401k Plan data: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN plan

KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 401k Plan overview

Plan Name	KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN
Plan identification number	501

KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

KLEHR HARRISON HARVEY BRANZBURG LLP has sponsored the creation of one or more 401k plans.

Company Name: KLEHR HARRISON HARVEY BRANZBURG LLP

Employer identification number (EIN): 231973697

NAIC Classification: 541110
NAIC Description: Offices of Lawyers

Additional information about KLEHR HARRISON HARVEY BRANZBURG LLP

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 4760579

More information about KLEHR HARRISON HARVEY BRANZBURG LLP

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2018-01-01
501 2017-01-01 THOMAS ECKER THOMAS ECKER 2018-07-30
501 2016-01-01 THOMAS ECKER THOMAS ECKER 2017-07-28
501 2015-01-01 THOMAS ECKER THOMAS ECKER 2016-07-27
501 2014-01-01 THOMAS ECKER THOMAS ECKER 2015-07-31
501 2013-01-01 THOMAS ECKER THOMAS ECKER 2014-07-31
501 2012-01-01 THOMAS ECKER THOMAS ECKER 2013-07-31
501 2011-01-01 THOMAS ECKER THOMAS ECKER 2012-07-30
501 2009-01-01 THOMAS ECKER
501 2009-01-01 THOMAS ECKER 2010-07-30

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01
501	2021-01-01
501	2020-01-01
501	2019-01-01
501	2018-01-01
501	2017-01-01	THOMAS ECKER	THOMAS ECKER	2018-07-30
501	2016-01-01	THOMAS ECKER	THOMAS ECKER	2017-07-28
501	2015-01-01	THOMAS ECKER	THOMAS ECKER	2016-07-27
501	2014-01-01	THOMAS ECKER	THOMAS ECKER	2015-07-31
501	2013-01-01	THOMAS ECKER	THOMAS ECKER	2014-07-31
501	2012-01-01	THOMAS ECKER	THOMAS ECKER	2013-07-31
501	2011-01-01	THOMAS ECKER	THOMAS ECKER	2012-07-30
501	2009-01-01	THOMAS ECKER
501	2009-01-01		THOMAS ECKER	2010-07-30

Plan Statistics for KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN

401k plan membership statisitcs for KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN

Measure Date Value
2022: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 122
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 122
2021: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 127
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 128
2020: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 133
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 133
2019: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 131
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 132
2018: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 122
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 2018-01-01 123
2017: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 131
Total of all active and inactive participants 2017-01-01 131
Total participants 2017-01-01 131
2016: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 132
Total of all active and inactive participants 2016-01-01 132
Total participants 2016-01-01 132
2015: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 129
Number of retired or separated participants receiving benefits 2015-01-01 2
Total of all active and inactive participants 2015-01-01 131
Total participants 2015-01-01 131
2014: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 128
Number of retired or separated participants receiving benefits 2014-01-01 5
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 133
Total participants 2014-01-01 133
2013: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 135
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 127
Number of retired or separated participants receiving benefits 2013-01-01 2
Total of all active and inactive participants 2013-01-01 129
Total participants 2013-01-01 129
2012: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 133
Number of retired or separated participants receiving benefits 2012-01-01 2
Total of all active and inactive participants 2012-01-01 135
Total participants 2012-01-01 135
2011: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 131
Number of retired or separated participants receiving benefits 2011-01-01 3
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 134
Total participants 2011-01-01 134
2009: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 146
Number of retired or separated participants receiving benefits 2009-01-01 15
Total of all active and inactive participants 2009-01-01 161
Total participants 2009-01-01 161

Measure	Date	Value
2022: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	122
Number of retired or separated participants receiving benefits	2022-01-01	0
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	122
2021: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	127
Number of retired or separated participants receiving benefits	2021-01-01	1
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	128
2020: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	133
Number of retired or separated participants receiving benefits	2020-01-01	0
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	133
2019: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	131
Number of retired or separated participants receiving benefits	2019-01-01	1
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	132
2018: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	122
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	123
2017: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	131
Total of all active and inactive participants	2017-01-01	131
Total participants	2017-01-01	131
2016: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	132
Total of all active and inactive participants	2016-01-01	132
Total participants	2016-01-01	132
2015: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	129
Number of retired or separated participants receiving benefits	2015-01-01	2
Total of all active and inactive participants	2015-01-01	131
Total participants	2015-01-01	131
2014: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	128
Number of retired or separated participants receiving benefits	2014-01-01	5
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	133
Total participants	2014-01-01	133
2013: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	135
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	127
Number of retired or separated participants receiving benefits	2013-01-01	2
Total of all active and inactive participants	2013-01-01	129
Total participants	2013-01-01	129
2012: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	133
Number of retired or separated participants receiving benefits	2012-01-01	2
Total of all active and inactive participants	2012-01-01	135
Total participants	2012-01-01	135
2011: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	131
Number of retired or separated participants receiving benefits	2011-01-01	3
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	134
Total participants	2011-01-01	134
2009: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	146
Number of retired or separated participants receiving benefits	2009-01-01	15
Total of all active and inactive participants	2009-01-01	161
Total participants	2009-01-01	161

Financial Data on KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN

Measure	Date	Value
2022 : KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$1,585,447
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,546,407
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,450,040
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,584,438
Value of total assets at end of year	2022-12-31	$289,821
Value of total assets at beginning of year	2022-12-31	$250,781
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$96,367
Total interest from all sources	2022-12-31	$1,009
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$541,928
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$272,685
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$39,040
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$289,821
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$250,781
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$17,136
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$250,781
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$250,781
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$1,009
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$327,662
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Assets. Invements in employer securities at end of year	2022-12-31	$0
Assets. Invements in employer securities at beginning of year	2022-12-31	$0
Contributions received in cash from employer	2022-12-31	$1,042,510
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,122,378
Contract administrator fees	2022-12-31	$96,367
Did the plan have assets held for investment	2022-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2022-12-31	390859910
2021 : KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,566,528
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,529,396
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,422,464
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,565,829
Value of total assets at end of year	2021-12-31	$250,781
Value of total assets at beginning of year	2021-12-31	$213,649
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$106,932
Total interest from all sources	2021-12-31	$699
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$543,433
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$19,798
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$37,132
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$250,781
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$213,649
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$250,781
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$193,851
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$193,851
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$699
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$301,581
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Contributions received in cash from employer	2021-12-31	$1,022,396
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,120,883
Contract administrator fees	2021-12-31	$106,932
Did the plan have assets held for investment	2021-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2021-12-31	390859910
2020 : KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,375,969
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,202,940
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,098,517
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,375,755
Value of total assets at end of year	2020-12-31	$213,649
Value of total assets at beginning of year	2020-12-31	$40,620
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$104,423
Total interest from all sources	2020-12-31	$214
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$459,208
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$19,798
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$39,855
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$173,029
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$213,649
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$40,620
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$193,851
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$765
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$765
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$214
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$279,631
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Assets. Invements in employer securities at end of year	2020-12-31	$0
Assets. Invements in employer securities at beginning of year	2020-12-31	$0
Contributions received in cash from employer	2020-12-31	$916,547
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$818,886
Contract administrator fees	2020-12-31	$104,423
Did the plan have assets held for investment	2020-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2020-12-31	390859910
2019 : KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,196,053
Total income from all sources (including contributions)	2019-12-31	$1,196,053
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,312,450
Total of all expenses incurred	2019-12-31	$1,312,450
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,199,520
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,199,520
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,195,804
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,195,804
Value of total assets at end of year	2019-12-31	$40,620
Value of total assets at end of year	2019-12-31	$40,620
Value of total assets at beginning of year	2019-12-31	$157,017
Value of total assets at beginning of year	2019-12-31	$157,017
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$112,930
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$112,930
Total interest from all sources	2019-12-31	$249
Total interest from all sources	2019-12-31	$249
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$424,811
Contributions received from participants	2019-12-31	$424,811
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$39,855
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$10,341
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$10,341
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$-116,397
Value of net income/loss	2019-12-31	$-116,397
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$40,620
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$40,620
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$157,017
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$157,017
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$765
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$146,676
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$146,676
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$146,676
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$146,676
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$249
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$249
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$244,002
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$244,002
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Contributions received in cash from employer	2019-12-31	$770,993
Contributions received in cash from employer	2019-12-31	$770,993
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$955,518
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$955,518
Contract administrator fees	2019-12-31	$112,930
Contract administrator fees	2019-12-31	$112,930
Did the plan have assets held for investment	2019-12-31	No
Did the plan have assets held for investment	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Accountancy firm name	2019-12-31	BAKER TILLY US, LLP
Accountancy firm name	2019-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2019-12-31	390859910
Accountancy firm EIN	2019-12-31	390859910
2018 : KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$1,262,811
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,105,794
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,030,236
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,262,606
Value of total assets at end of year	2018-12-31	$157,017
Value of total assets at beginning of year	2018-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$75,558
Total interest from all sources	2018-12-31	$205
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$396,650
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$10,341
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$157,017
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$157,017
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$146,676
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$205
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$744,530
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$865,956
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$285,706
Contract administrator fees	2018-12-31	$75,558
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
Did the plan have assets held for investment	2018-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	No
Opinion of an independent qualified public accountant for this plan	2018-12-31	Unqualified
Accountancy firm name	2018-12-31	BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN	2018-12-31	390859910

Form 5500 Responses for KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN

2022: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE 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: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE 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: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE 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: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE 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: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE 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: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: KLEHR HARRISON HARVEY BRANZBURG EMPLOYEE HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

31000015

Policy instance

Insurance contract or identification number	31000015
Number of Individuals Covered	122
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 $330,723
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

31000015

Policy instance

Insurance contract or identification number	31000015
Number of Individuals Covered	128
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 $301,581
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

31000015

Policy instance

Insurance contract or identification number	31000015
Number of Individuals Covered	133
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 $279,631
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

31000015

Policy instance

Insurance contract or identification number	31000015
Number of Individuals Covered	132
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 $273,516
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 number

0000027478

Policy instance

Insurance contract or identification number	0000027478
Number of Individuals Covered	240
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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	Yes
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
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

Insurance contract or identification number	VERIS
Number of Individuals Covered	123
Insurance policy start date	2018-06-01
Insurance policy end date	2018-12-31
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 $153,253
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 number

0000027478

Policy instance

Insurance contract or identification number	0000027478
Number of Individuals Covered	244
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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 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	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	KLEHR HARRISON HARVEY BRANZBURG LLP
Employer identification number (EIN):	231973697
NAIC Classification:	541110
NAIC Description:	Offices of Lawyers

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	4760579