OLIVER SPRINKLER CO., INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan OLIVER FIRE PROTECTION HEALTH PLAN
| Measure | Date | Value |
|---|
| 2022: OLIVER FIRE PROTECTION HEALTH PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 133 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 135 |
| 2021: OLIVER FIRE PROTECTION HEALTH PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 107 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 109 |
| 2020: OLIVER FIRE PROTECTION HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 114 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 115 |
| 2019: OLIVER FIRE PROTECTION HEALTH PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 111 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 111 |
| 2018: OLIVER FIRE PROTECTION HEALTH PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 104 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 105 |
| 2017: OLIVER FIRE PROTECTION HEALTH PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 87 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 97 |
| Number of retired or separated participants receiving benefits | 2017-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2017-04-01 | 0 |
| Total of all active and inactive participants | 2017-04-01 | 98 |
| 2016: OLIVER FIRE PROTECTION HEALTH PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 84 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 86 |
| Number of retired or separated participants receiving benefits | 2016-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-04-01 | 0 |
| Total of all active and inactive participants | 2016-04-01 | 87 |
| Measure | Date | Value |
|---|
| 2022 : OLIVER FIRE PROTECTION HEALTH PLAN 2022 401k financial data |
|---|
| Total plan liabilities at end of year | 2022-12-31 | $162,823 |
| Total plan liabilities at beginning of year | 2022-12-31 | $766,727 |
| Total income from all sources | 2022-12-31 | $1,764,773 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $711,522 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $126,191 |
| Total plan assets at end of year | 2022-12-31 | $490,389 |
| Total plan assets at beginning of year | 2022-12-31 | $41,042 |
| Value of fidelity bond covering the plan | 2022-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $425,260 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $565,895 |
| Contributions received from other sources (not participants or employers) | 2022-12-31 | $6,234 |
| Other income received | 2022-12-31 | $502 |
| Net income (gross income less expenses) | 2022-12-31 | $1,053,251 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $327,566 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $-725,685 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $1,332,777 |
| Value of corrective distributions | 2022-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $19,436 |
| 2021 : OLIVER FIRE PROTECTION HEALTH PLAN 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-12-31 | $766,727 |
| Total plan liabilities at beginning of year | 2021-12-31 | $84,974 |
| Total income from all sources | 2021-12-31 | $1,328,689 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $1,978,676 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $1,537,280 |
| Total plan assets at end of year | 2021-12-31 | $41,042 |
| Total plan assets at beginning of year | 2021-12-31 | $9,276 |
| Value of fidelity bond covering the plan | 2021-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $10,745 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $417,223 |
| Contributions received from other sources (not participants or employers) | 2021-12-31 | $10,745 |
| Other income received | 2021-12-31 | $133 |
| Net income (gross income less expenses) | 2021-12-31 | $-649,987 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $-725,685 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $-75,698 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $1,307,066 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $24,173 |
| 2020 : OLIVER FIRE PROTECTION HEALTH PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-12-31 | $84,974 |
| Total plan liabilities at beginning of year | 2020-12-31 | $83,666 |
| Total income from all sources | 2020-12-31 | $1,287,867 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $1,471,919 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $858,739 |
| Total plan assets at end of year | 2020-12-31 | $9,276 |
| Total plan assets at beginning of year | 2020-12-31 | $192,020 |
| Value of fidelity bond covering the plan | 2020-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $266,223 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $398,227 |
| Contributions received from other sources (not participants or employers) | 2020-12-31 | $5,612 |
| Other income received | 2020-12-31 | $350 |
| Net income (gross income less expenses) | 2020-12-31 | $-184,052 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $-75,698 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $108,354 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $1,015,682 |
| Value of corrective distributions | 2020-12-31 | $192,334 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $22,619 |
| 2019 : OLIVER FIRE PROTECTION HEALTH PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-31 | $83,666 |
| Total plan liabilities at beginning of year | 2019-12-31 | $83,786 |
| Total income from all sources | 2019-12-31 | $1,182,988 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $1,115,313 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $665,041 |
| Total plan assets at end of year | 2019-12-31 | $192,020 |
| Total plan assets at beginning of year | 2019-12-31 | $124,465 |
| Value of fidelity bond covering the plan | 2019-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $263,845 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $384,046 |
| Contributions received from other sources (not participants or employers) | 2019-12-31 | $1,634 |
| Other income received | 2019-12-31 | $402 |
| Net income (gross income less expenses) | 2019-12-31 | $67,675 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $108,354 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $40,679 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $917,107 |
| Value of corrective distributions | 2019-12-31 | $47,210 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $19,016 |
| 2018 : OLIVER FIRE PROTECTION HEALTH PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-12-31 | $83,786 |
| Total plan liabilities at beginning of year | 2018-12-31 | $60,662 |
| Total income from all sources | 2018-12-31 | $1,204,644 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $1,124,415 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $668,356 |
| Total plan assets at end of year | 2018-12-31 | $124,465 |
| Total plan assets at beginning of year | 2018-12-31 | $21,112 |
| Value of fidelity bond covering the plan | 2018-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $217,366 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $401,793 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $8,450 |
| Other income received | 2018-12-31 | $183 |
| Net income (gross income less expenses) | 2018-12-31 | $80,229 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $40,679 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $-39,550 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $978,645 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $54,266 |
| 2017 : OLIVER FIRE PROTECTION HEALTH PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-12-31 | $60,662 |
| Total plan liabilities at beginning of year | 2017-12-31 | $57,776 |
| Total income from all sources | 2017-12-31 | $758,462 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $911,527 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $501,350 |
| Total plan assets at end of year | 2017-12-31 | $21,112 |
| Total plan assets at beginning of year | 2017-12-31 | $171,291 |
| Value of fidelity bond covering the plan | 2017-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $146,800 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $236,230 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $19,433 |
| Other income received | 2017-12-31 | $7 |
| Net income (gross income less expenses) | 2017-12-31 | $-153,065 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $-39,550 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $113,515 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $592,222 |
| Value of corrective distributions | 2017-12-31 | $133,685 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $40,262 |
| Total plan liabilities at end of year | 2017-03-31 | $57,776 |
| Total income from all sources | 2017-03-31 | $888,064 |
| Expenses. Total of all expenses incurred | 2017-03-31 | $774,549 |
| Benefits paid (including direct rollovers) | 2017-03-31 | $472,758 |
| Total plan assets at end of year | 2017-03-31 | $171,291 |
| Value of fidelity bond covering the plan | 2017-03-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2017-03-31 | $193,436 |
| Expenses. Other expenses not covered elsewhere | 2017-03-31 | $256,163 |
| Contributions received from other sources (not participants or employers) | 2017-03-31 | $6,693 |
| Net income (gross income less expenses) | 2017-03-31 | $113,515 |
| Net plan assets at end of year (total assets less liabilities) | 2017-03-31 | $113,515 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-03-31 | $0 |
| Total contributions received or receivable from employer(s) | 2017-03-31 | $687,935 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-03-31 | $45,628 |
| 2022: OLIVER FIRE PROTECTION HEALTH PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: OLIVER FIRE PROTECTION HEALTH PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: OLIVER FIRE PROTECTION HEALTH PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: OLIVER FIRE PROTECTION HEALTH PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: OLIVER FIRE PROTECTION HEALTH PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: OLIVER FIRE PROTECTION HEALTH PLAN 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Submission has been amended | No |
| 2017-04-01 | This submission is the final filing | No |
| 2017-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-04-01 | Plan is a collectively bargained plan | No |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan funding arrangement – Trust | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement - Trust | Yes |
| 2016: OLIVER FIRE PROTECTION HEALTH PLAN 2016 form 5500 responses |
|---|
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | First time form 5500 has been submitted | Yes |
| 2016-04-01 | Submission has been amended | No |
| 2016-04-01 | This submission is the final filing | No |
| 2016-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-04-01 | Plan is a collectively bargained plan | No |
| 2016-04-01 | Plan funding arrangement – Insurance | Yes |
| 2016-04-01 | Plan funding arrangement – Trust | Yes |
| 2016-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-04-01 | Plan benefit arrangement - Trust | Yes |
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | 203159 |
| Policy instance | 1 |
| Insurance contract or identification number | 203159 | | Number of Individuals Covered | 133 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $483,392 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500197 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500197 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $347,502 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500197 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500197 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $327,002 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 111 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $346,348 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 97 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $187,467 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
