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REMCON PLASTICS, INC. GROUP MEDICAL PLAN 401k Plan overview

Plan NameREMCON PLASTICS, INC. GROUP MEDICAL PLAN
Plan identification number 501

REMCON PLASTICS, INC. GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

REMCON PLASTICS, INC. has sponsored the creation of one or more 401k plans.

Company Name:REMCON PLASTICS, INC.
Employer identification number (EIN):232221786
NAIC Classification:326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan REMCON PLASTICS, INC. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01CHRISTINE KAHN
5012016-01-01RICHARD MAGUIRE
5012015-07-01RICHARD MAGUIRE
5012014-07-01RICHARD MAGUIRE

Plan Statistics for REMCON PLASTICS, INC. GROUP MEDICAL PLAN

401k plan membership statisitcs for REMCON PLASTICS, INC. GROUP MEDICAL PLAN

Measure Date Value
2022: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0175
Total number of active participants reported on line 7a of the Form 55002022-01-0171
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0171
2021: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0165
Total number of active participants reported on line 7a of the Form 55002021-01-0153
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0153
2020: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0165
Total number of active participants reported on line 7a of the Form 55002020-01-0165
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0165
2019: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0161
Total number of active participants reported on line 7a of the Form 55002019-01-0165
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0165
2018: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0172
Total number of active participants reported on line 7a of the Form 55002018-01-0154
Number of retired or separated participants receiving benefits2018-01-017
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0161
2017: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0160
Total number of active participants reported on line 7a of the Form 55002017-01-0169
Number of retired or separated participants receiving benefits2017-01-013
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0172
2016: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0164
Total number of active participants reported on line 7a of the Form 55002016-01-0160
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0160
2015: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0163
Total number of active participants reported on line 7a of the Form 55002015-07-0164
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-0164
2014: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0155
Total number of active participants reported on line 7a of the Form 55002014-07-0163
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-0163

Financial Data on REMCON PLASTICS, INC. GROUP MEDICAL PLAN

Measure Date Value
2022 : REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$104,187
Total plan liabilities at beginning of year2022-12-31$110,231
Total income from all sources2022-12-31$864,886
Expenses. Total of all expenses incurred2022-12-31$700,587
Benefits paid (including direct rollovers)2022-12-31$303,831
Total plan assets at end of year2022-12-31$307,099
Total plan assets at beginning of year2022-12-31$148,844
Value of fidelity bond covering the plan2022-12-31$250,000
Total contributions received or receivable from participants2022-12-31$167,648
Expenses. Other expenses not covered elsewhere2022-12-31$351,150
Contributions received from other sources (not participants or employers)2022-12-31$1,453
Other income received2022-12-31$502
Net income (gross income less expenses)2022-12-31$164,299
Net plan assets at end of year (total assets less liabilities)2022-12-31$202,912
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$38,613
Total contributions received or receivable from employer(s)2022-12-31$695,283
Value of corrective distributions2022-12-31$37,594
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$8,012
2021 : REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$110,231
Total plan liabilities at beginning of year2021-12-31$202,287
Total income from all sources2021-12-31$621,546
Expenses. Total of all expenses incurred2021-12-31$424,065
Benefits paid (including direct rollovers)2021-12-31$141,874
Total plan assets at end of year2021-12-31$148,844
Total plan assets at beginning of year2021-12-31$43,419
Value of fidelity bond covering the plan2021-12-31$250,000
Total contributions received or receivable from participants2021-12-31$106,087
Expenses. Other expenses not covered elsewhere2021-12-31$258,016
Other income received2021-12-31$188
Net income (gross income less expenses)2021-12-31$197,481
Net plan assets at end of year (total assets less liabilities)2021-12-31$38,613
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$-158,868
Total contributions received or receivable from employer(s)2021-12-31$515,271
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$24,175
2020 : REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$202,287
Total plan liabilities at beginning of year2020-12-31$23,751
Total income from all sources2020-12-31$841,324
Expenses. Total of all expenses incurred2020-12-31$1,143,912
Benefits paid (including direct rollovers)2020-12-31$691,108
Total plan assets at end of year2020-12-31$43,419
Total plan assets at beginning of year2020-12-31$167,471
Value of fidelity bond covering the plan2020-12-31$250,000
Total contributions received or receivable from participants2020-12-31$111,522
Expenses. Other expenses not covered elsewhere2020-12-31$334,264
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$157
Net income (gross income less expenses)2020-12-31$-302,588
Net plan assets at end of year (total assets less liabilities)2020-12-31$-158,868
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$143,720
Total contributions received or receivable from employer(s)2020-12-31$729,645
Value of corrective distributions2020-12-31$88,963
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$29,577
2019 : REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$23,751
Total plan liabilities at beginning of year2019-12-31$38,477
Total income from all sources2019-12-31$658,880
Expenses. Total of all expenses incurred2019-12-31$710,835
Benefits paid (including direct rollovers)2019-12-31$314,987
Total plan assets at end of year2019-12-31$167,471
Total plan assets at beginning of year2019-12-31$234,152
Value of fidelity bond covering the plan2019-12-31$1,000,000
Total contributions received or receivable from participants2019-12-31$103,700
Expenses. Other expenses not covered elsewhere2019-12-31$251,483
Contributions received from other sources (not participants or employers)2019-12-31$10,745
Other income received2019-12-31$576
Net income (gross income less expenses)2019-12-31$-51,955
Net plan assets at end of year (total assets less liabilities)2019-12-31$143,720
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$195,675
Total contributions received or receivable from employer(s)2019-12-31$543,859
Value of corrective distributions2019-12-31$110,855
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$33,510
2018 : REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$38,477
Total plan liabilities at beginning of year2018-12-31$51,310
Total income from all sources2018-12-31$643,015
Expenses. Total of all expenses incurred2018-12-31$478,496
Benefits paid (including direct rollovers)2018-12-31$196,948
Total plan assets at end of year2018-12-31$234,152
Total plan assets at beginning of year2018-12-31$82,466
Value of fidelity bond covering the plan2018-12-31$250,000
Total contributions received or receivable from participants2018-12-31$96,331
Expenses. Other expenses not covered elsewhere2018-12-31$248,691
Contributions received from other sources (not participants or employers)2018-12-31$21,424
Other income received2018-12-31$407
Net income (gross income less expenses)2018-12-31$164,519
Net plan assets at end of year (total assets less liabilities)2018-12-31$195,675
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$31,156
Total contributions received or receivable from employer(s)2018-12-31$524,853
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$32,857
2017 : REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$51,310
Total plan liabilities at beginning of year2017-12-31$38,795
Total income from all sources2017-12-31$620,390
Expenses. Total of all expenses incurred2017-12-31$645,595
Benefits paid (including direct rollovers)2017-12-31$365,885
Total plan assets at end of year2017-12-31$82,466
Total plan assets at beginning of year2017-12-31$95,156
Value of fidelity bond covering the plan2017-12-31$250,000
Total contributions received or receivable from participants2017-12-31$87,770
Expenses. Other expenses not covered elsewhere2017-12-31$232,474
Contributions received from other sources (not participants or employers)2017-12-31$12,722
Other income received2017-12-31$168
Net income (gross income less expenses)2017-12-31$-25,205
Net plan assets at end of year (total assets less liabilities)2017-12-31$31,156
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$56,361
Total contributions received or receivable from employer(s)2017-12-31$519,730
Value of corrective distributions2017-12-31$6,407
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$40,829
2016 : REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$38,795
Total plan liabilities at beginning of year2016-12-31$22,558
Total income from all sources2016-12-31$451,045
Expenses. Total of all expenses incurred2016-12-31$459,872
Benefits paid (including direct rollovers)2016-12-31$238,298
Total plan assets at end of year2016-12-31$95,156
Total plan assets at beginning of year2016-12-31$87,746
Value of fidelity bond covering the plan2016-12-31$250,000
Total contributions received or receivable from participants2016-12-31$63,723
Expenses. Other expenses not covered elsewhere2016-12-31$178,056
Contributions received from other sources (not participants or employers)2016-12-31$4,065
Other income received2016-12-31$106
Net income (gross income less expenses)2016-12-31$-8,827
Net plan assets at end of year (total assets less liabilities)2016-12-31$56,361
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$65,188
Total contributions received or receivable from employer(s)2016-12-31$383,151
Value of corrective distributions2016-12-31$8,970
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$34,548
2015 : REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$22,558
Total plan liabilities at beginning of year2015-12-31$21,138
Total income from all sources2015-12-31$259,240
Expenses. Total of all expenses incurred2015-12-31$227,915
Benefits paid (including direct rollovers)2015-12-31$109,095
Total plan assets at end of year2015-12-31$87,746
Total plan assets at beginning of year2015-12-31$55,001
Value of fidelity bond covering the plan2015-12-31$250,000
Total contributions received or receivable from participants2015-12-31$40,406
Expenses. Other expenses not covered elsewhere2015-12-31$101,106
Other income received2015-12-31$92
Net income (gross income less expenses)2015-12-31$31,325
Net plan assets at end of year (total assets less liabilities)2015-12-31$65,188
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$33,863
Total contributions received or receivable from employer(s)2015-12-31$218,742
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$17,714
Total plan liabilities at end of year2015-06-30$21,138
Total income from all sources2015-06-30$386,333
Expenses. Total of all expenses incurred2015-06-30$352,470
Benefits paid (including direct rollovers)2015-06-30$175,051
Total plan assets at end of year2015-06-30$55,001
Value of fidelity bond covering the plan2015-06-30$250,000
Total contributions received or receivable from participants2015-06-30$62,841
Expenses. Other expenses not covered elsewhere2015-06-30$145,546
Contributions received from other sources (not participants or employers)2015-06-30$0
Other income received2015-06-30$92
Noncash contributions received2015-06-30$0
Net income (gross income less expenses)2015-06-30$33,863
Net plan assets at end of year (total assets less liabilities)2015-06-30$33,863
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$0
Total contributions received or receivable from employer(s)2015-06-30$323,400
Value of certain deemed distributions of participant loans2015-06-30$0
Value of corrective distributions2015-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$31,873

Form 5500 Responses for REMCON PLASTICS, INC. GROUP MEDICAL PLAN

2022: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: REMCON PLASTICS, INC. GROUP MEDICAL PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01First time form 5500 has been submittedYes
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number407388
Policy instance 1
Insurance contract or identification number407388
Number of Individuals Covered53
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $307,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number407388
Policy instance 1
Insurance contract or identification number407388
Number of Individuals Covered53
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $246,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number407388
Policy instance 1
Insurance contract or identification number407388
Number of Individuals Covered65
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $262,162
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 numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered65
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $216,891
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 numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered72
Insurance policy start date2017-07-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $188,036
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 numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered64
Insurance policy start date2015-07-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $67,266
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 numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered63
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,511
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 numberVERIS
Policy instance 2
Insurance contract or identification numberVERIS
Number of Individuals Covered63
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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