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LOCAL 837 HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameLOCAL 837 HEALTH AND WELFARE PLAN
Plan identification number 501

LOCAL 837 HEALTH AND WELFARE PLAN 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

401k Sponsoring company profile

LOCAL 837 HEALTH AND WELFARE PLAN BOARD OF TRUSTEES has sponsored the creation of one or more 401k plans.

Company Name:LOCAL 837 HEALTH AND WELFARE PLAN BOARD OF TRUSTEES
Employer identification number (EIN):231685740
NAIC Classification:493100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LOCAL 837 HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012019-01-01
5012018-01-01
5012017-01-01PAMELA PALMER DOMINIC MARANO2018-10-11
5012016-01-01PAMELA PALMER DOMINIC MARANO2017-10-11
5012015-01-01PAMELA PALMER DOMINIC MARANO2016-10-14
5012014-01-01PAMELA PALMER DOMINIC MARANO2015-10-15
5012013-01-01PAMELA PALMER DOMINIC MARANO2014-10-10
5012012-01-01PAMELA PALMER DOMINIC MARANO2013-10-15
5012011-01-01JOHN DULCZAK DOMINIC MARANO2012-10-15
5012010-01-01JOHN DULCZAK DOMINIC MARANO2011-10-17
5012009-01-01JOHN DULCZAK DOMINIC MARANO2010-10-14

Plan Statistics for LOCAL 837 HEALTH AND WELFARE PLAN

401k plan membership statisitcs for LOCAL 837 HEALTH AND WELFARE PLAN

Measure Date Value
2022: LOCAL 837 HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01196
Total number of active participants reported on line 7a of the Form 55002022-01-01191
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01191
Number of employers contributing to the scheme2022-01-016
2021: LOCAL 837 HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01201
Total number of active participants reported on line 7a of the Form 55002021-01-01196
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 participants2021-01-01196
Number of employers contributing to the scheme2021-01-016
2020: LOCAL 837 HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01229
Total number of active participants reported on line 7a of the Form 55002020-01-01201
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 participants2020-01-01201
Number of employers contributing to the scheme2020-01-016
2019: LOCAL 837 HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01282
Total number of active participants reported on line 7a of the Form 55002019-01-01229
Total of all active and inactive participants2019-01-01229
Number of employers contributing to the scheme2019-01-016
2018: LOCAL 837 HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01308
Total number of active participants reported on line 7a of the Form 55002018-01-01282
Total of all active and inactive participants2018-01-01282
Number of employers contributing to the scheme2018-01-015
2017: LOCAL 837 HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01303
Total number of active participants reported on line 7a of the Form 55002017-01-01308
Total of all active and inactive participants2017-01-01308
Number of employers contributing to the scheme2017-01-015
2016: LOCAL 837 HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01292
Total number of active participants reported on line 7a of the Form 55002016-01-01303
Total of all active and inactive participants2016-01-01303
Number of employers contributing to the scheme2016-01-016
2015: LOCAL 837 HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01348
Total number of active participants reported on line 7a of the Form 55002015-01-01292
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 participants2015-01-01292
2014: LOCAL 837 HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01360
Total number of active participants reported on line 7a of the Form 55002014-01-01348
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 participants2014-01-01348
2013: LOCAL 837 HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01354
Total number of active participants reported on line 7a of the Form 55002013-01-01360
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01360
2012: LOCAL 837 HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01427
Total number of active participants reported on line 7a of the Form 55002012-01-01354
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01354
2011: LOCAL 837 HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01446
Total number of active participants reported on line 7a of the Form 55002011-01-01427
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01427
2010: LOCAL 837 HEALTH AND WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01499
Total number of active participants reported on line 7a of the Form 55002010-01-01446
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01446
Total participants2010-01-01446
2009: LOCAL 837 HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,225
Total number of active participants reported on line 7a of the Form 55002009-01-01499
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01499

Financial Data on LOCAL 837 HEALTH AND WELFARE PLAN

Measure Date Value
2022 : LOCAL 837 HEALTH AND WELFARE PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-137,996
Total unrealized appreciation/depreciation of assets2022-12-31$-137,996
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$406,187
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$330,158
Total income from all sources (including contributions)2022-12-31$-139,399
Total loss/gain on sale of assets2022-12-31$100,850
Total of all expenses incurred2022-12-31$1,231,124
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$356,684
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$419,461
Value of total assets at end of year2022-12-31$8,701,153
Value of total assets at beginning of year2022-12-31$9,995,647
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$874,440
Total interest from all sources2022-12-31$100,730
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$92,546
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$92,546
Administrative expenses professional fees incurred2022-12-31$21,577
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$54,962
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$162,754
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$191,779
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$268,116
Administrative expenses (other) incurred2022-12-31$793,121
Liabilities. Value of operating payables at end of year2022-12-31$54,847
Liabilities. Value of operating payables at beginning of year2022-12-31$73,497
Total non interest bearing cash at end of year2022-12-31$225
Total non interest bearing cash at beginning of year2022-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,370,523
Value of net assets at end of year (total assets less liabilities)2022-12-31$8,294,966
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$9,665,489
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$22,416
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,743,831
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$4,165,771
Income. Interest from US Government securities2022-12-31$12,607
Income. Interest from corporate debt instruments2022-12-31$82,920
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$830,655
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$1,336,758
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$1,336,758
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$5,203
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$356,684
Asset value of US Government securities at end of year2022-12-31$909,950
Asset value of US Government securities at beginning of year2022-12-31$962,614
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-714,990
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Assets. Value of employer real property at end of year2022-12-31$268,116
Contributions received in cash from employer2022-12-31$364,499
Employer contributions (assets) at end of year2022-12-31$650,572
Employer contributions (assets) at beginning of year2022-12-31$1,187,051
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$2,127,305
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$2,141,903
Contract administrator fees2022-12-31$37,326
Liabilities. Value of benefit claims payable at end of year2022-12-31$83,224
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$256,661
Assets. Value of buildings and other operty used in plan operation at end of year2022-12-31$7,745
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-12-31$9,546
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$3,972,029
Aggregate carrying amount (costs) on sale of assets2022-12-31$3,871,179
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31FISCHER DORWART PC
Accountancy firm EIN2022-12-31232247478
2021 : LOCAL 837 HEALTH AND WELFARE PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$-97,806
Total unrealized appreciation/depreciation of assets2021-12-31$-97,806
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$330,158
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$413,496
Total income from all sources (including contributions)2021-12-31$1,381,759
Total loss/gain on sale of assets2021-12-31$5,884
Total of all expenses incurred2021-12-31$2,034,351
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,161,162
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$736,786
Value of total assets at end of year2021-12-31$9,995,647
Value of total assets at beginning of year2021-12-31$10,731,577
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$873,189
Total interest from all sources2021-12-31$102,051
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$239,553
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$239,553
Administrative expenses professional fees incurred2021-12-31$20,439
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$66,871
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$191,779
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$214,650
Administrative expenses (other) incurred2021-12-31$758,290
Liabilities. Value of operating payables at end of year2021-12-31$73,497
Liabilities. Value of operating payables at beginning of year2021-12-31$36,130
Total non interest bearing cash at end of year2021-12-31$225
Total non interest bearing cash at beginning of year2021-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-652,592
Value of net assets at end of year (total assets less liabilities)2021-12-31$9,665,489
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$10,318,081
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$49,388
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$4,165,771
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$3,560,928
Income. Interest from US Government securities2021-12-31$14,398
Income. Interest from corporate debt instruments2021-12-31$84,572
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,336,758
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$1,529,008
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$1,529,008
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$3,081
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,161,162
Asset value of US Government securities at end of year2021-12-31$962,614
Asset value of US Government securities at beginning of year2021-12-31$941,388
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$395,291
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$669,915
Employer contributions (assets) at end of year2021-12-31$1,187,051
Employer contributions (assets) at beginning of year2021-12-31$2,226,283
Asset. Corporate debt instrument debt (other) at end of year2021-12-31$2,141,903
Asset. Corporate debt instrument debt (other) at beginning of year2021-12-31$2,247,748
Contract administrator fees2021-12-31$45,072
Liabilities. Value of benefit claims payable at end of year2021-12-31$256,661
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$377,366
Assets. Value of buildings and other operty used in plan operation at end of year2021-12-31$9,546
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-12-31$11,347
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$2,921,627
Aggregate carrying amount (costs) on sale of assets2021-12-31$2,915,743
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2021-12-31232247478
2020 : LOCAL 837 HEALTH AND WELFARE PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$33,996
Total unrealized appreciation/depreciation of assets2020-12-31$33,996
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$413,496
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$570,370
Total income from all sources (including contributions)2020-12-31$2,891,256
Total loss/gain on sale of assets2020-12-31$-1,962
Total of all expenses incurred2020-12-31$2,624,100
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,718,951
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,498,172
Value of total assets at end of year2020-12-31$10,731,577
Value of total assets at beginning of year2020-12-31$10,621,295
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$905,149
Total interest from all sources2020-12-31$104,494
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$97,336
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$97,336
Administrative expenses professional fees incurred2020-12-31$20,473
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$21,749
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$214,650
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$184,840
Administrative expenses (other) incurred2020-12-31$820,289
Liabilities. Value of operating payables at end of year2020-12-31$36,130
Liabilities. Value of operating payables at beginning of year2020-12-31$54,174
Total non interest bearing cash at end of year2020-12-31$225
Total non interest bearing cash at beginning of year2020-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$267,156
Value of net assets at end of year (total assets less liabilities)2020-12-31$10,318,081
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$10,050,925
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$38,184
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$3,560,928
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$3,312,492
Income. Interest from US Government securities2020-12-31$14,426
Income. Interest from corporate debt instruments2020-12-31$81,898
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$1,529,008
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$2,590,074
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$2,590,074
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$8,170
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,718,951
Asset value of US Government securities at end of year2020-12-31$941,388
Asset value of US Government securities at beginning of year2020-12-31$904,701
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$159,220
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$2,476,423
Employer contributions (assets) at end of year2020-12-31$2,226,283
Employer contributions (assets) at beginning of year2020-12-31$1,488,253
Asset. Corporate debt instrument debt (other) at end of year2020-12-31$2,247,748
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$2,126,773
Contract administrator fees2020-12-31$26,203
Liabilities. Value of benefit claims payable at end of year2020-12-31$377,366
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$516,196
Assets. Value of buildings and other operty used in plan operation at end of year2020-12-31$11,347
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-12-31$13,937
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$4,624,174
Aggregate carrying amount (costs) on sale of assets2020-12-31$4,626,136
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2020-12-31232247478
2019 : LOCAL 837 HEALTH AND WELFARE PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$429,903
Total unrealized appreciation/depreciation of assets2019-12-31$429,903
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$570,370
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$601,731
Total income from all sources (including contributions)2019-12-31$4,198,873
Total loss/gain on sale of assets2019-12-31$-31,400
Total of all expenses incurred2019-12-31$3,709,126
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,782,073
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,451,871
Value of total assets at end of year2019-12-31$10,621,295
Value of total assets at beginning of year2019-12-31$10,162,909
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$927,053
Total interest from all sources2019-12-31$127,211
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$131,877
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$131,877
Administrative expenses professional fees incurred2019-12-31$28,376
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$155,556
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$12,466
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$184,840
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$196,961
Administrative expenses (other) incurred2019-12-31$811,698
Liabilities. Value of operating payables at end of year2019-12-31$54,174
Liabilities. Value of operating payables at beginning of year2019-12-31$41,058
Total non interest bearing cash at end of year2019-12-31$225
Total non interest bearing cash at beginning of year2019-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$489,747
Value of net assets at end of year (total assets less liabilities)2019-12-31$10,050,925
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$9,561,178
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$37,595
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,312,492
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,776,233
Income. Interest from US Government securities2019-12-31$15,362
Income. Interest from corporate debt instruments2019-12-31$77,364
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$2,590,074
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$2,534,708
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$2,534,708
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$34,485
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$2,782,073
Asset value of US Government securities at end of year2019-12-31$904,701
Asset value of US Government securities at beginning of year2019-12-31$873,672
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$89,411
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$3,283,849
Employer contributions (assets) at end of year2019-12-31$1,488,253
Employer contributions (assets) at beginning of year2019-12-31$1,729,535
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$2,126,773
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$2,034,483
Contract administrator fees2019-12-31$49,384
Liabilities. Value of benefit claims payable at end of year2019-12-31$516,196
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$560,673
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$13,937
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$17,092
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$2,978,434
Aggregate carrying amount (costs) on sale of assets2019-12-31$3,009,834
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2019-12-31232247478
2018 : LOCAL 837 HEALTH AND WELFARE PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-337,480
Total unrealized appreciation/depreciation of assets2018-12-31$-337,480
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$601,731
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$573,427
Total income from all sources (including contributions)2018-12-31$5,357,118
Total loss/gain on sale of assets2018-12-31$-48,214
Total of all expenses incurred2018-12-31$3,846,151
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$2,924,616
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$5,444,451
Value of total assets at end of year2018-12-31$10,162,909
Value of total assets at beginning of year2018-12-31$8,623,638
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$921,535
Total interest from all sources2018-12-31$124,826
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$197,499
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$197,499
Administrative expenses professional fees incurred2018-12-31$31,500
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$220,512
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$22,636
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$196,961
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$144,321
Administrative expenses (other) incurred2018-12-31$802,626
Liabilities. Value of operating payables at end of year2018-12-31$41,058
Liabilities. Value of operating payables at beginning of year2018-12-31$62,690
Total non interest bearing cash at end of year2018-12-31$225
Total non interest bearing cash at beginning of year2018-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$1,510,967
Value of net assets at end of year (total assets less liabilities)2018-12-31$9,561,178
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$8,050,211
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$39,637
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,776,233
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,958,164
Income. Interest from US Government securities2018-12-31$12,548
Income. Interest from corporate debt instruments2018-12-31$75,468
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$2,534,708
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$2,204,771
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$2,204,771
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$36,810
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$2,924,616
Asset value of US Government securities at end of year2018-12-31$873,672
Asset value of US Government securities at beginning of year2018-12-31$942,720
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-23,964
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$5,201,303
Employer contributions (assets) at end of year2018-12-31$1,729,535
Employer contributions (assets) at beginning of year2018-12-31$442,804
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$2,034,483
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$1,910,387
Contract administrator fees2018-12-31$47,772
Liabilities. Value of benefit claims payable at end of year2018-12-31$560,673
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$510,737
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$17,092
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$20,246
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$2,442,885
Aggregate carrying amount (costs) on sale of assets2018-12-31$2,491,099
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2018-12-31232247478
2017 : LOCAL 837 HEALTH AND WELFARE PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$314,696
Total unrealized appreciation/depreciation of assets2017-12-31$314,696
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$573,427
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$567,301
Total income from all sources (including contributions)2017-12-31$5,592,123
Total loss/gain on sale of assets2017-12-31$-127,912
Total of all expenses incurred2017-12-31$4,046,423
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$3,198,342
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$5,149,839
Value of total assets at end of year2017-12-31$8,623,638
Value of total assets at beginning of year2017-12-31$7,071,812
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$848,081
Total interest from all sources2017-12-31$135,836
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$119,664
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$119,664
Administrative expenses professional fees incurred2017-12-31$32,307
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$210,525
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$12,343
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$144,321
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$122,112
Administrative expenses (other) incurred2017-12-31$722,758
Liabilities. Value of operating payables at end of year2017-12-31$62,690
Liabilities. Value of operating payables at beginning of year2017-12-31$52,700
Total non interest bearing cash at end of year2017-12-31$225
Total non interest bearing cash at beginning of year2017-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,545,700
Value of net assets at end of year (total assets less liabilities)2017-12-31$8,050,211
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$6,504,511
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$35,599
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,958,164
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,598,180
Income. Interest from US Government securities2017-12-31$37,861
Income. Interest from corporate debt instruments2017-12-31$76,724
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$2,204,771
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$1,234,633
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$1,234,633
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$21,251
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$3,198,342
Asset value of US Government securities at end of year2017-12-31$942,720
Asset value of US Government securities at beginning of year2017-12-31$984,115
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$4,926,971
Employer contributions (assets) at end of year2017-12-31$442,804
Employer contributions (assets) at beginning of year2017-12-31$413,560
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$1,910,387
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$1,695,586
Contract administrator fees2017-12-31$57,417
Liabilities. Value of benefit claims payable at end of year2017-12-31$510,737
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$514,601
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$20,246
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$23,401
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$3,095,587
Aggregate carrying amount (costs) on sale of assets2017-12-31$3,223,499
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2017-12-31232247478
2016 : LOCAL 837 HEALTH AND WELFARE PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$32,396
Total unrealized appreciation/depreciation of assets2016-12-31$32,396
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$567,301
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$536,154
Total income from all sources (including contributions)2016-12-31$4,408,627
Total loss/gain on sale of assets2016-12-31$-104,321
Total of all expenses incurred2016-12-31$4,168,840
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,341,114
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$4,096,416
Value of total assets at end of year2016-12-31$7,071,812
Value of total assets at beginning of year2016-12-31$6,800,878
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$827,726
Total interest from all sources2016-12-31$93,736
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$75,177
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$75,177
Administrative expenses professional fees incurred2016-12-31$43,327
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$182,488
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$26,216
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$122,112
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$123,313
Administrative expenses (other) incurred2016-12-31$712,333
Liabilities. Value of operating payables at end of year2016-12-31$52,700
Liabilities. Value of operating payables at beginning of year2016-12-31$78,349
Total non interest bearing cash at end of year2016-12-31$225
Total non interest bearing cash at beginning of year2016-12-31$225
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$239,787
Value of net assets at end of year (total assets less liabilities)2016-12-31$6,504,511
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$6,264,724
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
Investment advisory and management fees2016-12-31$38,518
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,598,180
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,393,585
Income. Interest from US Government securities2016-12-31$23,572
Income. Interest from corporate debt instruments2016-12-31$54,231
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$1,234,633
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$876,861
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$876,861
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$15,933
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,341,114
Asset value of US Government securities at end of year2016-12-31$984,115
Asset value of US Government securities at beginning of year2016-12-31$674,891
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$215,223
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
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$3,887,712
Employer contributions (assets) at end of year2016-12-31$413,560
Employer contributions (assets) at beginning of year2016-12-31$584,412
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$1,695,586
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$2,121,036
Contract administrator fees2016-12-31$33,548
Liabilities. Value of benefit claims payable at end of year2016-12-31$514,601
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$457,805
Assets. Value of buildings and other operty used in plan operation at end of year2016-12-31$23,401
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$26,555
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$4,367,304
Aggregate carrying amount (costs) on sale of assets2016-12-31$4,471,625
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31FISCHER DORWART, PC
Accountancy firm EIN2016-12-31232247478
2015 : LOCAL 837 HEALTH AND WELFARE PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-196,444
Total unrealized appreciation/depreciation of assets2015-12-31$-196,444
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$536,154
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$474,247
Total income from all sources (including contributions)2015-12-31$3,838,116
Total loss/gain on sale of assets2015-12-31$-59,570
Total of all expenses incurred2015-12-31$3,409,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,542,874
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$3,906,969
Value of total assets at end of year2015-12-31$6,800,878
Value of total assets at beginning of year2015-12-31$6,310,812
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$867,083
Total interest from all sources2015-12-31$96,728
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$90,433
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$89,692
Administrative expenses professional fees incurred2015-12-31$42,074
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$168,121
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$33,319
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$123,313
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$114,305
Administrative expenses (other) incurred2015-12-31$709,645
Liabilities. Value of operating payables at end of year2015-12-31$78,349
Liabilities. Value of operating payables at beginning of year2015-12-31$32,729
Total non interest bearing cash at end of year2015-12-31$225
Total non interest bearing cash at beginning of year2015-12-31$225
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$428,159
Value of net assets at end of year (total assets less liabilities)2015-12-31$6,264,724
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$5,836,565
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
Investment advisory and management fees2015-12-31$42,928
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,393,585
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,515,342
Income. Interest from US Government securities2015-12-31$10,227
Income. Interest from corporate debt instruments2015-12-31$72,990
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$876,861
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$635,689
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$635,689
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$13,511
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$2,542,874
Asset value of US Government securities at end of year2015-12-31$674,891
Asset value of US Government securities at beginning of year2015-12-31$676,905
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
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$3,705,529
Employer contributions (assets) at end of year2015-12-31$584,412
Employer contributions (assets) at beginning of year2015-12-31$282,338
Income. Dividends from common stock2015-12-31$741
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$2,121,036
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$2,063,857
Contract administrator fees2015-12-31$72,436
Liabilities. Value of benefit claims payable at end of year2015-12-31$457,805
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$441,518
Assets. Value of buildings and other operty used in plan operation at end of year2015-12-31$26,555
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-12-31$22,151
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
Aggregate proceeds on sale of assets2015-12-31$3,348,844
Aggregate carrying amount (costs) on sale of assets2015-12-31$3,408,414
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 name2015-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2015-12-31232247478
2014 : LOCAL 837 HEALTH AND WELFARE PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$11,321
Total unrealized appreciation/depreciation of assets2014-12-31$11,321
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$474,247
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$735,749
Total income from all sources (including contributions)2014-12-31$3,366,161
Total loss/gain on sale of assets2014-12-31$-83,864
Total of all expenses incurred2014-12-31$3,617,832
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$2,783,222
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$3,188,179
Value of total assets at end of year2014-12-31$6,310,812
Value of total assets at beginning of year2014-12-31$6,823,985
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$834,610
Total interest from all sources2014-12-31$106,137
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$89,552
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$89,552
Administrative expenses professional fees incurred2014-12-31$32,214
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$119,323
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$26,565
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$114,305
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$91,178
Administrative expenses (other) incurred2014-12-31$694,633
Liabilities. Value of operating payables at end of year2014-12-31$32,729
Liabilities. Value of operating payables at beginning of year2014-12-31$79,007
Total non interest bearing cash at end of year2014-12-31$225
Total non interest bearing cash at beginning of year2014-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-251,671
Value of net assets at end of year (total assets less liabilities)2014-12-31$5,836,565
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$6,088,236
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
Investment advisory and management fees2014-12-31$40,666
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$2,515,342
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$762,585
Income. Interest from US Government securities2014-12-31$16,624
Income. Interest from corporate debt instruments2014-12-31$83,965
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$635,689
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$1,856,759
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$1,856,759
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$5,548
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$2,783,222
Asset value of US Government securities at end of year2014-12-31$676,905
Asset value of US Government securities at beginning of year2014-12-31$865,452
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$54,836
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
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$3,042,291
Employer contributions (assets) at end of year2014-12-31$282,338
Employer contributions (assets) at beginning of year2014-12-31$449,389
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$2,063,857
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$2,763,502
Contract administrator fees2014-12-31$67,097
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$10,271
Liabilities. Value of benefit claims payable at end of year2014-12-31$441,518
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$656,742
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$22,151
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$24,624
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
Aggregate proceeds on sale of assets2014-12-31$5,610,084
Aggregate carrying amount (costs) on sale of assets2014-12-31$5,693,948
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 name2014-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2014-12-31232247478
2013 : LOCAL 837 HEALTH AND WELFARE PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$56,436
Total unrealized appreciation/depreciation of assets2013-12-31$56,436
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$735,749
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$560,702
Total income from all sources (including contributions)2013-12-31$3,212,840
Total loss/gain on sale of assets2013-12-31$-212,629
Total of all expenses incurred2013-12-31$4,795,724
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$3,933,954
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$3,131,596
Value of total assets at end of year2013-12-31$6,823,985
Value of total assets at beginning of year2013-12-31$8,231,822
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$861,770
Total interest from all sources2013-12-31$224,307
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$931
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$768
Administrative expenses professional fees incurred2013-12-31$30,600
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$38,896
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$70,456
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$91,178
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$126,618
Administrative expenses (other) incurred2013-12-31$701,159
Liabilities. Value of operating payables at end of year2013-12-31$79,007
Liabilities. Value of operating payables at beginning of year2013-12-31$47,395
Total non interest bearing cash at end of year2013-12-31$225
Total non interest bearing cash at beginning of year2013-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-1,582,884
Value of net assets at end of year (total assets less liabilities)2013-12-31$6,088,236
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$7,671,120
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$40,912
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$762,585
Income. Interest from US Government securities2013-12-31$55,782
Income. Interest from corporate debt instruments2013-12-31$164,906
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$1,856,759
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$744,884
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$744,884
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$3,619
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$3,933,954
Asset value of US Government securities at end of year2013-12-31$865,452
Asset value of US Government securities at beginning of year2013-12-31$1,967,017
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$12,199
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$3,022,244
Employer contributions (assets) at end of year2013-12-31$449,389
Employer contributions (assets) at beginning of year2013-12-31$449,692
Income. Dividends from common stock2013-12-31$163
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$2,763,502
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$4,916,172
Contract administrator fees2013-12-31$89,099
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$10,271
Liabilities. Value of benefit claims payable at end of year2013-12-31$656,742
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$513,307
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$24,624
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$27,214
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$7,060,518
Aggregate carrying amount (costs) on sale of assets2013-12-31$7,273,147
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2013-12-31232247478
2012 : LOCAL 837 HEALTH AND WELFARE PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$-13,800
Total unrealized appreciation/depreciation of assets2012-12-31$-13,800
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$560,702
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$775,800
Total income from all sources (including contributions)2012-12-31$4,186,296
Total loss/gain on sale of assets2012-12-31$-96,106
Total of all expenses incurred2012-12-31$4,975,786
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$4,100,676
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$4,029,156
Value of total assets at end of year2012-12-31$8,231,822
Value of total assets at beginning of year2012-12-31$9,236,410
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$875,110
Total interest from all sources2012-12-31$267,046
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$31,821
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$26,708
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$48,892
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$126,618
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$205,462
Administrative expenses (other) incurred2012-12-31$726,512
Liabilities. Value of operating payables at end of year2012-12-31$47,395
Liabilities. Value of operating payables at beginning of year2012-12-31$55,461
Total non interest bearing cash at end of year2012-12-31$225
Total non interest bearing cash at beginning of year2012-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-789,490
Value of net assets at end of year (total assets less liabilities)2012-12-31$7,671,120
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$8,460,610
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$45,284
Income. Interest from US Government securities2012-12-31$44,773
Income. Interest from corporate debt instruments2012-12-31$213,298
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$744,884
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$604,440
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$604,440
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$8,975
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$4,100,676
Asset value of US Government securities at end of year2012-12-31$1,967,017
Asset value of US Government securities at beginning of year2012-12-31$2,649,290
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$3,953,556
Employer contributions (assets) at end of year2012-12-31$449,692
Employer contributions (assets) at beginning of year2012-12-31$486,913
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$4,916,172
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$5,284,449
Contract administrator fees2012-12-31$71,493
Liabilities. Value of benefit claims payable at end of year2012-12-31$513,307
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$720,339
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$27,214
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$5,631
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$8,983,279
Aggregate carrying amount (costs) on sale of assets2012-12-31$9,079,385
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2012-12-31232247478
2011 : LOCAL 837 HEALTH AND WELFARE PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-112,989
Total unrealized appreciation/depreciation of assets2011-12-31$-112,989
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$775,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$469,490
Total income from all sources (including contributions)2011-12-31$4,164,925
Total loss/gain on sale of assets2011-12-31$-43,115
Total of all expenses incurred2011-12-31$4,613,919
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$3,860,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$4,062,604
Value of total assets at end of year2011-12-31$9,236,410
Value of total assets at beginning of year2011-12-31$9,379,094
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$753,690
Total interest from all sources2011-12-31$258,425
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$36,875
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$17,981
Participant contributions at beginning of year2011-12-31$1,280
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$27,365
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$205,462
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$172,114
Administrative expenses (other) incurred2011-12-31$648,331
Liabilities. Value of operating payables at end of year2011-12-31$55,461
Liabilities. Value of operating payables at beginning of year2011-12-31$39,450
Total non interest bearing cash at end of year2011-12-31$225
Total non interest bearing cash at beginning of year2011-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-448,994
Value of net assets at end of year (total assets less liabilities)2011-12-31$8,460,610
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$8,909,604
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$26,489
Income. Interest from US Government securities2011-12-31$63,437
Income. Interest from corporate debt instruments2011-12-31$179,541
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$604,440
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$569,824
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$569,824
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$15,447
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$3,860,229
Asset value of US Government securities at end of year2011-12-31$2,649,290
Asset value of US Government securities at beginning of year2011-12-31$4,689,511
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$4,017,258
Employer contributions (assets) at end of year2011-12-31$486,913
Employer contributions (assets) at beginning of year2011-12-31$559,072
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$5,284,449
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$3,378,553
Contract administrator fees2011-12-31$41,995
Liabilities. Value of benefit claims payable at end of year2011-12-31$720,339
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$430,040
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$5,631
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$8,515
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$16,218,081
Aggregate carrying amount (costs) on sale of assets2011-12-31$16,261,196
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2011-12-31232247478
2010 : LOCAL 837 HEALTH AND WELFARE PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$-24,877
Total unrealized appreciation/depreciation of assets2010-12-31$-24,877
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$469,490
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$661,123
Total income from all sources (including contributions)2010-12-31$4,574,539
Total loss/gain on sale of assets2010-12-31$-25,644
Total of all expenses incurred2010-12-31$4,101,755
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$3,577,259
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$4,363,998
Value of total assets at end of year2010-12-31$9,379,094
Value of total assets at beginning of year2010-12-31$9,097,943
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$524,496
Total interest from all sources2010-12-31$261,062
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$38,507
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$31,760
Participant contributions at end of year2010-12-31$1,280
Participant contributions at beginning of year2010-12-31$3,920
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$59,586
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$172,114
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$193,244
Administrative expenses (other) incurred2010-12-31$428,100
Liabilities. Value of operating payables at end of year2010-12-31$39,450
Liabilities. Value of operating payables at beginning of year2010-12-31$35,407
Total non interest bearing cash at end of year2010-12-31$225
Total non interest bearing cash at beginning of year2010-12-31$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$472,784
Value of net assets at end of year (total assets less liabilities)2010-12-31$8,909,604
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$8,436,820
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$26,896
Income. Interest from US Government securities2010-12-31$95,976
Income. Interest from corporate debt instruments2010-12-31$147,959
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$569,824
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$488,707
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$488,707
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$17,127
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$3,577,259
Asset value of US Government securities at end of year2010-12-31$4,689,511
Asset value of US Government securities at beginning of year2010-12-31$5,074,790
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$4,272,652
Employer contributions (assets) at end of year2010-12-31$559,072
Employer contributions (assets) at beginning of year2010-12-31$435,574
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$3,378,553
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$2,889,730
Contract administrator fees2010-12-31$30,993
Liabilities. Value of benefit claims payable at end of year2010-12-31$430,040
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$625,716
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$8,515
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$11,753
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$3,941,466
Aggregate carrying amount (costs) on sale of assets2010-12-31$3,967,110
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31FISCHER DORWART, P.C.
Accountancy firm EIN2010-12-31232247478

Form 5500 Responses for LOCAL 837 HEALTH AND WELFARE PLAN

2022: LOCAL 837 HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entityMulti-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 planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: LOCAL 837 HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: LOCAL 837 HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: LOCAL 837 HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: LOCAL 837 HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: LOCAL 837 HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: LOCAL 837 HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entityMulti-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 planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: LOCAL 837 HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entityMulti-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 planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: LOCAL 837 HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entityMulti-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 planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: LOCAL 837 HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entityMulti-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 planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: LOCAL 837 HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: LOCAL 837 HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: LOCAL 837 HEALTH AND WELFARE PLAN 2010 form 5500 responses
2010-01-01Type of plan entityMulti-employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: LOCAL 837 HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberGL-0032-VU
Policy instance 1
Insurance contract or identification numberGL-0032-VU
Number of Individuals Covered191
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $17,725
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 $146,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,725
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number418206
Policy instance 2
Insurance contract or identification number418206
Number of Individuals Covered19
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $527
Total amount of fees paid to insurance companyUSD $66
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $5,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $527
Insurance broker organization code?3
Amount paid for insurance broker fees66
Additional information about fees paid to insurance brokerCOMPENSATION
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberGL-0032-VU
Policy instance 2
Insurance contract or identification numberGL-0032-VU
Number of Individuals Covered196
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $22,840
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 $190,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,840
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number418206
Policy instance 1
Insurance contract or identification number418206
Number of Individuals Covered55
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $849
Total amount of fees paid to insurance companyUSD $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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $8,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $849
Insurance broker organization code?3
Amount paid for insurance broker fees106
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number418206
Policy instance 1
Insurance contract or identification number418206
Number of Individuals Covered59
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,298
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $11,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,298
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberGL-0032-VU
Policy instance 2
Insurance contract or identification numberGL-0032-VU
Number of Individuals Covered201
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $22,727
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 $189,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,727
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number418206
Policy instance 2
Insurance contract or identification number418206
Number of Individuals Covered217
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,143
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $25,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,143
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberGL-0032-VU
Policy instance 1
Insurance contract or identification numberGL-0032-VU
Number of Individuals Covered226
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $43,036
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 $358,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,036
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberGL-0032-VU
Policy instance 2
Insurance contract or identification numberGL-0032-VU
Number of Individuals Covered279
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $49,019
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 $408,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,019
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number418206
Policy instance 1
Insurance contract or identification number418206
Number of Individuals Covered282
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,292
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $25,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,292
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberGL0032VU
Policy instance 1
Insurance contract or identification numberGL0032VU
Number of Individuals Covered257
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $50,397
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 $419,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,397
Insurance broker organization code?3
Insurance broker nameLABOR FIRST LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number418206
Policy instance 2
Insurance contract or identification number418206
Number of Individuals Covered257
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,072
Total amount of fees paid to insurance companyUSD $275
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $23,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,072
Amount paid for insurance broker fees275
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number418206
Policy instance 2
Insurance contract or identification number418206
Number of Individuals Covered217
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $2,597
Total amount of fees paid to insurance companyUSD $524
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $20,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,597
Amount paid for insurance broker fees524
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC.
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSL10247
Policy instance 1
Insurance contract or identification numberSL10247
Number of Individuals Covered284
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $46,948
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 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 $362,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,697
Insurance broker organization code?3
Insurance broker nameUPSTATE FINANCIAL SERVICES
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract numberSE3E50038
Policy instance 5
Insurance contract or identification numberSE3E50038
Number of Individuals Covered256
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $36,547
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 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 $282,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,547
Insurance broker organization code?3
Insurance broker nameLABOR FIRST LLC
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3064
Policy instance 4
Insurance contract or identification numberPA3064
Number of Individuals Covered348
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $389
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 $77,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $389
Insurance broker organization code?4
Insurance broker nameDE VALLEY HEALTH CARE COALITION
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract number8386-4EL
Policy instance 3
Insurance contract or identification number8386-4EL
Number of Individuals Covered196
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,609
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
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 $14,701
Commission paid to Insurance BrokerUSD $1,609
Insurance broker organization code?3
Insurance broker nameLABOR FIRST, LLC
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number6130
Policy instance 2
Insurance contract or identification number6130
Number of Individuals Covered5
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $276
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 $9,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $276
Insurance broker organization code?3
Insurance broker nameEMERSON REID DBA TRA BENEFIT
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number6130
Policy instance 1
Insurance contract or identification number6130
Number of Individuals Covered198
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,672
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 $260,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,672
Insurance broker organization code?3
Insurance broker nameEMERSON REID DBA TRA BENEFIT
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3072
Policy instance 6
Insurance contract or identification numberPA3072
Number of Individuals Covered169
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $70
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 $14,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70
Insurance broker organization code?4
Insurance broker nameDE VALLEY HEALTH CARE COALITION
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract numberSE450038
Policy instance 4
Insurance contract or identification numberSE450038
Number of Individuals Covered117
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $15,559
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 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 $130,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,559
Insurance broker organization code?3
Insurance broker name
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3064
Policy instance 3
Insurance contract or identification numberPA3064
Number of Individuals Covered357
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $623
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 $132,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $623
Insurance broker organization code?4
Insurance broker nameDE VALLEY HEALTH CARE COALITION
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number6130
Policy instance 2
Insurance contract or identification number6130
Number of Individuals Covered199
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $74,056
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 $1,457,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,876
Insurance broker organization code?3
Insurance broker nameEMERSON REID
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract number8386-4EL
Policy instance 1
Insurance contract or identification number8386-4EL
Number of Individuals Covered153
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,234
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
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 $27,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,234
Insurance broker organization code?3
Insurance broker nameLABOR FIRST LLC
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number6130
Policy instance 5
Insurance contract or identification number6130
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,266
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 $37,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $954
Insurance broker organization code?3
Insurance broker nameEMERSON REID
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3064
Policy instance 2
Insurance contract or identification numberPA3064
Number of Individuals Covered234
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $700
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 $152,204
Commission paid to Insurance BrokerUSD $700
Insurance broker organization code?4
Insurance broker nameDE VALLEY HEALTH CARE COALITION
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract numberSE3E50028
Policy instance 3
Insurance contract or identification numberSE3E50028
Number of Individuals Covered155
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $27,928
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 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 $186,191
Commission paid to Insurance BrokerUSD $13,964
Insurance broker organization code?3
Insurance broker nameAON CONSULTING
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract number8386-BCS
Policy instance 4
Insurance contract or identification number8386-BCS
Number of Individuals Covered290
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,285
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
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 $40,976
Commission paid to Insurance BrokerUSD $3,285
Insurance broker organization code?3
Insurance broker nameLABOR FIRST LLC
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number6130
Policy instance 5
Insurance contract or identification number6130
Number of Individuals Covered136
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $102,170
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 $1,623,220
Commission paid to Insurance BrokerUSD $102,170
Insurance broker organization code?3
Insurance broker nameCBIZ BENEFITS & INSURANCE
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number6130
Policy instance 1
Insurance contract or identification number6130
Number of Individuals Covered2
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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?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 $32,794
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3072
Policy instance 6
Insurance contract or identification numberPA3072
Number of Individuals Covered64
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $60
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 $18,816
Commission paid to Insurance BrokerUSD $60
Insurance broker organization code?4
Insurance broker nameDE VALLEY HEALTH CARE COALITION
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3072
Policy instance 1
Insurance contract or identification numberPA3072
Number of Individuals Covered177
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $67
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 $14,917
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3064
Policy instance 2
Insurance contract or identification numberPA3064
Number of Individuals Covered699
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $760
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 $160,940
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number87543
Policy instance 7
Insurance contract or identification number87543
Number of Individuals Covered300
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract number8386-BCS
Policy instance 3
Insurance contract or identification number8386-BCS
Number of Individuals Covered297
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,302
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
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 $41,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract numberSE3E50028
Policy instance 4
Insurance contract or identification numberSE3E50028
Number of Individuals Covered196
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $26,652
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 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 $177,684
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberLO 8386
Policy instance 3
Insurance contract or identification numberLO 8386
Number of Individuals Covered259
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,005
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $47,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number6130
Policy instance 6
Insurance contract or identification number6130
Number of Individuals Covered3
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $24
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3072
Policy instance 1
Insurance contract or identification numberPA3072
Number of Individuals Covered153
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $81
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 $12,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSE3E-50028
Policy instance 2
Insurance contract or identification numberSE3E-50028
Number of Individuals Covered164
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?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 $226,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number6130
Policy instance 4
Insurance contract or identification number6130
Number of Individuals Covered372
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $61,503
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPA3064
Policy instance 5
Insurance contract or identification numberPA3064
Number of Individuals Covered658
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $814
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 $165,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number87543
Policy instance 7
Insurance contract or identification number87543
Number of Individuals Covered285
Insurance policy start date2010-01-01
Insurance policy end date2010-01-31
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?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 $18,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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