OREFIELD COLD STORAGE & DISTRIBUTION CENTER has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN
401k plan membership statisitcs for OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN
| Measure | Date | Value |
|---|
| 2020: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-01 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 0 |
| Number of retired or separated participants receiving benefits | 2020-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-09-01 | 0 |
| Total of all active and inactive participants | 2020-09-01 | 0 |
| 2019: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 151 |
| Number of retired or separated participants receiving benefits | 2019-09-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2019-09-01 | 0 |
| Total of all active and inactive participants | 2019-09-01 | 153 |
| 2018: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 164 |
| Number of retired or separated participants receiving benefits | 2018-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2018-09-01 | 0 |
| Total of all active and inactive participants | 2018-09-01 | 165 |
| 2017: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 178 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 167 |
| Number of retired or separated participants receiving benefits | 2017-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2017-09-01 | 0 |
| Total of all active and inactive participants | 2017-09-01 | 168 |
| 2016: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 177 |
| Number of retired or separated participants receiving benefits | 2016-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 0 |
| Total of all active and inactive participants | 2016-09-01 | 178 |
| 2015: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 168 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 168 |
| 2014: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 163 |
| Number of retired or separated participants receiving benefits | 2014-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-09-01 | 0 |
| Total of all active and inactive participants | 2014-09-01 | 163 |
| 2013: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-09-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 151 |
| Number of retired or separated participants receiving benefits | 2013-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2013-09-01 | 0 |
| Total of all active and inactive participants | 2013-09-01 | 152 |
| 2012: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-09-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 146 |
| Number of retired or separated participants receiving benefits | 2012-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2012-09-01 | 0 |
| Total of all active and inactive participants | 2012-09-01 | 147 |
| 2011: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-09-01 | 121 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 124 |
| Number of retired or separated participants receiving benefits | 2011-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-09-01 | 0 |
| Total of all active and inactive participants | 2011-09-01 | 124 |
| 2010: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-09-01 | 170 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-09-01 | 121 |
| Number of retired or separated participants receiving benefits | 2010-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-09-01 | 0 |
| Total of all active and inactive participants | 2010-09-01 | 121 |
| 2009: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 169 |
| Number of retired or separated participants receiving benefits | 2009-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2009-09-01 | 0 |
| Total of all active and inactive participants | 2009-09-01 | 170 |
| Measure | Date | Value |
|---|
| 2017 : OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2017 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2017-08-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-08-31 | $115,049 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-08-31 | $440,430 |
| Total income from all sources (including contributions) | 2017-08-31 | $1,634,955 |
| Total loss/gain on sale of assets | 2017-08-31 | $0 |
| Total of all expenses incurred | 2017-08-31 | $1,635,558 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-08-31 | $1,557,051 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-08-31 | $1,634,776 |
| Value of total assets at end of year | 2017-08-31 | $115,500 |
| Value of total assets at beginning of year | 2017-08-31 | $441,484 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-08-31 | $78,507 |
| Total interest from all sources | 2017-08-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-08-31 | $179 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-08-31 | No |
| Was this plan covered by a fidelity bond | 2017-08-31 | Yes |
| Value of fidelity bond cover | 2017-08-31 | $125,000 |
| If this is an individual account plan, was there a blackout period | 2017-08-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-08-31 | No |
| Contributions received from participants | 2017-08-31 | $645,334 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-08-31 | $100,587 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-08-31 | $167,648 |
| Liabilities. Value of operating payables at end of year | 2017-08-31 | $75,304 |
| Liabilities. Value of operating payables at beginning of year | 2017-08-31 | $172,024 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-08-31 | No |
| Value of net income/loss | 2017-08-31 | $-603 |
| Value of net assets at end of year (total assets less liabilities) | 2017-08-31 | $451 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-08-31 | $1,054 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-08-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-08-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-08-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-08-31 | $14,913 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-08-31 | $273,836 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-08-31 | $273,836 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-08-31 | $1,557,051 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-08-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-08-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-08-31 | No |
| Contributions received in cash from employer | 2017-08-31 | $989,442 |
| Income. Dividends from preferred stock | 2017-08-31 | $179 |
| Contract administrator fees | 2017-08-31 | $78,507 |
| Liabilities. Value of benefit claims payable at end of year | 2017-08-31 | $39,745 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-08-31 | $268,406 |
| Did the plan have assets held for investment | 2017-08-31 | Yes |
| 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 | 2017-08-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-08-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-08-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-08-31 | Unqualified |
| Accountancy firm name | 2017-08-31 | MOLINARI OSWALD LLC |
| Accountancy firm EIN | 2017-08-31 | 233015901 |
| 2016 : OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2016 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2016-08-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-08-31 | $440,430 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-08-31 | $134,698 |
| Total income from all sources (including contributions) | 2016-08-31 | $1,361,557 |
| Total loss/gain on sale of assets | 2016-08-31 | $0 |
| Total of all expenses incurred | 2016-08-31 | $1,360,697 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-08-31 | $1,282,878 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-08-31 | $1,361,459 |
| Value of total assets at end of year | 2016-08-31 | $441,484 |
| Value of total assets at beginning of year | 2016-08-31 | $134,892 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-08-31 | $77,819 |
| Total interest from all sources | 2016-08-31 | $98 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-08-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-08-31 | No |
| Was this plan covered by a fidelity bond | 2016-08-31 | Yes |
| Value of fidelity bond cover | 2016-08-31 | $125,000 |
| If this is an individual account plan, was there a blackout period | 2016-08-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-08-31 | No |
| Contributions received from participants | 2016-08-31 | $566,514 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-08-31 | $167,648 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-08-31 | $99,628 |
| Liabilities. Value of operating payables at end of year | 2016-08-31 | $172,024 |
| Liabilities. Value of operating payables at beginning of year | 2016-08-31 | $95,869 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-08-31 | No |
| Value of net income/loss | 2016-08-31 | $860 |
| Value of net assets at end of year (total assets less liabilities) | 2016-08-31 | $1,054 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-08-31 | $194 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-08-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-08-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-08-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-08-31 | $273,836 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-08-31 | $35,264 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-08-31 | $35,264 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-08-31 | $98 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-08-31 | $1,282,878 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-08-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-08-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-08-31 | No |
| Contributions received in cash from employer | 2016-08-31 | $794,945 |
| Contract administrator fees | 2016-08-31 | $77,819 |
| Liabilities. Value of benefit claims payable at end of year | 2016-08-31 | $268,406 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-08-31 | $38,829 |
| Did the plan have assets held for investment | 2016-08-31 | Yes |
| 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 | 2016-08-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-08-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-08-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-08-31 | Unqualified |
| Accountancy firm name | 2016-08-31 | MOLINARI OSWALD LLC |
| Accountancy firm EIN | 2016-08-31 | 233015901 |
| 2015 : OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2015 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2015-08-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-08-31 | $134,698 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-08-31 | $81,800 |
| Total income from all sources (including contributions) | 2015-08-31 | $1,154,811 |
| Total loss/gain on sale of assets | 2015-08-31 | $0 |
| Total of all expenses incurred | 2015-08-31 | $1,154,703 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-08-31 | $1,079,009 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-08-31 | $1,154,703 |
| Value of total assets at end of year | 2015-08-31 | $134,892 |
| Value of total assets at beginning of year | 2015-08-31 | $81,886 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-08-31 | $75,694 |
| Total interest from all sources | 2015-08-31 | $108 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-08-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-08-31 | No |
| Was this plan covered by a fidelity bond | 2015-08-31 | Yes |
| Value of fidelity bond cover | 2015-08-31 | $125,000 |
| If this is an individual account plan, was there a blackout period | 2015-08-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-08-31 | No |
| Contributions received from participants | 2015-08-31 | $210,387 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-08-31 | $99,628 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-08-31 | $53,460 |
| Liabilities. Value of operating payables at end of year | 2015-08-31 | $95,869 |
| Liabilities. Value of operating payables at beginning of year | 2015-08-31 | $23,626 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-08-31 | No |
| Value of net income/loss | 2015-08-31 | $108 |
| Value of net assets at end of year (total assets less liabilities) | 2015-08-31 | $194 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-08-31 | $86 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-08-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-08-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-08-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-08-31 | $35,264 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-08-31 | $28,426 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-08-31 | $28,426 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-08-31 | $108 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-08-31 | $1,079,009 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-08-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-08-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-08-31 | No |
| Contributions received in cash from employer | 2015-08-31 | $944,316 |
| Contract administrator fees | 2015-08-31 | $75,694 |
| Liabilities. Value of benefit claims payable at end of year | 2015-08-31 | $38,829 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-08-31 | $58,174 |
| Did the plan have assets held for investment | 2015-08-31 | Yes |
| 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 | 2015-08-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-08-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-08-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-08-31 | Unqualified |
| Accountancy firm name | 2015-08-31 | MOLINARI OSWALD LLC |
| Accountancy firm EIN | 2015-08-31 | 233015901 |
| 2014 : OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2014 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2014-08-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-08-31 | $81,800 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-08-31 | $0 |
| Total income from all sources (including contributions) | 2014-08-31 | $1,014,579 |
| Total loss/gain on sale of assets | 2014-08-31 | $0 |
| Total of all expenses incurred | 2014-08-31 | $1,014,493 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-08-31 | $943,031 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-08-31 | $1,014,493 |
| Value of total assets at end of year | 2014-08-31 | $81,886 |
| Value of total assets at beginning of year | 2014-08-31 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-08-31 | $71,462 |
| Total interest from all sources | 2014-08-31 | $86 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-08-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-08-31 | No |
| Was this plan covered by a fidelity bond | 2014-08-31 | Yes |
| Value of fidelity bond cover | 2014-08-31 | $125,000 |
| If this is an individual account plan, was there a blackout period | 2014-08-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-08-31 | No |
| Contributions received from participants | 2014-08-31 | $177,607 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-08-31 | $53,460 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-08-31 | $0 |
| Liabilities. Value of operating payables at end of year | 2014-08-31 | $23,626 |
| Liabilities. Value of operating payables at beginning of year | 2014-08-31 | $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 | 2014-08-31 | No |
| Value of net income/loss | 2014-08-31 | $86 |
| Value of net assets at end of year (total assets less liabilities) | 2014-08-31 | $86 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-08-31 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-08-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-08-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-08-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-08-31 | $28,426 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-08-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-08-31 | $0 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-08-31 | $86 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-08-31 | $943,031 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-08-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-08-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-08-31 | No |
| Contributions received in cash from employer | 2014-08-31 | $836,886 |
| Contract administrator fees | 2014-08-31 | $71,462 |
| Liabilities. Value of benefit claims payable at end of year | 2014-08-31 | $58,174 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-08-31 | $0 |
| Did the plan have assets held for investment | 2014-08-31 | Yes |
| 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 | 2014-08-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-08-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-08-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-08-31 | Unqualified |
| Accountancy firm name | 2014-08-31 | MOLINARI OSWALD LLC |
| Accountancy firm EIN | 2014-08-31 | 233015901 |
| 2020: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2020 form 5500 responses |
|---|
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | Submission has been amended | No |
| 2020-09-01 | This submission is the final filing | Yes |
| 2020-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-09-01 | Plan is a collectively bargained plan | No |
| 2020-09-01 | Plan funding arrangement – Insurance | Yes |
| 2020-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2019 form 5500 responses |
|---|
| 2019-09-01 | Type of plan entity | Single employer plan |
| 2019-09-01 | Submission has been amended | No |
| 2019-09-01 | This submission is the final filing | No |
| 2019-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-09-01 | Plan is a collectively bargained plan | No |
| 2019-09-01 | Plan funding arrangement – Insurance | Yes |
| 2019-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2018 form 5500 responses |
|---|
| 2018-09-01 | Type of plan entity | Single employer plan |
| 2018-09-01 | Submission has been amended | No |
| 2018-09-01 | This submission is the final filing | No |
| 2018-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-09-01 | Plan is a collectively bargained plan | No |
| 2018-09-01 | Plan funding arrangement – Insurance | Yes |
| 2018-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2017 form 5500 responses |
|---|
| 2017-09-01 | Type of plan entity | Single employer plan |
| 2017-09-01 | Submission has been amended | No |
| 2017-09-01 | This submission is the final filing | No |
| 2017-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-09-01 | Plan is a collectively bargained plan | No |
| 2017-09-01 | Plan funding arrangement – Insurance | Yes |
| 2017-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2016 form 5500 responses |
|---|
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | Submission has been amended | No |
| 2016-09-01 | This submission is the final filing | No |
| 2016-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-09-01 | Plan is a collectively bargained plan | No |
| 2016-09-01 | Plan funding arrangement – Insurance | Yes |
| 2016-09-01 | Plan funding arrangement – Trust | Yes |
| 2016-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement - Trust | Yes |
| 2016-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2015 form 5500 responses |
|---|
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | Submission has been amended | No |
| 2015-09-01 | This submission is the final filing | No |
| 2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-09-01 | Plan is a collectively bargained plan | No |
| 2015-09-01 | Plan funding arrangement – Insurance | Yes |
| 2015-09-01 | Plan funding arrangement – Trust | Yes |
| 2015-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement - Trust | Yes |
| 2015-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2014 form 5500 responses |
|---|
| 2014-09-01 | Type of plan entity | Single employer plan |
| 2014-09-01 | Submission has been amended | No |
| 2014-09-01 | This submission is the final filing | No |
| 2014-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-09-01 | Plan is a collectively bargained plan | No |
| 2014-09-01 | Plan funding arrangement – Insurance | Yes |
| 2014-09-01 | Plan funding arrangement – Trust | Yes |
| 2014-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-09-01 | Plan benefit arrangement - Trust | Yes |
| 2014-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2013 form 5500 responses |
|---|
| 2013-09-01 | Type of plan entity | Single employer plan |
| 2013-09-01 | Submission has been amended | Yes |
| 2013-09-01 | This submission is the final filing | No |
| 2013-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-09-01 | Plan is a collectively bargained plan | No |
| 2013-09-01 | Plan funding arrangement – Insurance | Yes |
| 2013-09-01 | Plan funding arrangement – Trust | Yes |
| 2013-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-09-01 | Plan benefit arrangement - Trust | Yes |
| 2013-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2012 form 5500 responses |
|---|
| 2012-09-01 | Type of plan entity | Single employer plan |
| 2012-09-01 | Submission has been amended | No |
| 2012-09-01 | This submission is the final filing | No |
| 2012-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-09-01 | Plan is a collectively bargained plan | No |
| 2012-09-01 | Plan funding arrangement – Insurance | Yes |
| 2012-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2011 form 5500 responses |
|---|
| 2011-09-01 | Type of plan entity | Single employer plan |
| 2011-09-01 | Submission has been amended | No |
| 2011-09-01 | This submission is the final filing | No |
| 2011-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-09-01 | Plan is a collectively bargained plan | No |
| 2011-09-01 | Plan funding arrangement – Insurance | Yes |
| 2011-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2010 form 5500 responses |
|---|
| 2010-09-01 | Type of plan entity | Single employer plan |
| 2010-09-01 | Submission has been amended | No |
| 2010-09-01 | This submission is the final filing | No |
| 2010-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-09-01 | Plan is a collectively bargained plan | No |
| 2010-09-01 | Plan funding arrangement – Insurance | Yes |
| 2010-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: OREFIELD COLD STORAGE & DISTRIBUTION CENTER INC. GROUP HEALTH PLAN 2009 form 5500 responses |
|---|
| 2009-09-01 | Type of plan entity | Single employer plan |
| 2009-09-01 | Submission has been amended | No |
| 2009-09-01 | This submission is the final filing | No |
| 2009-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-09-01 | Plan is a collectively bargained plan | No |
| 2009-09-01 | Plan funding arrangement – Insurance | Yes |
| 2009-09-01 | Plan benefit arrangement – Insurance | Yes |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0149893 |
| Policy instance | 4 |
| Insurance contract or identification number | 0149893 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $7,680 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $1,272,598 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,680 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | L7553 |
| Policy instance | 3 |
| Insurance contract or identification number | L7553 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $5,265 | | Total amount of fees paid to insurance company | USD $200 | | 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 | | Other welfare benefits provided | SUPPLEMENTAL ACCIDENT AND ILLNESS | | 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 $40,682 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,379 | | Amount paid for insurance broker fees | 122 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 070562 |
| Policy instance | 2 |
| Insurance contract or identification number | 070562 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $492 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | 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 $9,800 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $492 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 907463 |
| Policy instance | 1 |
| Insurance contract or identification number | 907463 | | Number of Individuals Covered | 188 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $5,392 | | 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 | No | | Dental Insurance Welfare Benefit | Yes | | 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 $54,179 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,392 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | L7553 |
| Policy instance | 3 |
| Insurance contract or identification number | L7553 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $7,010 | | Total amount of fees paid to insurance company | USD $266 | | 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 | | Other welfare benefits provided | SUPPLEMENTAL ACCIDENT AND ILLNESS | | 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 $41,191 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,187 | | Amount paid for insurance broker fees | 205 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 070562 |
| Policy instance | 2 |
| Insurance contract or identification number | 070562 | | Number of Individuals Covered | 194 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $53,706 | | 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 | Yes | | 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 $1,749,098 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,706 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 907463 |
| Policy instance | 1 |
| Insurance contract or identification number | 907463 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $6,076 | | 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 | No | | Dental Insurance Welfare Benefit | Yes | | 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 $61,230 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,076 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 070562 |
| Policy instance | 4 |
| Insurance contract or identification number | 070562 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $585 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | 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 $11,620 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $585 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | L7553 |
| Policy instance | 3 |
| Insurance contract or identification number | L7553 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $6,991 | | 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 | 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 | | Other welfare benefits provided | SUPPLEMENTAL ACCIDENT AND ILLNESS | | 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 $46,302 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,516 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00531678 |
| Policy instance | 2 |
| Insurance contract or identification number | 00531678 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $39,325 | | 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 | | Commission paid to Insurance Broker | USD $39,325 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 907463 |
| Policy instance | 1 |
| Insurance contract or identification number | 907463 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $6,412 | | 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 | No | | Dental Insurance Welfare Benefit | Yes | | 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 $63,470 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,412 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | L7553 |
| Policy instance | 3 |
| Insurance contract or identification number | L7553 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $4,962 | | Total amount of fees paid to insurance company | USD $541 | | 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 | | Other welfare benefits provided | SUPPLEMENTAL ACCIDENT AND ILLNESS | | 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 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 070562 |
| Policy instance | 2 |
| Insurance contract or identification number | 070562 | | Number of Individuals Covered | 236 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $38,338 | | 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 | Yes | | 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 $1,629,681 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 907463 |
| Policy instance | 1 |
| Insurance contract or identification number | 907463 | | Number of Individuals Covered | 265 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $6,545 | | 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 | No | | Dental Insurance Welfare Benefit | Yes | | 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 $65,714 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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