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BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 401k Plan overview

Plan NameBUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN
Plan identification number 501

BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN Benefits

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

401k Sponsoring company profile

BUSINESS INFORMATION GROUP INC. has sponsored the creation of one or more 401k plans.

Company Name:BUSINESS INFORMATION GROUP INC.
Employer identification number (EIN):232672440
NAIC Classification:541519
NAIC Description:Other Computer Related Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-12-01
5012018-12-01
5012017-12-01
5012016-12-01WILLIAM LUDWIG
5012015-12-01WILLIAM LUDWIG
5012014-12-01WILLIAM LUDWIG

Plan Statistics for BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN

Measure Date Value
2022: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0182
Total number of active participants reported on line 7a of the Form 55002022-01-0182
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0120
Total of all active and inactive participants2022-01-01102
2021: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0184
Total number of active participants reported on line 7a of the Form 55002021-01-0182
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0182
2020: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0196
Total number of active participants reported on line 7a of the Form 55002020-01-0182
Number of retired or separated participants receiving benefits2020-01-012
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0184
2019: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-0186
Total number of active participants reported on line 7a of the Form 55002019-12-0196
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-0196
2018: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-0175
Total number of active participants reported on line 7a of the Form 55002018-12-0183
Number of retired or separated participants receiving benefits2018-12-013
Number of other retired or separated participants entitled to future benefits2018-12-010
Total of all active and inactive participants2018-12-0186
2017: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-0170
Total number of active participants reported on line 7a of the Form 55002017-12-0174
Number of retired or separated participants receiving benefits2017-12-011
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-0175
2016: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-0157
Total number of active participants reported on line 7a of the Form 55002016-12-0169
Number of retired or separated participants receiving benefits2016-12-011
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-0170
2015: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-0153
Total number of active participants reported on line 7a of the Form 55002015-12-0157
Number of retired or separated participants receiving benefits2015-12-010
Number of other retired or separated participants entitled to future benefits2015-12-010
Total of all active and inactive participants2015-12-0157
2014: BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-12-0144
Total number of active participants reported on line 7a of the Form 55002014-12-0153
Number of retired or separated participants receiving benefits2014-12-010
Number of other retired or separated participants entitled to future benefits2014-12-010
Total of all active and inactive participants2014-12-0153

Financial Data on BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN

Measure Date Value
2022 : BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$138,937
Total income from all sources2022-12-31$634,727
Expenses. Total of all expenses incurred2022-12-31$754,804
Benefits paid (including direct rollovers)2022-12-31$292,106
Total plan assets at end of year2022-12-31$0
Total plan assets at beginning of year2022-12-31$259,014
Value of fidelity bond covering the plan2022-12-31$1,000,000
Total contributions received or receivable from participants2022-12-31$0
Expenses. Other expenses not covered elsewhere2022-12-31$177,571
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$76
Net income (gross income less expenses)2022-12-31$-120,077
Net plan assets at end of year (total assets less liabilities)2022-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$120,077
Total contributions received or receivable from employer(s)2022-12-31$634,651
Value of corrective distributions2022-12-31$277,370
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$7,757
2021 : BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$138,937
Total plan liabilities at beginning of year2021-12-31$150,118
Total income from all sources2021-12-31$1,356,972
Expenses. Total of all expenses incurred2021-12-31$1,236,895
Benefits paid (including direct rollovers)2021-12-31$827,721
Total plan assets at end of year2021-12-31$259,014
Total plan assets at beginning of year2021-12-31$150,118
Value of fidelity bond covering the plan2021-12-31$1,000,000
Total contributions received or receivable from participants2021-12-31$347,380
Expenses. Other expenses not covered elsewhere2021-12-31$339,705
Other income received2021-12-31$81
Net income (gross income less expenses)2021-12-31$120,077
Net plan assets at end of year (total assets less liabilities)2021-12-31$120,077
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$0
Total contributions received or receivable from employer(s)2021-12-31$1,009,511
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$69,469
2020 : BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$150,118
Total plan liabilities at beginning of year2020-12-31$4,561
Total income from all sources2020-12-31$1,068,155
Expenses. Total of all expenses incurred2020-12-31$1,154,249
Benefits paid (including direct rollovers)2020-12-31$782,227
Total plan assets at end of year2020-12-31$150,118
Total plan assets at beginning of year2020-12-31$90,655
Value of fidelity bond covering the plan2020-12-31$1,000,000
Total contributions received or receivable from participants2020-12-31$321,402
Expenses. Other expenses not covered elsewhere2020-12-31$298,896
Other income received2020-12-31$135
Net income (gross income less expenses)2020-12-31$-86,094
Net plan assets at end of year (total assets less liabilities)2020-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$86,094
Total contributions received or receivable from employer(s)2020-12-31$746,618
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$73,126
2019 : BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$4,561
Total plan liabilities at beginning of year2019-12-31$19,974
Total income from all sources2019-12-31$34,327
Expenses. Total of all expenses incurred2019-12-31$73,935
Benefits paid (including direct rollovers)2019-12-31$39,641
Total plan assets at end of year2019-12-31$90,655
Total plan assets at beginning of year2019-12-31$145,676
Value of fidelity bond covering the plan2019-12-31$1,000,000
Total contributions received or receivable from participants2019-12-31$18,657
Expenses. Other expenses not covered elsewhere2019-12-31$26,891
Other income received2019-12-31$33
Net income (gross income less expenses)2019-12-31$-39,608
Net plan assets at end of year (total assets less liabilities)2019-12-31$86,094
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$125,702
Total contributions received or receivable from employer(s)2019-12-31$15,637
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$7,403
Total plan liabilities at end of year2019-11-30$19,974
Total plan liabilities at beginning of year2019-11-30$42,134
Total income from all sources2019-11-30$939,742
Expenses. Total of all expenses incurred2019-11-30$1,077,248
Benefits paid (including direct rollovers)2019-11-30$731,767
Total plan assets at end of year2019-11-30$145,676
Total plan assets at beginning of year2019-11-30$305,342
Value of fidelity bond covering the plan2019-11-30$1,000,000
Total contributions received or receivable from participants2019-11-30$317,969
Expenses. Other expenses not covered elsewhere2019-11-30$265,391
Other income received2019-11-30$669
Net income (gross income less expenses)2019-11-30$-137,506
Net plan assets at end of year (total assets less liabilities)2019-11-30$125,702
Net plan assets at beginning of year (total assets less liabilities)2019-11-30$263,208
Total contributions received or receivable from employer(s)2019-11-30$621,104
Expenses. Administrative service providers (salaries,fees and commissions)2019-11-30$80,090
2017 : BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2017 401k financial data
Total plan liabilities at end of year2017-11-30$4,550
Total plan liabilities at beginning of year2017-11-30$0
Total income from all sources2017-11-30$884,505
Expenses. Total of all expenses incurred2017-11-30$741,344
Benefits paid (including direct rollovers)2017-11-30$503,362
Total plan assets at end of year2017-11-30$214,355
Total plan assets at beginning of year2017-11-30$66,644
Value of fidelity bond covering the plan2017-11-30$1,000,000
Total contributions received or receivable from participants2017-11-30$338,310
Expenses. Other expenses not covered elsewhere2017-11-30$168,692
Other income received2017-11-30$373
Net income (gross income less expenses)2017-11-30$143,161
Net plan assets at end of year (total assets less liabilities)2017-11-30$209,805
Net plan assets at beginning of year (total assets less liabilities)2017-11-30$66,644
Total contributions received or receivable from employer(s)2017-11-30$545,822
Expenses. Administrative service providers (salaries,fees and commissions)2017-11-30$69,290
2016 : BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2016 401k financial data
Total plan liabilities at end of year2016-11-30$0
Total plan liabilities at beginning of year2016-11-30$6,427
Total income from all sources2016-11-30$741,949
Expenses. Total of all expenses incurred2016-11-30$685,814
Benefits paid (including direct rollovers)2016-11-30$494,730
Total plan assets at end of year2016-11-30$66,644
Total plan assets at beginning of year2016-11-30$16,936
Value of fidelity bond covering the plan2016-11-30$2,000,000
Total contributions received or receivable from participants2016-11-30$266,275
Expenses. Other expenses not covered elsewhere2016-11-30$138,998
Other income received2016-11-30$181
Net income (gross income less expenses)2016-11-30$56,135
Net plan assets at end of year (total assets less liabilities)2016-11-30$66,644
Net plan assets at beginning of year (total assets less liabilities)2016-11-30$10,509
Total contributions received or receivable from employer(s)2016-11-30$475,493
Expenses. Administrative service providers (salaries,fees and commissions)2016-11-30$52,086
2015 : BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN 2015 401k financial data
Total plan liabilities at end of year2015-11-30$6,427
Total income from all sources2015-11-30$614,582
Expenses. Total of all expenses incurred2015-11-30$604,073
Benefits paid (including direct rollovers)2015-11-30$446,490
Total plan assets at end of year2015-11-30$16,936
Total plan assets at beginning of year2015-11-30$0
Value of fidelity bond covering the plan2015-11-30$2,000,000
Total contributions received or receivable from participants2015-11-30$151,061
Expenses. Other expenses not covered elsewhere2015-11-30$113,740
Other income received2015-11-30$26
Net income (gross income less expenses)2015-11-30$10,509
Net plan assets at end of year (total assets less liabilities)2015-11-30$10,509
Net plan assets at beginning of year (total assets less liabilities)2015-11-30$0
Total contributions received or receivable from employer(s)2015-11-30$463,495
Expenses. Administrative service providers (salaries,fees and commissions)2015-11-30$43,843

Form 5500 Responses for BUSINESS INFORMATION GROUP INC. EMPLOYEE HEALTH PLAN

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

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberSL30800013
Policy instance 1
Insurance contract or identification numberSL30800013
Number of Individuals Covered82
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 $413,868
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 numberSL30800013
Policy instance 1
Insurance contract or identification numberSL30800013
Number of Individuals Covered82
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 $339,705
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 numberSL30800013
Policy instance 1
Insurance contract or identification numberSL30800013
Number of Individuals Covered82
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 $283,938
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 numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered96
Insurance policy start date2019-12-01
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 $26,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered83
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
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 $265,391
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 numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered74
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
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 $210,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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