THE FREDERICKS COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 30 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 31 |
| 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 | 31 |
| 2021: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 29 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 30 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| 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 | 30 |
| 2020: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 30 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 29 |
| 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 | 29 |
| 2019: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 30 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 30 |
| 2018: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 37 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| 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 | 37 |
| 2017: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 36 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 37 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 37 |
| 2016: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 33 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 36 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 36 |
| 2015: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 32 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 33 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 33 |
| Measure | Date | Value |
|---|
| 2022 : THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2022 401k financial data |
|---|
| Total plan liabilities at end of year | 2022-12-31 | $24,643 |
| Total plan liabilities at beginning of year | 2022-12-31 | $37,908 |
| Total income from all sources | 2022-12-31 | $483,290 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $449,201 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $160,342 |
| Total plan assets at end of year | 2022-12-31 | $177,932 |
| Total plan assets at beginning of year | 2022-12-31 | $157,108 |
| Value of fidelity bond covering the plan | 2022-12-31 | $550,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $135,886 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $181,977 |
| Contributions received from other sources (not participants or employers) | 2022-12-31 | $0 |
| Other income received | 2022-12-31 | $0 |
| Net income (gross income less expenses) | 2022-12-31 | $34,089 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $153,289 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $119,200 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $347,404 |
| Value of corrective distributions | 2022-12-31 | $92,382 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $14,500 |
| 2021 : THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-12-31 | $37,908 |
| Total plan liabilities at beginning of year | 2021-12-31 | $57,652 |
| Total income from all sources | 2021-12-31 | $429,246 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $268,511 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $73,957 |
| Total plan assets at end of year | 2021-12-31 | $157,108 |
| Total plan assets at beginning of year | 2021-12-31 | $16,117 |
| Value of fidelity bond covering the plan | 2021-12-31 | $550,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $308,312 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $153,367 |
| Contributions received from other sources (not participants or employers) | 2021-12-31 | $120,934 |
| Net income (gross income less expenses) | 2021-12-31 | $160,735 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $119,200 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $-41,535 |
| Value of corrective distributions | 2021-12-31 | $27,848 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $13,339 |
| 2020 : THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-12-31 | $57,652 |
| Total plan liabilities at beginning of year | 2020-12-31 | $35,469 |
| Total income from all sources | 2020-12-31 | $438,150 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $439,608 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $220,035 |
| Total plan assets at end of year | 2020-12-31 | $16,117 |
| Total plan assets at beginning of year | 2020-12-31 | $-4,608 |
| Value of fidelity bond covering the plan | 2020-12-31 | $550,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $126,572 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $149,042 |
| Contributions received from other sources (not participants or employers) | 2020-12-31 | $0 |
| Other income received | 2020-12-31 | $0 |
| Net income (gross income less expenses) | 2020-12-31 | $-1,458 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $-41,535 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $-40,077 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $311,578 |
| Value of corrective distributions | 2020-12-31 | $57,751 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $12,780 |
| 2019 : THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-31 | $40,077 |
| Total plan liabilities at beginning of year | 2019-12-31 | $24,704 |
| Total income from all sources | 2019-12-31 | $455,575 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $539,788 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $329,990 |
| Total plan assets at end of year | 2019-12-31 | $0 |
| Total plan assets at beginning of year | 2019-12-31 | $68,840 |
| Value of fidelity bond covering the plan | 2019-12-31 | $550,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $131,753 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $169,274 |
| Contributions received from other sources (not participants or employers) | 2019-12-31 | $5,396 |
| Other income received | 2019-12-31 | $0 |
| Net income (gross income less expenses) | 2019-12-31 | $-84,213 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $-40,077 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $44,136 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $318,426 |
| Value of corrective distributions | 2019-12-31 | $26,270 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $14,254 |
| 2018 : THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-12-31 | $24,704 |
| Total plan liabilities at beginning of year | 2018-12-31 | $33,927 |
| Total income from all sources | 2018-12-31 | $479,189 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $413,080 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $227,631 |
| Total plan assets at end of year | 2018-12-31 | $68,840 |
| Total plan assets at beginning of year | 2018-12-31 | $11,954 |
| Value of fidelity bond covering the plan | 2018-12-31 | $550,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $140,726 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $171,257 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $0 |
| Net income (gross income less expenses) | 2018-12-31 | $66,109 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $44,136 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $-21,973 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $338,463 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $14,192 |
| 2017 : THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-12-31 | $33,927 |
| Total plan liabilities at beginning of year | 2017-12-31 | $29,912 |
| Total income from all sources | 2017-12-31 | $484,265 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $486,724 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $291,317 |
| Total plan assets at end of year | 2017-12-31 | $11,954 |
| Total plan assets at beginning of year | 2017-12-31 | $10,398 |
| Value of fidelity bond covering the plan | 2017-12-31 | $550,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $140,256 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $180,410 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $8,485 |
| Net income (gross income less expenses) | 2017-12-31 | $-2,459 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $-21,973 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $-19,514 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $335,524 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $14,997 |
| 2016 : THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-12-31 | $29,912 |
| Total plan liabilities at beginning of year | 2016-12-31 | $28,046 |
| Total income from all sources | 2016-12-31 | $322,703 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $320,315 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $154,936 |
| Total plan assets at end of year | 2016-12-31 | $10,398 |
| Total plan assets at beginning of year | 2016-12-31 | $6,144 |
| Value of fidelity bond covering the plan | 2016-12-31 | $550,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $149,366 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $0 |
| Other income received | 2016-12-31 | $14 |
| Net income (gross income less expenses) | 2016-12-31 | $2,388 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $-19,514 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $-21,902 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $322,689 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $16,013 |
| 2015 : THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-12-31 | $28,046 |
| Total plan liabilities at beginning of year | 2015-12-31 | $0 |
| Total income from all sources | 2015-12-31 | $344,971 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $366,873 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $192,418 |
| Total plan assets at end of year | 2015-12-31 | $6,144 |
| Total plan assets at beginning of year | 2015-12-31 | $0 |
| Value of fidelity bond covering the plan | 2015-12-31 | $550,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $102,394 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $157,207 |
| Contributions received from other sources (not participants or employers) | 2015-12-31 | $0 |
| Other income received | 2015-12-31 | $23 |
| Net income (gross income less expenses) | 2015-12-31 | $-21,902 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $-21,902 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $242,554 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $17,248 |
| 2022: THE FREDERICKS COMPANY EMPLOYEE BENEFIT 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: THE FREDERICKS COMPANY EMPLOYEE BENEFIT 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: THE FREDERICKS COMPANY EMPLOYEE BENEFIT 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: THE FREDERICKS COMPANY EMPLOYEE BENEFIT 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: THE FREDERICKS COMPANY EMPLOYEE BENEFIT 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: THE FREDERICKS COMPANY EMPLOYEE BENEFIT 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 funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: THE FREDERICKS COMPANY EMPLOYEE BENEFIT 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 funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: THE FREDERICKS COMPANY EMPLOYEE BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 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 funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500033 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500033 | | Number of Individuals Covered | 31 | | 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 $157,104 | | 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 | 30500033 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500033 | | Number of Individuals Covered | 30 | | 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 $129,971 | | 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 | 30500033 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500033 | | Number of Individuals Covered | 29 | | 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 $126,148 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 30 | | 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 $142,700 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 37 | | 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 | 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 $143,234 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 37 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $151,066 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 33 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | 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 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 $115,079 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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