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NEWVITAE, INC. GROUP HEALTH PLAN 401k Plan overview

Plan NameNEWVITAE, INC. GROUP HEALTH PLAN
Plan identification number 501

NEWVITAE, INC. GROUP HEALTH PLAN Benefits

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

401k Sponsoring company profile

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

Company Name:NEWVITAE, INC.
Employer identification number (EIN):232627394
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEWVITAE, INC. GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01MICHELLE BECK
5012016-10-01MICHELLE BECK
5012015-10-01MICHELLE BECK

Plan Statistics for NEWVITAE, INC. GROUP HEALTH PLAN

401k plan membership statisitcs for NEWVITAE, INC. GROUP HEALTH PLAN

Measure Date Value
2022: NEWVITAE, INC. GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01120
Total number of active participants reported on line 7a of the Form 55002022-01-01117
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01117
2021: NEWVITAE, INC. GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01129
Total number of active participants reported on line 7a of the Form 55002021-01-01119
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01120
2020: NEWVITAE, INC. GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01140
Total number of active participants reported on line 7a of the Form 55002020-01-01128
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01129
2019: NEWVITAE, INC. GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01119
Total number of active participants reported on line 7a of the Form 55002019-01-01140
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01140
2018: NEWVITAE, INC. GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01115
Total number of active participants reported on line 7a of the Form 55002018-01-01119
Number of retired or separated participants receiving benefits2018-01-013
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01122
2017: NEWVITAE, INC. GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0182
Total number of active participants reported on line 7a of the Form 55002017-01-01114
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01115
2016: NEWVITAE, INC. GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-0180
Total number of active participants reported on line 7a of the Form 55002016-10-0182
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-0182
2015: NEWVITAE, INC. GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-0180
Total number of active participants reported on line 7a of the Form 55002015-10-0180
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-0180

Financial Data on NEWVITAE, INC. GROUP HEALTH PLAN

Measure Date Value
2022 : NEWVITAE, INC. GROUP HEALTH PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$113,873
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$164,002
Total income from all sources (including contributions)2022-12-31$1,590,995
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,309,566
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,231,257
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,588,718
Value of total assets at end of year2022-12-31$935,577
Value of total assets at beginning of year2022-12-31$704,277
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$78,309
Total interest from all sources2022-12-31$2,277
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$300,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$295,305
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$104,693
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$96,701
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$281,429
Value of net assets at end of year (total assets less liabilities)2022-12-31$821,704
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$540,275
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$935,577
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$704,277
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$704,277
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$2,277
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$457,719
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,293,413
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$773,538
Contract administrator fees2022-12-31$78,309
Liabilities. Value of benefit claims payable at end of year2022-12-31$9,180
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$67,301
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WIPFLI LLP
Accountancy firm EIN2022-12-31390758449
2021 : NEWVITAE, INC. GROUP HEALTH PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$164,002
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$175,031
Total income from all sources (including contributions)2021-12-31$1,715,877
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,690,196
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,604,958
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,713,953
Value of total assets at end of year2021-12-31$704,277
Value of total assets at beginning of year2021-12-31$689,625
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$85,238
Total interest from all sources2021-12-31$1,924
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$300,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$339,132
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$5,931
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$96,701
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$84,672
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$25,681
Value of net assets at end of year (total assets less liabilities)2021-12-31$540,275
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$514,594
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$704,277
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$683,694
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$683,694
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$1,924
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$424,626
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,374,821
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,180,332
Contract administrator fees2021-12-31$85,238
Liabilities. Value of benefit claims payable at end of year2021-12-31$67,301
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$90,359
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WIPFLI LLP
Accountancy firm EIN2021-12-31390758449
2019 : NEWVITAE, INC. GROUP HEALTH PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$102,768
Total plan liabilities at beginning of year2019-12-31$105,748
Total income from all sources2019-12-31$1,447,871
Expenses. Total of all expenses incurred2019-12-31$1,181,410
Benefits paid (including direct rollovers)2019-12-31$694,781
Total plan assets at end of year2019-12-31$438,715
Total plan assets at beginning of year2019-12-31$175,234
Value of fidelity bond covering the plan2019-12-31$300,000
Total contributions received or receivable from participants2019-12-31$276,181
Expenses. Other expenses not covered elsewhere2019-12-31$433,203
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$589
Net income (gross income less expenses)2019-12-31$266,461
Net plan assets at end of year (total assets less liabilities)2019-12-31$335,947
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$69,486
Total contributions received or receivable from employer(s)2019-12-31$1,171,101
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$53,426
2018 : NEWVITAE, INC. GROUP HEALTH PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$105,748
Total plan liabilities at beginning of year2018-12-31$42,781
Total income from all sources2018-12-31$1,276,295
Expenses. Total of all expenses incurred2018-12-31$1,529,297
Benefits paid (including direct rollovers)2018-12-31$923,641
Total plan assets at end of year2018-12-31$175,234
Total plan assets at beginning of year2018-12-31$365,269
Value of fidelity bond covering the plan2018-12-31$300,000
Total contributions received or receivable from participants2018-12-31$258,213
Expenses. Other expenses not covered elsewhere2018-12-31$422,980
Contributions received from other sources (not participants or employers)2018-12-31$16,477
Other income received2018-12-31$588
Net income (gross income less expenses)2018-12-31$-253,002
Net plan assets at end of year (total assets less liabilities)2018-12-31$69,486
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$322,488
Total contributions received or receivable from employer(s)2018-12-31$1,001,017
Value of corrective distributions2018-12-31$131,369
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$51,307
2017 : NEWVITAE, INC. GROUP HEALTH PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$42,781
Total plan liabilities at beginning of year2017-12-31$39,798
Total income from all sources2017-12-31$1,058,679
Expenses. Total of all expenses incurred2017-12-31$1,034,864
Benefits paid (including direct rollovers)2017-12-31$492,112
Total plan assets at end of year2017-12-31$365,269
Total plan assets at beginning of year2017-12-31$338,471
Value of fidelity bond covering the plan2017-12-31$300,000
Total contributions received or receivable from participants2017-12-31$212,914
Expenses. Other expenses not covered elsewhere2017-12-31$309,796
Contributions received from other sources (not participants or employers)2017-12-31$5,478
Other income received2017-12-31$820
Net income (gross income less expenses)2017-12-31$23,815
Net plan assets at end of year (total assets less liabilities)2017-12-31$322,488
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$298,673
Total contributions received or receivable from employer(s)2017-12-31$839,467
Value of corrective distributions2017-12-31$183,917
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$49,039
2016 : NEWVITAE, INC. GROUP HEALTH PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$39,798
Total plan liabilities at beginning of year2016-12-31$47,776
Total income from all sources2016-12-31$213,406
Expenses. Total of all expenses incurred2016-12-31$146,767
Benefits paid (including direct rollovers)2016-12-31$76,835
Total plan assets at end of year2016-12-31$338,471
Total plan assets at beginning of year2016-12-31$279,810
Value of fidelity bond covering the plan2016-12-31$300,000
Total contributions received or receivable from participants2016-12-31$43,563
Expenses. Other expenses not covered elsewhere2016-12-31$59,413
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$156
Net income (gross income less expenses)2016-12-31$66,639
Net plan assets at end of year (total assets less liabilities)2016-12-31$298,673
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$232,034
Total contributions received or receivable from employer(s)2016-12-31$169,687
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$10,519
Total plan liabilities at end of year2016-09-30$47,776
Total plan liabilities at beginning of year2016-09-30$0
Total income from all sources2016-09-30$850,132
Expenses. Total of all expenses incurred2016-09-30$618,098
Benefits paid (including direct rollovers)2016-09-30$338,974
Total plan assets at end of year2016-09-30$279,810
Total plan assets at beginning of year2016-09-30$0
Value of fidelity bond covering the plan2016-09-30$300,000
Total contributions received or receivable from participants2016-09-30$235,405
Expenses. Other expenses not covered elsewhere2016-09-30$237,541
Other income received2016-09-30$272
Net income (gross income less expenses)2016-09-30$232,034
Net plan assets at end of year (total assets less liabilities)2016-09-30$232,034
Net plan assets at beginning of year (total assets less liabilities)2016-09-30$0
Total contributions received or receivable from employer(s)2016-09-30$614,455
Expenses. Administrative service providers (salaries,fees and commissions)2016-09-30$41,583

Form 5500 Responses for NEWVITAE, INC. GROUP HEALTH PLAN

2022: NEWVITAE, INC. GROUP HEALTH PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NEWVITAE, INC. GROUP HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NEWVITAE, INC. GROUP HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: NEWVITAE, INC. GROUP HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: NEWVITAE, INC. GROUP HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: NEWVITAE, INC. GROUP HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: NEWVITAE, INC. GROUP HEALTH PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2015: NEWVITAE, INC. GROUP HEALTH PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01First time form 5500 has been submittedYes
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500145
Policy instance 1
Insurance contract or identification number30500145
Number of Individuals Covered117
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $457,719
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 number30500145
Policy instance 1
Insurance contract or identification number30500145
Number of Individuals Covered120
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $424,626
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 number30500145
Policy instance 1
Insurance contract or identification number30500145
Number of Individuals Covered129
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $405,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered140
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $343,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered115
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $240,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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