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GOODHART SONS, INC. GROUP HEALTH INSURANCE 401k Plan overview

Plan NameGOODHART SONS, INC. GROUP HEALTH INSURANCE
Plan identification number 501

GOODHART SONS, INC. GROUP HEALTH INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

GOODHART SONS, INC. has sponsored the creation of one or more 401k plans.

Company Name:GOODHART SONS, INC.
Employer identification number (EIN):231685243
NAIC Classification:332900

Additional information about GOODHART SONS, INC.

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1979-07-30
Company Identification Number: F035342
Legal Registered Office Address: 4701 COX ROAD, SUITE 285

GLEN ALLEN
United States of America (USA)
23060

More information about GOODHART SONS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOODHART SONS, INC. GROUP HEALTH INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01JACK GRAHAM2022-06-08
5012020-01-01JACK GRAHAM2021-04-13
5012019-01-01JACK GRAHAM2020-05-20
5012019-01-01JACK GRAHAM2021-04-12
5012018-01-01
5012017-01-01
5012016-01-01JACK GRAHAM
5012015-01-01JACK GRAHAM
5012014-01-01JACK GRAHAM
5012013-01-01JACK GRAHAM
5012012-01-02WILLIAM L. SHARP
5012011-01-02WILLIAM L. SHARP
5012010-01-02WILLIAM L. SHARP
5012009-01-02WILLIAM L. SHARP GARY W. GOODHART2010-09-16

Plan Statistics for GOODHART SONS, INC. GROUP HEALTH INSURANCE

401k plan membership statisitcs for GOODHART SONS, INC. GROUP HEALTH INSURANCE

Measure Date Value
2022: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2022 401k membership
Total participants, beginning-of-year2022-01-0197
Total number of active participants reported on line 7a of the Form 55002022-01-0195
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0197
2021: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-01-01104
Total number of active participants reported on line 7a of the Form 55002021-01-01103
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01103
Number of employers contributing to the scheme2021-01-010
2020: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-01-01112
Total number of active participants reported on line 7a of the Form 55002020-01-01112
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01112
Number of employers contributing to the scheme2020-01-010
2019: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-01-01114
Total number of active participants reported on line 7a of the Form 55002019-01-01112
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01112
Number of employers contributing to the scheme2019-01-010
2018: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-01-01214
Total number of active participants reported on line 7a of the Form 55002018-01-01114
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01114
Number of employers contributing to the scheme2018-01-010
2017: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-01-01107
Total number of active participants reported on line 7a of the Form 55002017-01-01107
Number of retired or separated participants receiving benefits2017-01-01107
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01214
2016: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-01121
Total number of active participants reported on line 7a of the Form 55002016-01-01116
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01116
2015: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01110
Total number of active participants reported on line 7a of the Form 55002015-01-01121
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01121
2014: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01109
Total number of active participants reported on line 7a of the Form 55002014-01-01110
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01110
2013: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-01119
Total number of active participants reported on line 7a of the Form 55002013-01-01107
Number of retired or separated participants receiving benefits2013-01-012
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01109
2012: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-02114
Total number of active participants reported on line 7a of the Form 55002012-01-02115
Number of retired or separated participants receiving benefits2012-01-024
Number of other retired or separated participants entitled to future benefits2012-01-020
Total of all active and inactive participants2012-01-02119
2011: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-02120
Total number of active participants reported on line 7a of the Form 55002011-01-02110
Number of retired or separated participants receiving benefits2011-01-024
Number of other retired or separated participants entitled to future benefits2011-01-020
Total of all active and inactive participants2011-01-02114
2010: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-01-02138
Total number of active participants reported on line 7a of the Form 55002010-01-02116
Number of retired or separated participants receiving benefits2010-01-024
Number of other retired or separated participants entitled to future benefits2010-01-020
Total of all active and inactive participants2010-01-02120
2009: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-02141
Total number of active participants reported on line 7a of the Form 55002009-01-02137
Number of retired or separated participants receiving benefits2009-01-021
Number of other retired or separated participants entitled to future benefits2009-01-020
Total of all active and inactive participants2009-01-02138

Financial Data on GOODHART SONS, INC. GROUP HEALTH INSURANCE

Measure Date Value
2016 : GOODHART SONS, INC. GROUP HEALTH INSURANCE 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets from this plan2016-12-31$164,141
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$77,111
Total income from all sources (including contributions)2016-12-31$1,568,085
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,578,514
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,465,291
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,567,867
Value of total assets at end of year2016-12-31$0
Value of total assets at beginning of year2016-12-31$251,681
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$113,223
Total interest from all sources2016-12-31$218
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$482,775
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$16,740
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$39,253
Administrative expenses (other) incurred2016-12-31$113,223
Liabilities. Value of operating payables at end of year2016-12-31$0
Liabilities. Value of operating payables at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-10,429
Value of net assets at end of year (total assets less liabilities)2016-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$174,570
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$212,428
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$212,428
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$218
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$497,483
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,068,352
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$967,808
Liabilities. Value of benefit claims payable at end of year2016-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$77,111
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31RKL LLP
Accountancy firm EIN2016-12-31232108173
2015 : GOODHART SONS, INC. GROUP HEALTH INSURANCE 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$77,111
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$71,793
Total income from all sources (including contributions)2015-12-31$1,308,749
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$1,362,537
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,251,878
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,307,925
Value of total assets at end of year2015-12-31$251,681
Value of total assets at beginning of year2015-12-31$300,151
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$110,659
Total interest from all sources2015-12-31$824
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$458,195
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$16,984
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$39,253
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$386
Administrative expenses (other) incurred2015-12-31$110,659
Liabilities. Value of operating payables at end of year2015-12-31$0
Liabilities. Value of operating payables at beginning of year2015-12-31$169
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-53,788
Value of net assets at end of year (total assets less liabilities)2015-12-31$174,570
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$228,358
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$212,428
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$299,765
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$299,765
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$824
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$409,105
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$832,746
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$842,773
Liabilities. Value of benefit claims payable at end of year2015-12-31$77,111
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$71,624
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31REINSEL KUNTZ LESHER LLP
Accountancy firm EIN2015-12-31232108173
2014 : GOODHART SONS, INC. GROUP HEALTH INSURANCE 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$71,793
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$1,483,324
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,254,966
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,164,276
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,482,861
Value of total assets at end of year2014-12-31$300,151
Value of total assets at beginning of year2014-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$90,690
Total interest from all sources2014-12-31$463
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$417,214
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$10,393
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$386
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$0
Administrative expenses (other) incurred2014-12-31$90,690
Liabilities. Value of operating payables at end of year2014-12-31$169
Liabilities. Value of operating payables at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$228,358
Value of net assets at end of year (total assets less liabilities)2014-12-31$228,358
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$299,765
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$463
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$555,949
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$1,055,254
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$608,327
Liabilities. Value of benefit claims payable at end of year2014-12-31$71,624
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$0
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31REINSEL KUNTZ LESHER LLP
Accountancy firm EIN2014-12-31232108173

Form 5500 Responses for GOODHART SONS, INC. GROUP HEALTH INSURANCE

2022: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2012 form 5500 responses
2012-01-02Type of plan entitySingle employer plan
2012-01-02Plan funding arrangement – InsuranceYes
2012-01-02Plan funding arrangement – General assets of the sponsorYes
2012-01-02Plan benefit arrangement – InsuranceYes
2012-01-02Plan benefit arrangement – General assets of the sponsorYes
2011: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2011 form 5500 responses
2011-01-02Type of plan entitySingle employer plan
2011-01-02Plan funding arrangement – InsuranceYes
2011-01-02Plan benefit arrangement – InsuranceYes
2010: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2010 form 5500 responses
2010-01-02Type of plan entitySingle employer plan
2010-01-02Plan funding arrangement – InsuranceYes
2010-01-02Plan benefit arrangement – InsuranceYes
2009: GOODHART SONS, INC. GROUP HEALTH INSURANCE 2009 form 5500 responses
2009-01-02Type of plan entitySingle employer plan
2009-01-02Submission has been amendedNo
2009-01-02This submission is the final filingNo
2009-01-02This return/report is a short plan year return/report (less than 12 months)No
2009-01-02Plan is a collectively bargained planNo
2009-01-02Plan funding arrangement – InsuranceYes
2009-01-02Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00527179
Policy instance 2
Insurance contract or identification number00527179
Number of Individuals Covered196
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 BenefitYes
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 $5,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00510541
Policy instance 1
Insurance contract or identification number00510541
Number of Individuals Covered97
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $16,963
Total amount of fees paid to insurance companyUSD $3,577
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D,OPTIONAL LIFE & AD&D
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 $101,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,105
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number527179
Policy instance 2
Insurance contract or identification number527179
Number of Individuals Covered194
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number510541
Policy instance 1
Insurance contract or identification number510541
Number of Individuals Covered103
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $8,567
Total amount of fees paid to insurance companyUSD $6,469
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $93,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,567
Amount paid for insurance broker fees6469
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number510541
Policy instance 1
Insurance contract or identification number510541
Number of Individuals Covered112
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $8,067
Total amount of fees paid to insurance companyUSD $4,493
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $95,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,067
Amount paid for insurance broker fees4493
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number527179
Policy instance 2
Insurance contract or identification number527179
Number of Individuals Covered96
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number527179
Policy instance 1
Insurance contract or identification number527179
Number of Individuals Covered100
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number510541
Policy instance 2
Insurance contract or identification number510541
Number of Individuals Covered112
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $8,158
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $99,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,158
Amount paid for insurance broker fees0
Insurance broker organization code?3
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number527179
Policy instance 2
Insurance contract or identification number527179
Number of Individuals Covered100
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number510541
Policy instance 1
Insurance contract or identification number510541
Number of Individuals Covered112
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $8,067
Total amount of fees paid to insurance companyUSD $4,493
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $95,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,067
Amount paid for insurance broker fees4493
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number527179
Policy instance 2
Insurance contract or identification number527179
Number of Individuals Covered103
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number510541
Policy instance 1
Insurance contract or identification number510541
Number of Individuals Covered114
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,162
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $97,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,075
Amount paid for insurance broker fees0
Insurance broker organization code?3
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number527179
Policy instance 2
Insurance contract or identification number527179
Number of Individuals Covered106
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00510541
Policy instance 1
Insurance contract or identification number00510541
Number of Individuals Covered117
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,595
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $87,172
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,595
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameINGROUP ASSOCIATES, INC.
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 3
Insurance contract or identification numberVERIS
Number of Individuals Covered117
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $299,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00510541
Policy instance 2
Insurance contract or identification number00510541
Number of Individuals Covered121
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,430
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, OPTIONAL AD&D, OPTIONAL LIFE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $63,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,430
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameINGROUP ASSOCIATES INC.
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SECURITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68721 )
Policy contract number40505
Policy instance 4
Insurance contract or identification number40505
Number of Individuals Covered97
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,565
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $33,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,503
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameINGROUP ASSOCIATES INC
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number1806860000
Policy instance 1
Insurance contract or identification number1806860000
Number of Individuals Covered267
Insurance policy start date2014-01-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $6,063
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $202,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,063
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameENGLE-HAMBRIGHT & DAVIES
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05914858
Policy instance 2
Insurance contract or identification numberTM05914858
Number of Individuals Covered133
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,074
Total amount of fees paid to insurance companyUSD $1,065
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $24,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,130
Amount paid for insurance broker fees1065
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameINGROUP ASSOCIATES INC
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberVERIS
Policy instance 3
Insurance contract or identification numberVERIS
Number of Individuals Covered0
Insurance policy start date2014-03-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $250,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number1806863000
Policy instance 1
Insurance contract or identification number1806863000
Number of Individuals Covered263
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $36,561
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,186,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,892
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameERC-HICKORY CONSULTING GROUP LLC
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 )
Policy contract number1806864000
Policy instance 2
Insurance contract or identification number1806864000
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $380
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $12,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $312
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameERC-HICKORY CONSULTING GROUP LLC
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number1806860000
Policy instance 1
Insurance contract or identification number1806860000
Number of Individuals Covered274
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $39,933
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,140,935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,933
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameERC-HICKORY CONSULTING GROUP LLC
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number1806860000
Policy instance 1
Insurance contract or identification number1806860000
Number of Individuals Covered249
Insurance policy start date2011-03-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $29,734
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $849,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 )
Policy contract number1806860000
Policy instance 2
Insurance contract or identification number1806860000
Number of Individuals Covered2
Insurance policy start date2011-03-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $384
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00521530
Policy instance 3
Insurance contract or identification number00521530
Number of Individuals Covered120
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $41,178
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIGNIFICA INSURANCE GROUP, INC. (National Association of Insurance Commissioners NAIC id number: 67636 )
Policy contract number62-4567
Policy instance 1
Insurance contract or identification number62-4567
Number of Individuals Covered135
Insurance policy start date2010-01-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $6,432
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,432
Insurance broker organization code?3
Insurance broker nameHICKORY CONSULTING GROUP, LLC

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