2021-06-30$11,976
Liabilities. Value of benefit claims payable at beginning of year2021-06-30$21,147
Assets. Value of buildings and other operty used in plan operation at end of year2021-06-30$1,663
Did the plan have assets held for investment2021-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
Aggregate proceeds on sale of assets2021-06-30$68,049
Aggregate carrying amount (costs) on sale of assets2021-06-30$68,000
Opinion of an independent qualified public accountant for this plan2021-06-30Unqualified
Accountancy firm name2021-06-30FISCHER DORWART, PC
Accountancy firm EIN2021-06-30232247478
2020 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$27,358
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$18,626
Total income from all sources (including contributions)2020-06-30$1,531,037
Total loss/gain on sale of assets2020-06-30$0
Total of all expenses incurred2020-06-30$1,256,725
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-06-30$1,201,043
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-06-30$1,503,118
Value of total assets at end of year2020-06-30$3,369,702
Value of total assets at beginning of year2020-06-30$3,086,658
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-06-30$55,682
Total interest from all sources2020-06-30$27,919
Total dividends received (eg from common stock, registered investment company shares)2020-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-06-30No
Administrative expenses professional fees incurred2020-06-30$19,511
Was this plan covered by a fidelity bond2020-06-30Yes
Value of fidelity bond cover2020-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2020-06-30$40,209
Administrative expenses (other) incurred2020-06-30$36,171
Liabilities. Value of operating payables at end of year2020-06-30$6,211
Liabilities. Value of operating payables at beginning of year2020-06-30$5,465
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Value of net income/loss2020-06-30$274,312
Value of net assets at end of year (total assets less liabilities)2020-06-30$3,342,344
Value of net assets at beginning of year (total assets less liabilities)2020-06-30$3,068,032
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-06-30$794,351
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-06-30$766,432
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-06-30$2,512,332
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-06-30$2,241,289
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-06-30$2,241,289
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-06-30$27,919
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30No
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Contributions received in cash from employer2020-06-30$1,462,909
Employer contributions (assets) at end of year2020-06-30$63,019
Employer contributions (assets) at beginning of year2020-06-30$78,937
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-06-30$1,201,043
Liabilities. Value of benefit claims payable at end of year2020-06-30$21,147
Liabilities. Value of benefit claims payable at beginning of year2020-06-30$13,161
Did the plan have assets held for investment2020-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-06-30No
Opinion of an independent qualified public accountant for this plan2020-06-30Unqualified
Accountancy firm name2020-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2020-06-30232247478
2019 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$18,626
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$18,532
Total income from all sources (including contributions)2019-06-30$1,826,062
Total loss/gain on sale of assets2019-06-30$0
Total of all expenses incurred2019-06-30$1,193,582
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-06-30$1,150,270
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-06-30$1,791,611
Value of total assets at end of year2019-06-30$3,086,658
Value of total assets at beginning of year2019-06-30$2,454,084
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-06-30$43,312
Total interest from all sources2019-06-30$81
Total dividends received (eg from common stock, registered investment company shares)2019-06-30$18,630
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2019-06-30$18,630
Administrative expenses professional fees incurred2019-06-30$6,687
Was this plan covered by a fidelity bond2019-06-30Yes
Value of fidelity bond cover2019-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2019-06-30$36,632
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-06-30$1,114
Administrative expenses (other) incurred2019-06-30$36,625
Liabilities. Value of operating payables at end of year2019-06-30$5,465
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Value of net income/loss2019-06-30$632,480
Value of net assets at end of year (total assets less liabilities)2019-06-30$3,068,032
Value of net assets at beginning of year (total assets less liabilities)2019-06-30$2,435,552
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-06-30$766,432
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-06-30$732,431
Income. Interest from US Government securities2019-06-30$80
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-06-30$2,241,289
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-06-30$1,584,419
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-06-30$1,584,419
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-06-30$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-06-30$15,740
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Contributions received in cash from employer2019-06-30$1,754,979
Employer contributions (assets) at end of year2019-06-30$78,937
Employer contributions (assets) at beginning of year2019-06-30$135,662
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-06-30$1,150,270
Liabilities. Value of benefit claims payable at end of year2019-06-30$13,161
Liabilities. Value of benefit claims payable at beginning of year2019-06-30$18,532
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-06-30$458
Did the plan have assets held for investment2019-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-06-30No
Opinion of an independent qualified public accountant for this plan2019-06-30Unqualified
Accountancy firm name2019-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2019-06-30232247478
2018 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$18,532
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$17,068
Total income from all sources (including contributions)2018-06-30$1,946,983
Total loss/gain on sale of assets2018-06-30$0
Total of all expenses incurred2018-06-30$1,213,281
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-06-30$1,172,336
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-06-30$1,944,536
Value of total assets at end of year2018-06-30$2,454,084
Value of total assets at beginning of year2018-06-30$1,718,918
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-06-30$40,945
Total interest from all sources2018-06-30$1
Total dividends received (eg from common stock, registered investment company shares)2018-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Administrative expenses professional fees incurred2018-06-30$4,875
Was this plan covered by a fidelity bond2018-06-30Yes
Value of fidelity bond cover2018-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2018-06-30$29,559
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-06-30$1,114
Administrative expenses (other) incurred2018-06-30$36,070
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net income/loss2018-06-30$733,702
Value of net assets at end of year (total assets less liabilities)2018-06-30$2,435,552
Value of net assets at beginning of year (total assets less liabilities)2018-06-30$1,701,850
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-06-30$732,431
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-06-30$729,985
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-06-30$1,584,419
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-06-30$921,894
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-06-30$921,894
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-06-30$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-06-30$2,446
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30No
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Contributions received in cash from employer2018-06-30$1,914,977
Employer contributions (assets) at end of year2018-06-30$135,662
Employer contributions (assets) at beginning of year2018-06-30$66,081
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-06-30$1,172,336
Liabilities. Value of benefit claims payable at end of year2018-06-30$18,532
Liabilities. Value of benefit claims payable at beginning of year2018-06-30$17,068
Assets. Value of buildings and other operty used in plan operation at end of year2018-06-30$458
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-06-30$958
Did the plan have assets held for investment2018-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-06-30No
Opinion of an independent qualified public accountant for this plan2018-06-30Unqualified
Accountancy firm name2018-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2018-06-30232247478
2017 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$17,068
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$14,984
Total income from all sources (including contributions)2017-06-30$1,523,104
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$1,182,449
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$1,142,292
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$1,509,157
Value of total assets at end of year2017-06-30$1,718,918
Value of total assets at beginning of year2017-06-30$1,376,179
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$40,157
Total interest from all sources2017-06-30$169
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$13,642
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2017-06-30$13,642
Administrative expenses professional fees incurred2017-06-30$5,764
Was this plan covered by a fidelity bond2017-06-30Yes
Value of fidelity bond cover2017-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2017-06-30$58,887
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-06-30$9,303
Other income not declared elsewhere2017-06-30$7,375
Administrative expenses (other) incurred2017-06-30$34,393
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net income/loss2017-06-30$340,655
Value of net assets at end of year (total assets less liabilities)2017-06-30$1,701,850
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$1,361,195
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-06-30$729,985
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-06-30$723,577
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-06-30$921,894
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-06-30$577,272
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-06-30$577,272
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-06-30$169
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-06-30$-7,239
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Contributions received in cash from employer2017-06-30$1,450,270
Employer contributions (assets) at end of year2017-06-30$66,081
Employer contributions (assets) at beginning of year2017-06-30$64,569
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-06-30$1,142,292
Liabilities. Value of benefit claims payable at end of year2017-06-30$17,068
Liabilities. Value of benefit claims payable at beginning of year2017-06-30$14,984
Assets. Value of buildings and other operty used in plan operation at end of year2017-06-30$958
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-06-30$1,458
Did the plan have assets held for investment2017-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-06-30No
Opinion of an independent qualified public accountant for this plan2017-06-30Unqualified
Accountancy firm name2017-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2017-06-30232247478
2016 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$14,984
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$15,461
Total income from all sources (including contributions)2016-06-30$1,465,538
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$1,046,695
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$1,000,093
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$1,454,040
Value of total assets at end of year2016-06-30$1,376,179
Value of total assets at beginning of year2016-06-30$957,813
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$46,602
Total interest from all sources2016-06-30$198
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$12,332
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2016-06-30$12,332
Administrative expenses professional fees incurred2016-06-30$15,005
Was this plan covered by a fidelity bond2016-06-30Yes
Value of fidelity bond cover2016-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2016-06-30$22,321
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-06-30$9,303
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-06-30$5,073
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-06-30$0
Administrative expenses (other) incurred2016-06-30$31,597
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$418,843
Value of net assets at end of year (total assets less liabilities)2016-06-30$1,361,195
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$942,352
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-06-30$723,577
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-06-30$712,273
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-06-30$577,272
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-06-30$158,122
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-06-30$158,122
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-06-30$198
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-06-30$-1,032
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Contributions received in cash from employer2016-06-30$1,431,719
Employer contributions (assets) at end of year2016-06-30$64,569
Employer contributions (assets) at beginning of year2016-06-30$80,387
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-06-30$1,000,093
Liabilities. Value of benefit claims payable at end of year2016-06-30$14,984
Liabilities. Value of benefit claims payable at beginning of year2016-06-30$15,461
Assets. Value of buildings and other operty used in plan operation at end of year2016-06-30$1,458
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-06-30$1,958
Did the plan have assets held for investment2016-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-06-30No
Opinion of an independent qualified public accountant for this plan2016-06-30Unqualified
Accountancy firm name2016-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2016-06-30232247478
2015 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$15,461
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$67,459
Total income from all sources (including contributions)2015-06-30$1,182,917
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$1,203,189
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$1,159,315
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$1,177,481
Value of total assets at end of year2015-06-30$957,813
Value of total assets at beginning of year2015-06-30$1,030,083
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$43,874
Total interest from all sources2015-06-30$48
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$14,021
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2015-06-30$14,021
Administrative expenses professional fees incurred2015-06-30$10,573
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2015-06-30$23,890
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-06-30$5,073
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-06-30$1,081
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-06-30$53,944
Administrative expenses (other) incurred2015-06-30$33,301
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-20,272
Value of net assets at end of year (total assets less liabilities)2015-06-30$942,352
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$962,624
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-06-30$712,273
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-06-30$707,678
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-06-30$158,122
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-06-30$268,969
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-06-30$268,969
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-06-30$48
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-06-30$-8,633
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Contributions received in cash from employer2015-06-30$1,153,591
Employer contributions (assets) at end of year2015-06-30$80,387
Employer contributions (assets) at beginning of year2015-06-30$49,897
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$1,159,315
Liabilities. Value of benefit claims payable at end of year2015-06-30$15,461
Liabilities. Value of benefit claims payable at beginning of year2015-06-30$13,515
Assets. Value of buildings and other operty used in plan operation at end of year2015-06-30$1,958
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-06-30$2,458
Did the plan have assets held for investment2015-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30No
Opinion of an independent qualified public accountant for this plan2015-06-30Unqualified
Accountancy firm name2015-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2015-06-30232247478
2014 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$67,459
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$184,068
Total income from all sources (including contributions)2014-06-30$1,221,120
Total loss/gain on sale of assets2014-06-30$0
Total of all expenses incurred2014-06-30$1,041,500
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$998,354
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$1,205,471
Value of total assets at end of year2014-06-30$1,030,083
Value of total assets at beginning of year2014-06-30$967,072
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$43,146
Total interest from all sources2014-06-30$278
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$15,371
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2014-06-30$15,371
Administrative expenses professional fees incurred2014-06-30$6,987
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2014-06-30$33,219
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-06-30$1,081
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-06-30$1,292
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-06-30$53,944
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-06-30$168,222
Administrative expenses (other) incurred2014-06-30$36,159
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$179,620
Value of net assets at end of year (total assets less liabilities)2014-06-30$962,624
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$783,004
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-30$707,678
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-30$771,456
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-06-30$268,969
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-06-30$134,191
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-06-30$134,191
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-06-30$278
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$1,172,252
Employer contributions (assets) at end of year2014-06-30$49,897
Employer contributions (assets) at beginning of year2014-06-30$59,673
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$998,354
Liabilities. Value of benefit claims payable at end of year2014-06-30$13,515
Liabilities. Value of benefit claims payable at beginning of year2014-06-30$15,846
Assets. Value of buildings and other operty used in plan operation at end of year2014-06-30$2,458
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-06-30$460
Did the plan have assets held for investment2014-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30No
Opinion of an independent qualified public accountant for this plan2014-06-30Unqualified
Accountancy firm name2014-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2014-06-30232247478
2013 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$184,068
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$39,912
Total income from all sources (including contributions)2013-06-30$1,232,762
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$1,418,902
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$1,258,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$1,223,884
Value of total assets at end of year2013-06-30$967,072
Value of total assets at beginning of year2013-06-30$1,009,056
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$160,602
Total interest from all sources2013-06-30$1,739
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$7,269
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-06-30$7,269
Administrative expenses professional fees incurred2013-06-30$3,100
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2013-06-30$44,580
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-06-30$1,292
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-06-30$1,457
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-06-30$168,222
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-06-30$27,538
Administrative expenses (other) incurred2013-06-30$157,502
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$-186,140
Value of net assets at end of year (total assets less liabilities)2013-06-30$783,004
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$969,144
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$771,456
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$839,317
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-06-30$134,191
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-06-30$145,428
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-06-30$145,428
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-06-30$1,739
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-06-30$-130
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$1,179,304
Employer contributions (assets) at end of year2013-06-30$59,673
Employer contributions (assets) at beginning of year2013-06-30$21,516
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$1,258,300
Liabilities. Value of benefit claims payable at end of year2013-06-30$15,846
Liabilities. Value of benefit claims payable at beginning of year2013-06-30$12,374
Assets. Value of buildings and other operty used in plan operation at end of year2013-06-30$460
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-06-30$1,338
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30No
Opinion of an independent qualified public accountant for this plan2013-06-30Unqualified
Accountancy firm name2013-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2013-06-30232247478
2012 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$39,912
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$68,307
Total income from all sources (including contributions)2012-06-30$837,283
Total of all expenses incurred2012-06-30$1,175,198
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$1,025,387
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$817,582
Value of total assets at end of year2012-06-30$1,009,056
Value of total assets at beginning of year2012-06-30$1,375,366
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$149,811
Total interest from all sources2012-06-30$924
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$15,289
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-06-30$15,289
Administrative expenses professional fees incurred2012-06-30$3,100
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2012-06-30$95,127
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-06-30$1,457
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-06-30$1,362
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-06-30$27,538
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-06-30$57,993
Administrative expenses (other) incurred2012-06-30$146,711
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$-337,915
Value of net assets at end of year (total assets less liabilities)2012-06-30$969,144
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$1,307,059
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$839,317
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-06-30$1,136,274
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-06-30$145,428
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-06-30$210,252
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-06-30$210,252
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-06-30$924
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-06-30$3,488
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$722,455
Employer contributions (assets) at end of year2012-06-30$21,516
Employer contributions (assets) at beginning of year2012-06-30$25,261
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$1,025,387
Liabilities. Value of benefit claims payable at end of year2012-06-30$12,374
Liabilities. Value of benefit claims payable at beginning of year2012-06-30$10,314
Assets. Value of buildings and other operty used in plan operation at end of year2012-06-30$1,338
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-06-30$2,217
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30No
Opinion of an independent qualified public accountant for this plan2012-06-30Unqualified
Accountancy firm name2012-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2012-06-30232247478
2011 : IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$68,307
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$55,388
Total income from all sources (including contributions)2011-06-30$712,848
Total loss/gain on sale of assets2011-06-30$0
Total of all expenses incurred2011-06-30$1,177,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$935,096
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$659,119
Value of total assets at end of year2011-06-30$1,375,366
Value of total assets at beginning of year2011-06-30$1,826,865
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$242,170
Total interest from all sources2011-06-30$2,095
Total dividends received (eg from common stock, registered investment company shares)2011-06-30$46,786
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2011-06-30$46,786
Administrative expenses professional fees incurred2011-06-30$4,100
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$250,000
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Income. Received or receivable in cash from other sources (including rollovers)2011-06-30$57,444
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-06-30$1,362
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-06-30$4,589
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-06-30$57,993
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-06-30$41,536
Administrative expenses (other) incurred2011-06-30$238,070
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$-464,418
Value of net assets at end of year (total assets less liabilities)2011-06-30$1,307,059
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$1,771,477
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-06-30$1,136,274
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-06-30$210,252
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-06-30$1,788,641
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-06-30$1,788,641
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-06-30$2,095
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-06-30$4,848
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$601,675
Employer contributions (assets) at end of year2011-06-30$25,261
Employer contributions (assets) at beginning of year2011-06-30$30,539
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$935,096
Liabilities. Value of benefit claims payable at end of year2011-06-30$10,314
Liabilities. Value of benefit claims payable at beginning of year2011-06-30$13,852
Assets. Value of buildings and other operty used in plan operation at end of year2011-06-30$2,217
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-06-30$3,096
Did the plan have assets held for investment2011-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30No
Opinion of an independent qualified public accountant for this plan2011-06-30Unqualified
Accountancy firm name2011-06-30FISCHER DORWART, P.C.
Accountancy firm EIN2011-06-30232247478

Form 5500 Responses for IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE

2021: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2021 form 5500 responses
2021-07-01Type of plan entityMulti-employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2020 form 5500 responses
2020-07-01Type of plan entityMulti-employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2019 form 5500 responses
2019-07-01Type of plan entityMulti-employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes
2018: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2018 form 5500 responses
2018-07-01Type of plan entityMulti-employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes
2017: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2017 form 5500 responses
2017-07-01Type of plan entityMulti-employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2016 form 5500 responses
2016-07-01Type of plan entityMulti-employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2015 form 5500 responses
2015-07-01Type of plan entityMulti-employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2014 form 5500 responses
2014-07-01Type of plan entityMulti-employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2013 form 5500 responses
2013-07-01Type of plan entityMulti-employer plan
2013-07-01Submission has been amendedYes
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement - TrustYes
2012: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2012 form 5500 responses
2012-07-01Type of plan entityMulti-employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement - TrustYes
2011: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2011 form 5500 responses
2011-07-01Type of plan entityMulti-employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement - TrustYes
2009: IRON WORKERS LOCAL UNION 401 SUPPLEMENTAL WELFARE 2009 form 5500 responses
2009-07-01Type of plan entityMulti-employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY OF NE (National Association of Insurance Commissioners NAIC id number: 12634 )
Policy contract number317496
Policy instance 4
Insurance contract or identification number317496
Number of Individuals Covered3
Insurance policy start date2022-01-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $150
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $150
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberAGP007010
Policy instance 3
Insurance contract or identification numberAGP007010
Number of Individuals Covered350
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $123,965
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number317498
Policy instance 2
Insurance contract or identification number317498
Number of Individuals Covered344
Insurance policy start date2022-01-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $17,450
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $381,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,450
Insurance broker organization code?3
SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 1
Insurance contract or identification numberH2001
Number of Individuals Covered362
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $358,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY OF NE (National Association of Insurance Commissioners NAIC id number: 12634 )
Policy contract number317496
Policy instance 1
Insurance contract or identification number317496
Number of Individuals Covered3
Insurance policy start date2021-01-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $150
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $150
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number317498
Policy instance 2
Insurance contract or identification number317498
Number of Individuals Covered353
Insurance policy start date2021-01-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $18,550
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $367,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,550
Insurance broker organization code?3
SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 3
Insurance contract or identification numberH2001
Number of Individuals Covered359
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $184,147
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 numberAGP007010
Policy instance 4
Insurance contract or identification numberAGP007010
Number of Individuals Covered349
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $216,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
HUMANA INSURANCE COMPANY OF NE (National Association of Insurance Commissioners NAIC id number: 12634 )
Policy contract number317496
Policy instance 5
Insurance contract or identification number317496
Number of Individuals Covered3
Insurance policy start date2020-01-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $150
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $150
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number885916G
Policy instance 4
Insurance contract or identification number885916G
Number of Individuals Covered345
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $16,421
Total amount of fees paid to insurance companyUSD $7,106
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSHORT & LONG TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $148,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,421
Amount paid for insurance broker fees7106
Additional information about fees paid to insurance brokerFEES BONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberAGP007010
Policy instance 3
Insurance contract or identification numberAGP007010
Number of Individuals Covered345
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $431,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
SILVERSCRIPT (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract numberK40033817
Policy instance 2
Insurance contract or identification numberK40033817
Number of Individuals Covered0
Insurance policy start date2019-07-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $125,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number317498
Policy instance 1
Insurance contract or identification number317498
Number of Individuals Covered342
Insurance policy start date2020-01-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $16,950
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $149,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,950
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberAGP007010
Policy instance 1
Insurance contract or identification numberAGP007010
Number of Individuals Covered342
Insurance policy start date2019-01-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $179,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
MEDCO CONTAINMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63762 )
Policy contract numberNGL40361
Policy instance 2
Insurance contract or identification numberNGL40361
Number of Individuals Covered0
Insurance policy start date2018-07-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $145,579
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 number885916G
Policy instance 3
Insurance contract or identification number885916G
Number of Individuals Covered658
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $16,477
Total amount of fees paid to insurance companyUSD $11,581
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSHORT & LONG TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $126,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,477
Amount paid for insurance broker fees11581
Additional information about fees paid to insurance brokerFEES BONUS
Insurance broker organization code?3
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number2949
Policy instance 4
Insurance contract or identification number2949
Number of Individuals Covered0
Insurance policy start date2018-07-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $223,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 965172
Policy instance 5
Insurance contract or identification numberLK 965172
Number of Individuals Covered0
Insurance policy start date2018-07-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $244
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedLONG TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $244
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 752083
Policy instance 6
Insurance contract or identification numberLK 752083
Number of Individuals Covered0
Insurance policy start date2018-07-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $539
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $539
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 965172
Policy instance 5
Insurance contract or identification numberLK 965172
Number of Individuals Covered344
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $4,893
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedLONG TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $89,314
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 numberLK 752083
Policy instance 4
Insurance contract or identification numberLK 752083
Number of Individuals Covered344
Insurance policy start date2017-10-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $2,930
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $39,592
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDCO CONTAINMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63762 )
Policy contract numberNGL40361
Policy instance 3
Insurance contract or identification numberNGL40361
Number of Individuals Covered338
Insurance policy start date2018-01-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $142,691
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 numberAE466946
Policy instance 2
Insurance contract or identification numberAE466946
Number of Individuals Covered331
Insurance policy start date2017-07-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $155,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 )
Policy contract number2949
Policy instance 1
Insurance contract or identification number2949
Number of Individuals Covered344
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $427,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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