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SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameSPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN
Plan identification number 501

SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

SPANGLER AND BOYER MECHANICAL, INC. has sponsored the creation of one or more 401k plans.

Company Name:SPANGLER AND BOYER MECHANICAL, INC.
Employer identification number (EIN):232670632
NAIC Classification:541330
NAIC Description:Engineering Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01
5012021-05-01
5012020-05-01
5012019-05-01
5012018-05-01
5012017-05-01STEVEN SPANGLER
5012016-05-01STEVEN SPANGLER
5012015-05-01STEVEN SPANGLER

Plan Statistics for SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-0129
Total number of active participants reported on line 7a of the Form 55002022-05-0128
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-0128
2021: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-0132
Total number of active participants reported on line 7a of the Form 55002021-05-0129
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-0129
2020: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-0132
Total number of active participants reported on line 7a of the Form 55002020-05-0132
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-0132
2019: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-0129
Total number of active participants reported on line 7a of the Form 55002019-05-0131
Number of retired or separated participants receiving benefits2019-05-011
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-0132
2018: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-0125
Total number of active participants reported on line 7a of the Form 55002018-05-0128
Number of retired or separated participants receiving benefits2018-05-011
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-0129
2017: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-0120
Total number of active participants reported on line 7a of the Form 55002017-05-0125
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-0125
2016: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-0120
Total number of active participants reported on line 7a of the Form 55002016-05-0120
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-0120
2015: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-0120
Total number of active participants reported on line 7a of the Form 55002015-05-0120
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-0120

Financial Data on SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN

Measure Date Value
2023 : SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2023 401k financial data
Total plan liabilities at end of year2023-04-30$49,912
Total plan liabilities at beginning of year2023-04-30$19,971
Total income from all sources2023-04-30$461,588
Expenses. Total of all expenses incurred2023-04-30$395,963
Benefits paid (including direct rollovers)2023-04-30$130,764
Total plan assets at end of year2023-04-30$243,031
Total plan assets at beginning of year2023-04-30$147,465
Value of fidelity bond covering the plan2023-04-30$30,000
Total contributions received or receivable from participants2023-04-30$90,499
Expenses. Other expenses not covered elsewhere2023-04-30$220,331
Net income (gross income less expenses)2023-04-30$65,625
Net plan assets at end of year (total assets less liabilities)2023-04-30$193,119
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$127,494
Total contributions received or receivable from employer(s)2023-04-30$371,089
Value of corrective distributions2023-04-30$30,000
Expenses. Administrative service providers (salaries,fees and commissions)2023-04-30$14,868
2022 : SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total plan liabilities at end of year2022-04-30$19,971
Total plan liabilities at beginning of year2022-04-30$27,495
Total income from all sources2022-04-30$415,613
Expenses. Total of all expenses incurred2022-04-30$322,183
Benefits paid (including direct rollovers)2022-04-30$117,243
Total plan assets at end of year2022-04-30$147,465
Total plan assets at beginning of year2022-04-30$61,559
Value of fidelity bond covering the plan2022-04-30$30,000
Total contributions received or receivable from participants2022-04-30$101,315
Expenses. Other expenses not covered elsewhere2022-04-30$189,707
Net income (gross income less expenses)2022-04-30$93,430
Net plan assets at end of year (total assets less liabilities)2022-04-30$127,494
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$34,064
Total contributions received or receivable from employer(s)2022-04-30$314,298
Expenses. Administrative service providers (salaries,fees and commissions)2022-04-30$15,233
2021 : SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2021 401k financial data
Total plan liabilities at end of year2021-04-30$27,495
Total plan liabilities at beginning of year2021-04-30$31,684
Total income from all sources2021-04-30$447,204
Expenses. Total of all expenses incurred2021-04-30$443,054
Benefits paid (including direct rollovers)2021-04-30$225,196
Total plan assets at end of year2021-04-30$61,559
Total plan assets at beginning of year2021-04-30$61,598
Value of fidelity bond covering the plan2021-04-30$30,000
Total contributions received or receivable from participants2021-04-30$94,754
Expenses. Other expenses not covered elsewhere2021-04-30$195,737
Contributions received from other sources (not participants or employers)2021-04-30$0
Other income received2021-04-30$0
Net income (gross income less expenses)2021-04-30$4,150
Net plan assets at end of year (total assets less liabilities)2021-04-30$34,064
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$29,914
Total contributions received or receivable from employer(s)2021-04-30$352,450
Value of corrective distributions2021-04-30$6,503
Expenses. Administrative service providers (salaries,fees and commissions)2021-04-30$15,618
2020 : SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2020 401k financial data
Total plan liabilities at end of year2020-04-30$31,684
Total plan liabilities at beginning of year2020-04-30$12,978
Total income from all sources2020-04-30$405,232
Expenses. Total of all expenses incurred2020-04-30$493,687
Benefits paid (including direct rollovers)2020-04-30$235,608
Total plan assets at end of year2020-04-30$61,598
Total plan assets at beginning of year2020-04-30$131,347
Value of fidelity bond covering the plan2020-04-30$30,000
Total contributions received or receivable from participants2020-04-30$71,954
Expenses. Other expenses not covered elsewhere2020-04-30$166,836
Contributions received from other sources (not participants or employers)2020-04-30$18,709
Other income received2020-04-30$0
Net income (gross income less expenses)2020-04-30$-88,455
Net plan assets at end of year (total assets less liabilities)2020-04-30$29,914
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$118,369
Total contributions received or receivable from employer(s)2020-04-30$314,569
Value of corrective distributions2020-04-30$76,528
Expenses. Administrative service providers (salaries,fees and commissions)2020-04-30$14,715
2018 : SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total plan liabilities at end of year2018-04-30$9,540
Total plan liabilities at beginning of year2018-04-30$12,638
Total income from all sources2018-04-30$323,238
Expenses. Total of all expenses incurred2018-04-30$308,856
Benefits paid (including direct rollovers)2018-04-30$138,479
Total plan assets at end of year2018-04-30$114,749
Total plan assets at beginning of year2018-04-30$103,465
Value of fidelity bond covering the plan2018-04-30$30,000
Total contributions received or receivable from participants2018-04-30$61,941
Expenses. Other expenses not covered elsewhere2018-04-30$126,040
Net income (gross income less expenses)2018-04-30$14,382
Net plan assets at end of year (total assets less liabilities)2018-04-30$105,209
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$90,827
Total contributions received or receivable from employer(s)2018-04-30$261,297
Value of corrective distributions2018-04-30$33,000
Expenses. Administrative service providers (salaries,fees and commissions)2018-04-30$11,337
2017 : SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total plan liabilities at end of year2017-04-30$12,638
Total plan liabilities at beginning of year2017-04-30$10,524
Total income from all sources2017-04-30$265,414
Expenses. Total of all expenses incurred2017-04-30$258,799
Benefits paid (including direct rollovers)2017-04-30$109,289
Total plan assets at end of year2017-04-30$103,465
Total plan assets at beginning of year2017-04-30$94,736
Value of fidelity bond covering the plan2017-04-30$30,000
Total contributions received or receivable from participants2017-04-30$52,297
Expenses. Other expenses not covered elsewhere2017-04-30$100,406
Contributions received from other sources (not participants or employers)2017-04-30$0
Net income (gross income less expenses)2017-04-30$6,615
Net plan assets at end of year (total assets less liabilities)2017-04-30$90,827
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$84,212
Total contributions received or receivable from employer(s)2017-04-30$213,117
Value of corrective distributions2017-04-30$38,399
Expenses. Administrative service providers (salaries,fees and commissions)2017-04-30$10,705
2016 : SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total plan liabilities at end of year2016-04-30$10,524
Total plan liabilities at beginning of year2016-04-30$0
Total income from all sources2016-04-30$273,806
Expenses. Total of all expenses incurred2016-04-30$189,594
Benefits paid (including direct rollovers)2016-04-30$76,286
Total plan assets at end of year2016-04-30$94,736
Total plan assets at beginning of year2016-04-30$0
Value of fidelity bond covering the plan2016-04-30$30,000
Total contributions received or receivable from participants2016-04-30$54,750
Expenses. Other expenses not covered elsewhere2016-04-30$102,548
Contributions received from other sources (not participants or employers)2016-04-30$0
Other income received2016-04-30$104
Net income (gross income less expenses)2016-04-30$84,212
Net plan assets at end of year (total assets less liabilities)2016-04-30$84,212
Net plan assets at beginning of year (total assets less liabilities)2016-04-30$0
Total contributions received or receivable from employer(s)2016-04-30$218,952
Expenses. Administrative service providers (salaries,fees and commissions)2016-04-30$10,760

Form 5500 Responses for SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN

2022: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2016: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – TrustYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement - TrustYes
2015: SPANGLER AND BOYER MECHANICAL EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01First time form 5500 has been submittedYes
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number305500116
Policy instance 1
Insurance contract or identification number305500116
Number of Individuals Covered28
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
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 $200,809
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 number30500116
Policy instance 1
Insurance contract or identification number30500116
Number of Individuals Covered29
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
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 $169,925
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 number30500116
Policy instance 1
Insurance contract or identification number30500116
Number of Individuals Covered32
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
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 $174,831
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 number30500116
Policy instance 1
Insurance contract or identification number30500116
Number of Individuals Covered32
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
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 $147,827
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 numberE706961
Number of Individuals Covered138
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,862
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,290
Insurance broker organization code?3
Welfare Benefit Premiums Paid to CarrierUSD $130,584
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 Covered25
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
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 $110,282
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 Covered20
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $89,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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