TRI-BORO CONSTRUCTION SUPPLIES, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN
401k plan membership statisitcs for TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2022: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-02-01 | 50 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 50 |
| Number of retired or separated participants receiving benefits | 2022-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-02-01 | 0 |
| Total of all active and inactive participants | 2022-02-01 | 50 |
| 2021: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-02-01 | 58 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 50 |
| Number of retired or separated participants receiving benefits | 2021-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-02-01 | 0 |
| Total of all active and inactive participants | 2021-02-01 | 50 |
| 2020: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-02-01 | 66 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 58 |
| Number of retired or separated participants receiving benefits | 2020-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-02-01 | 0 |
| Total of all active and inactive participants | 2020-02-01 | 58 |
| 2019: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-02-01 | 58 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 66 |
| Number of retired or separated participants receiving benefits | 2019-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-02-01 | 0 |
| Total of all active and inactive participants | 2019-02-01 | 66 |
| 2018: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-02-01 | 57 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 58 |
| Number of retired or separated participants receiving benefits | 2018-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-02-01 | 0 |
| Total of all active and inactive participants | 2018-02-01 | 58 |
| 2017: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-02-01 | 55 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 57 |
| Number of retired or separated participants receiving benefits | 2017-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-02-01 | 0 |
| Total of all active and inactive participants | 2017-02-01 | 57 |
| 2016: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-02-01 | 55 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 54 |
| Number of retired or separated participants receiving benefits | 2016-02-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-02-01 | 0 |
| Total of all active and inactive participants | 2016-02-01 | 55 |
| 2015: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-02-01 | 54 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 54 |
| Number of retired or separated participants receiving benefits | 2015-02-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-02-01 | 0 |
| Total of all active and inactive participants | 2015-02-01 | 55 |
| 2014: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-02-01 | 54 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 54 |
| Number of retired or separated participants receiving benefits | 2014-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-02-01 | 0 |
| Total of all active and inactive participants | 2014-02-01 | 54 |
| Measure | Date | Value |
|---|
| 2023 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2023 401k financial data |
|---|
| Total plan liabilities at end of year | 2023-01-31 | $48,424 |
| Total plan liabilities at beginning of year | 2023-01-31 | $27,195 |
| Total income from all sources | 2023-01-31 | $501,628 |
| Expenses. Total of all expenses incurred | 2023-01-31 | $633,510 |
| Benefits paid (including direct rollovers) | 2023-01-31 | $321,777 |
| Total plan assets at end of year | 2023-01-31 | $109,445 |
| Total plan assets at beginning of year | 2023-01-31 | $220,098 |
| Value of fidelity bond covering the plan | 2023-01-31 | $250,000 |
| Total contributions received or receivable from participants | 2023-01-31 | $191,075 |
| Expenses. Other expenses not covered elsewhere | 2023-01-31 | $241,473 |
| Other income received | 2023-01-31 | $380 |
| Net income (gross income less expenses) | 2023-01-31 | $-131,882 |
| Net plan assets at end of year (total assets less liabilities) | 2023-01-31 | $61,021 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-01-31 | $192,903 |
| Total contributions received or receivable from employer(s) | 2023-01-31 | $310,173 |
| Value of corrective distributions | 2023-01-31 | $60,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2023-01-31 | $10,260 |
| 2022 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2022 401k financial data |
|---|
| Total plan liabilities at end of year | 2022-01-31 | $27,195 |
| Total plan liabilities at beginning of year | 2022-01-31 | $17,127 |
| Total income from all sources | 2022-01-31 | $567,231 |
| Expenses. Total of all expenses incurred | 2022-01-31 | $747,263 |
| Benefits paid (including direct rollovers) | 2022-01-31 | $350,443 |
| Total plan assets at end of year | 2022-01-31 | $220,098 |
| Total plan assets at beginning of year | 2022-01-31 | $390,062 |
| Value of fidelity bond covering the plan | 2022-01-31 | $250,000 |
| Total contributions received or receivable from participants | 2022-01-31 | $210,863 |
| Expenses. Other expenses not covered elsewhere | 2022-01-31 | $261,109 |
| Other income received | 2022-01-31 | $838 |
| Net income (gross income less expenses) | 2022-01-31 | $-180,032 |
| Net plan assets at end of year (total assets less liabilities) | 2022-01-31 | $192,903 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-01-31 | $372,935 |
| Total contributions received or receivable from employer(s) | 2022-01-31 | $355,530 |
| Value of corrective distributions | 2022-01-31 | $120,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-01-31 | $15,711 |
| 2021 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-01-31 | $17,127 |
| Total plan liabilities at beginning of year | 2021-01-31 | $38,671 |
| Total income from all sources | 2021-01-31 | $626,454 |
| Expenses. Total of all expenses incurred | 2021-01-31 | $549,000 |
| Benefits paid (including direct rollovers) | 2021-01-31 | $197,674 |
| Total plan assets at end of year | 2021-01-31 | $390,062 |
| Total plan assets at beginning of year | 2021-01-31 | $334,152 |
| Value of fidelity bond covering the plan | 2021-01-31 | $250,000 |
| Total contributions received or receivable from participants | 2021-01-31 | $235,430 |
| Expenses. Other expenses not covered elsewhere | 2021-01-31 | $272,307 |
| Contributions received from other sources (not participants or employers) | 2021-01-31 | $0 |
| Other income received | 2021-01-31 | $1,063 |
| Net income (gross income less expenses) | 2021-01-31 | $77,454 |
| Net plan assets at end of year (total assets less liabilities) | 2021-01-31 | $372,935 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-01-31 | $295,481 |
| Total contributions received or receivable from employer(s) | 2021-01-31 | $389,961 |
| Value of corrective distributions | 2021-01-31 | $60,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-01-31 | $19,019 |
| 2020 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-01-31 | $38,671 |
| Total plan liabilities at beginning of year | 2020-01-31 | $22,858 |
| Total income from all sources | 2020-01-31 | $632,219 |
| Expenses. Total of all expenses incurred | 2020-01-31 | $593,366 |
| Benefits paid (including direct rollovers) | 2020-01-31 | $255,805 |
| Total plan assets at end of year | 2020-01-31 | $334,152 |
| Total plan assets at beginning of year | 2020-01-31 | $279,486 |
| Value of fidelity bond covering the plan | 2020-01-31 | $250,000 |
| Total contributions received or receivable from participants | 2020-01-31 | $225,451 |
| Expenses. Other expenses not covered elsewhere | 2020-01-31 | $244,936 |
| Contributions received from other sources (not participants or employers) | 2020-01-31 | $0 |
| Other income received | 2020-01-31 | $688 |
| Net income (gross income less expenses) | 2020-01-31 | $38,853 |
| Net plan assets at end of year (total assets less liabilities) | 2020-01-31 | $295,481 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-01-31 | $256,628 |
| Total contributions received or receivable from employer(s) | 2020-01-31 | $406,080 |
| Value of corrective distributions | 2020-01-31 | $60,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-01-31 | $32,625 |
| 2019 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-01-31 | $22,858 |
| Total plan liabilities at beginning of year | 2019-01-31 | $32,615 |
| Total income from all sources | 2019-01-31 | $592,222 |
| Expenses. Total of all expenses incurred | 2019-01-31 | $671,968 |
| Benefits paid (including direct rollovers) | 2019-01-31 | $203,355 |
| Total plan assets at end of year | 2019-01-31 | $279,486 |
| Total plan assets at beginning of year | 2019-01-31 | $368,989 |
| Value of fidelity bond covering the plan | 2019-01-31 | $250,000 |
| Total contributions received or receivable from participants | 2019-01-31 | $204,777 |
| Expenses. Other expenses not covered elsewhere | 2019-01-31 | $233,418 |
| Other income received | 2019-01-31 | $756 |
| Net income (gross income less expenses) | 2019-01-31 | $-79,746 |
| Net plan assets at end of year (total assets less liabilities) | 2019-01-31 | $256,628 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-01-31 | $336,374 |
| Total contributions received or receivable from employer(s) | 2019-01-31 | $386,689 |
| Value of corrective distributions | 2019-01-31 | $207,280 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-01-31 | $27,915 |
| 2018 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-01-31 | $32,615 |
| Total plan liabilities at beginning of year | 2018-01-31 | $30,680 |
| Total income from all sources | 2018-01-31 | $622,232 |
| Expenses. Total of all expenses incurred | 2018-01-31 | $605,305 |
| Benefits paid (including direct rollovers) | 2018-01-31 | $175,394 |
| Total plan assets at end of year | 2018-01-31 | $368,989 |
| Total plan assets at beginning of year | 2018-01-31 | $350,127 |
| Value of fidelity bond covering the plan | 2018-01-31 | $250,000 |
| Total contributions received or receivable from participants | 2018-01-31 | $202,381 |
| Expenses. Other expenses not covered elsewhere | 2018-01-31 | $208,609 |
| Contributions received from other sources (not participants or employers) | 2018-01-31 | $10,488 |
| Other income received | 2018-01-31 | $816 |
| Net income (gross income less expenses) | 2018-01-31 | $16,927 |
| Net plan assets at end of year (total assets less liabilities) | 2018-01-31 | $336,374 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-01-31 | $319,447 |
| Total contributions received or receivable from employer(s) | 2018-01-31 | $408,547 |
| Value of corrective distributions | 2018-01-31 | $186,609 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-01-31 | $34,693 |
| 2017 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-01-31 | $30,680 |
| Total plan liabilities at beginning of year | 2017-01-31 | $43,889 |
| Total income from all sources | 2017-01-31 | $619,137 |
| Expenses. Total of all expenses incurred | 2017-01-31 | $382,700 |
| Benefits paid (including direct rollovers) | 2017-01-31 | $151,915 |
| Total plan assets at end of year | 2017-01-31 | $350,127 |
| Total plan assets at beginning of year | 2017-01-31 | $126,899 |
| Value of fidelity bond covering the plan | 2017-01-31 | $250,000 |
| Total contributions received or receivable from participants | 2017-01-31 | $234,693 |
| Expenses. Other expenses not covered elsewhere | 2017-01-31 | $173,137 |
| Contributions received from other sources (not participants or employers) | 2017-01-31 | $0 |
| Other income received | 2017-01-31 | $521 |
| Net income (gross income less expenses) | 2017-01-31 | $236,437 |
| Net plan assets at end of year (total assets less liabilities) | 2017-01-31 | $319,447 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-01-31 | $83,010 |
| Total contributions received or receivable from employer(s) | 2017-01-31 | $383,923 |
| Value of corrective distributions | 2017-01-31 | $24,097 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-01-31 | $33,551 |
| 2016 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-01-31 | $43,889 |
| Total plan liabilities at beginning of year | 2016-01-31 | $34,511 |
| Total income from all sources | 2016-01-31 | $504,470 |
| Expenses. Total of all expenses incurred | 2016-01-31 | $391,477 |
| Benefits paid (including direct rollovers) | 2016-01-31 | $207,702 |
| Total plan assets at end of year | 2016-01-31 | $126,899 |
| Total plan assets at beginning of year | 2016-01-31 | $4,528 |
| Value of fidelity bond covering the plan | 2016-01-31 | $500,000 |
| Total contributions received or receivable from participants | 2016-01-31 | $228,899 |
| Expenses. Other expenses not covered elsewhere | 2016-01-31 | $152,094 |
| Other income received | 2016-01-31 | $80 |
| Net income (gross income less expenses) | 2016-01-31 | $112,993 |
| Net plan assets at end of year (total assets less liabilities) | 2016-01-31 | $83,010 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-01-31 | $-29,983 |
| Total contributions received or receivable from employer(s) | 2016-01-31 | $275,491 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-01-31 | $31,681 |
| 2015 : TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-01-31 | $34,511 |
| Total plan liabilities at beginning of year | 2015-01-31 | $0 |
| Total income from all sources | 2015-01-31 | $458,587 |
| Expenses. Total of all expenses incurred | 2015-01-31 | $488,570 |
| Benefits paid (including direct rollovers) | 2015-01-31 | $314,148 |
| Total plan assets at end of year | 2015-01-31 | $4,528 |
| Total plan assets at beginning of year | 2015-01-31 | $0 |
| Value of fidelity bond covering the plan | 2015-01-31 | $500,000 |
| Total contributions received or receivable from participants | 2015-01-31 | $253,639 |
| Other income received | 2015-01-31 | $16 |
| Net income (gross income less expenses) | 2015-01-31 | $-29,983 |
| Net plan assets at end of year (total assets less liabilities) | 2015-01-31 | $-29,983 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-01-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-01-31 | $204,932 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-01-31 | $174,422 |
| 2022: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2022 form 5500 responses |
|---|
| 2022-02-01 | Type of plan entity | Single employer plan |
| 2022-02-01 | Submission has been amended | No |
| 2022-02-01 | This submission is the final filing | No |
| 2022-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-02-01 | Plan is a collectively bargained plan | No |
| 2022-02-01 | Plan funding arrangement – Insurance | Yes |
| 2022-02-01 | Plan funding arrangement – Trust | Yes |
| 2022-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-02-01 | Plan benefit arrangement - Trust | Yes |
| 2021: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2021 form 5500 responses |
|---|
| 2021-02-01 | Type of plan entity | Single employer plan |
| 2021-02-01 | Submission has been amended | No |
| 2021-02-01 | This submission is the final filing | No |
| 2021-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-02-01 | Plan is a collectively bargained plan | No |
| 2021-02-01 | Plan funding arrangement – Insurance | Yes |
| 2021-02-01 | Plan funding arrangement – Trust | Yes |
| 2021-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-02-01 | Plan benefit arrangement - Trust | Yes |
| 2020: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2020 form 5500 responses |
|---|
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Submission has been amended | No |
| 2020-02-01 | This submission is the final filing | No |
| 2020-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-02-01 | Plan is a collectively bargained plan | No |
| 2020-02-01 | Plan funding arrangement – Insurance | Yes |
| 2020-02-01 | Plan funding arrangement – Trust | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement - Trust | Yes |
| 2019: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2019 form 5500 responses |
|---|
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | Submission has been amended | No |
| 2019-02-01 | This submission is the final filing | No |
| 2019-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-02-01 | Plan is a collectively bargained plan | No |
| 2019-02-01 | Plan funding arrangement – Insurance | Yes |
| 2019-02-01 | Plan funding arrangement – Trust | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement - Trust | Yes |
| 2018: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2018 form 5500 responses |
|---|
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | Submission has been amended | No |
| 2018-02-01 | This submission is the final filing | No |
| 2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-02-01 | Plan is a collectively bargained plan | No |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan funding arrangement – Trust | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement - Trust | Yes |
| 2017: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2017 form 5500 responses |
|---|
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Submission has been amended | No |
| 2017-02-01 | This submission is the final filing | No |
| 2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-02-01 | Plan is a collectively bargained plan | No |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan funding arrangement – Trust | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement - Trust | Yes |
| 2016: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2016 form 5500 responses |
|---|
| 2016-02-01 | Type of plan entity | Single employer plan |
| 2016-02-01 | Submission has been amended | No |
| 2016-02-01 | This submission is the final filing | No |
| 2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-02-01 | Plan is a collectively bargained plan | No |
| 2016-02-01 | Plan funding arrangement – Insurance | Yes |
| 2016-02-01 | Plan funding arrangement – Trust | Yes |
| 2016-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement - Trust | Yes |
| 2015: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2015 form 5500 responses |
|---|
| 2015-02-01 | Type of plan entity | Single employer plan |
| 2015-02-01 | Submission has been amended | No |
| 2015-02-01 | This submission is the final filing | No |
| 2015-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-02-01 | Plan is a collectively bargained plan | No |
| 2015-02-01 | Plan funding arrangement – Insurance | Yes |
| 2015-02-01 | Plan funding arrangement – Trust | Yes |
| 2015-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-02-01 | Plan benefit arrangement - Trust | Yes |
| 2014: TRI-BORO CONSTRUCTION SUPPLIES, INC. GROUP MEDICAL PLAN 2014 form 5500 responses |
|---|
| 2014-02-01 | Type of plan entity | Single employer plan |
| 2014-02-01 | First time form 5500 has been submitted | Yes |
| 2014-02-01 | Submission has been amended | No |
| 2014-02-01 | This submission is the final filing | No |
| 2014-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-02-01 | Plan is a collectively bargained plan | No |
| 2014-02-01 | Plan funding arrangement – Trust | Yes |
| 2014-02-01 | Plan benefit arrangement - Trust | Yes |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500096 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500096 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | 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 $212,440 | | 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 | 30500096 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500096 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | 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 $225,791 | | 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 | 30500096 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500096 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | 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 $236,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| 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 | 66 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | 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 $228,817 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| 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 | 57 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | 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 $173,899 | | 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 | 55 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $122,124 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | VERIS |
| Policy instance | 2 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 0 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $-250 | | 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 | 54 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $10,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | VERIS |
| Policy instance | 2 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 54 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $100,094 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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