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PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 401k Plan overview

Plan NamePERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN
Plan identification number 501

PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN Benefits

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

401k Sponsoring company profile

PERSON DIRECTED SUPPORTS, INC. has sponsored the creation of one or more 401k plans.

Company Name:PERSON DIRECTED SUPPORTS, INC.
Employer identification number (EIN):233039587
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PERSON DIRECTED SUPPORTS, 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
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01SANDRA REGUERA
5012016-01-01SANDRA REGUERA
5012015-01-01SANDRA REGUERA
5012014-01-01TIM MORRIS
5012013-01-01SANDRA M REGUERA
5012012-01-01MEGAN MARTIN
5012011-09-01MEGAN MARTIN

Plan Statistics for PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN

401k plan membership statisitcs for PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN

Measure Date Value
2022: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01203
Total number of active participants reported on line 7a of the Form 55002022-01-01152
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01153
2021: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01162
Total number of active participants reported on line 7a of the Form 55002021-01-01203
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 participants2021-01-01203
2020: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01169
Total number of active participants reported on line 7a of the Form 55002020-01-01162
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01162
2019: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01129
Total number of active participants reported on line 7a of the Form 55002019-01-01169
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 participants2019-01-01169
2018: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01103
Total number of active participants reported on line 7a of the Form 55002018-01-01129
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01129
2017: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0193
Total number of active participants reported on line 7a of the Form 55002017-01-01103
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01103
2016: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0152
Total number of active participants reported on line 7a of the Form 55002016-01-0175
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0175
2015: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0147
Total number of active participants reported on line 7a of the Form 55002015-01-0152
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0152
2014: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0152
Total number of active participants reported on line 7a of the Form 55002014-01-0147
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0147
2013: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0149
Total number of active participants reported on line 7a of the Form 55002013-01-0151
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0152
2012: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0134
Total number of active participants reported on line 7a of the Form 55002012-01-0149
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0149
2011: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-0152
Total number of active participants reported on line 7a of the Form 55002011-09-0134
Number of retired or separated participants receiving benefits2011-09-010
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-0134

Financial Data on PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN

Measure Date Value
2022 : PERSON DIRECTED SUPPORTS, 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$243,653
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$253,495
Total income from all sources (including contributions)2022-12-31$2,104,736
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,183,091
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,370,704
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,104,449
Value of total assets at end of year2022-12-31$104,293
Value of total assets at beginning of year2022-12-31$192,490
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$812,387
Total interest from all sources2022-12-31$287
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$500,000
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$627,334
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$98,056
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$189,600
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$253,495
Administrative expenses (other) incurred2022-12-31$670,337
Liabilities. Value of operating payables at end of year2022-12-31$5,021
Liabilities. Value of operating payables at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-78,355
Value of net assets at end of year (total assets less liabilities)2022-12-31$-139,360
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$-61,005
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
Investment advisory and management fees2022-12-31$36,862
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$6,237
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$192,490
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$192,490
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$287
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$1,370,704
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$1,477,115
Contract administrator fees2022-12-31$105,188
Liabilities. Value of benefit claims payable at end of year2022-12-31$49,032
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$0
Did the plan have assets held for investment2022-12-31Yes
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 name2022-12-31YOUNG OAKES BROWN & CO., PC
Accountancy firm EIN2022-12-31251589048
2021 : PERSON DIRECTED SUPPORTS, 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$253,495
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$106,739
Total income from all sources (including contributions)2021-12-31$2,067,174
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$2,562,171
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,680,682
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,066,081
Value of total assets at end of year2021-12-31$192,490
Value of total assets at beginning of year2021-12-31$540,731
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$881,489
Total interest from all sources2021-12-31$1,093
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$500,000
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$707,059
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$253,495
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$106,739
Administrative expenses (other) incurred2021-12-31$722,182
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-494,997
Value of net assets at end of year (total assets less liabilities)2021-12-31$-61,005
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$433,992
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
Investment advisory and management fees2021-12-31$42,539
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$192,490
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$540,731
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$540,731
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$1,093
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,680,682
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$1,359,022
Contract administrator fees2021-12-31$116,768
Did the plan have assets held for investment2021-12-31Yes
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 name2021-12-31YOUNG OAKES BROWN & CO., PC
Accountancy firm EIN2021-12-31251589048
2020 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$106,739
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$99,368
Total income from all sources (including contributions)2020-12-31$1,698,863
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,669,033
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$967,744
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,697,621
Value of total assets at end of year2020-12-31$540,731
Value of total assets at beginning of year2020-12-31$503,530
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$701,289
Total interest from all sources2020-12-31$1,242
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$577,419
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$106,739
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$99,368
Administrative expenses (other) incurred2020-12-31$571,099
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$29,830
Value of net assets at end of year (total assets less liabilities)2020-12-31$433,992
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$404,162
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$34,449
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$540,731
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$503,530
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$503,530
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$1,242
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$967,744
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,120,202
Contract administrator fees2020-12-31$95,741
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31YOUNG OAKES BROWN & CO., PC
Accountancy firm EIN2020-12-31251589048
2019 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$99,368
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$9,660
Total income from all sources (including contributions)2019-12-31$2,158,294
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,857,214
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,083,007
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,157,264
Value of total assets at end of year2019-12-31$503,530
Value of total assets at beginning of year2019-12-31$112,742
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$774,207
Total interest from all sources2019-12-31$1,030
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$574,870
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$9,680
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$99,368
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Administrative expenses (other) incurred2019-12-31$632,873
Liabilities. Value of operating payables at end of year2019-12-31$0
Liabilities. Value of operating payables at beginning of year2019-12-31$9,660
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$301,080
Value of net assets at end of year (total assets less liabilities)2019-12-31$404,162
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$103,082
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$35,276
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$503,530
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$103,062
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$103,062
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$1,030
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,083,007
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$1,582,394
Contract administrator fees2019-12-31$106,058
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31YOUNG OAKES BROWN & CO., PC
Accountancy firm EIN2019-12-31251589048
2018 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$9,660
Total plan liabilities at beginning of year2018-12-31$16,877
Total income from all sources2018-12-31$1,391,639
Expenses. Total of all expenses incurred2018-12-31$1,407,745
Benefits paid (including direct rollovers)2018-12-31$901,476
Total plan assets at end of year2018-12-31$112,742
Total plan assets at beginning of year2018-12-31$136,065
Value of fidelity bond covering the plan2018-12-31$1,000,000
Total contributions received or receivable from participants2018-12-31$433,291
Expenses. Other expenses not covered elsewhere2018-12-31$399,227
Other income received2018-12-31$306
Net income (gross income less expenses)2018-12-31$-16,106
Net plan assets at end of year (total assets less liabilities)2018-12-31$103,082
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$119,188
Total contributions received or receivable from employer(s)2018-12-31$958,042
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$107,042
2017 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$16,877
Total plan liabilities at beginning of year2017-12-31$75,767
Total income from all sources2017-12-31$1,142,860
Expenses. Total of all expenses incurred2017-12-31$1,176,151
Benefits paid (including direct rollovers)2017-12-31$747,667
Total plan assets at end of year2017-12-31$136,065
Total plan assets at beginning of year2017-12-31$228,246
Value of fidelity bond covering the plan2017-12-31$1,000,000
Total contributions received or receivable from participants2017-12-31$350,549
Expenses. Other expenses not covered elsewhere2017-12-31$328,678
Other income received2017-12-31$408
Net income (gross income less expenses)2017-12-31$-33,291
Net plan assets at end of year (total assets less liabilities)2017-12-31$119,188
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$152,479
Total contributions received or receivable from employer(s)2017-12-31$791,903
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$99,806
2016 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$75,767
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$788,130
Expenses. Total of all expenses incurred2016-12-31$693,012
Benefits paid (including direct rollovers)2016-12-31$445,489
Total plan assets at end of year2016-12-31$228,246
Total plan assets at beginning of year2016-12-31$57,361
Value of fidelity bond covering the plan2016-12-31$1,000,000
Total contributions received or receivable from participants2016-12-31$219,913
Expenses. Other expenses not covered elsewhere2016-12-31$191,032
Other income received2016-12-31$258
Net income (gross income less expenses)2016-12-31$95,118
Net plan assets at end of year (total assets less liabilities)2016-12-31$152,479
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$57,361
Total contributions received or receivable from employer(s)2016-12-31$567,959
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$56,491
2015 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$44,826
Total income from all sources2015-12-31$506,571
Expenses. Total of all expenses incurred2015-12-31$449,210
Benefits paid (including direct rollovers)2015-12-31$274,917
Total plan assets at end of year2015-12-31$57,361
Total plan assets at beginning of year2015-12-31$44,826
Value of fidelity bond covering the plan2015-12-31$1,000,000
Total contributions received or receivable from participants2015-12-31$64,775
Expenses. Other expenses not covered elsewhere2015-12-31$133,685
Other income received2015-12-31$121
Net income (gross income less expenses)2015-12-31$57,361
Net plan assets at end of year (total assets less liabilities)2015-12-31$57,361
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$0
Total contributions received or receivable from employer(s)2015-12-31$441,675
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$40,608
2014 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$44,826
Total income from all sources2014-12-31$500,673
Expenses. Total of all expenses incurred2014-12-31$502,253
Benefits paid (including direct rollovers)2014-12-31$347,573
Total plan assets at end of year2014-12-31$44,826
Total plan assets at beginning of year2014-12-31$1,580
Value of fidelity bond covering the plan2014-12-31$200,000
Total contributions received or receivable from participants2014-12-31$149,486
Expenses. Other expenses not covered elsewhere2014-12-31$110,576
Other income received2014-12-31$20
Net income (gross income less expenses)2014-12-31$-1,580
Net plan assets at end of year (total assets less liabilities)2014-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,580
Total contributions received or receivable from employer(s)2014-12-31$351,167
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$44,104
2013 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2013 401k financial data
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$366,762
Expenses. Total of all expenses incurred2013-12-31$365,182
Benefits paid (including direct rollovers)2013-12-31$232,536
Total plan assets at end of year2013-12-31$1,580
Total plan assets at beginning of year2013-12-31$0
Value of fidelity bond covering the plan2013-12-31$200,000
Total contributions received or receivable from participants2013-12-31$125,626
Expenses. Other expenses not covered elsewhere2013-12-31$85,024
Other income received2013-12-31$16
Net income (gross income less expenses)2013-12-31$1,580
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,580
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$241,120
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$47,622
2012 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$24,112
Total income from all sources2012-12-31$294,327
Expenses. Total of all expenses incurred2012-12-31$314,138
Benefits paid (including direct rollovers)2012-12-31$277,415
Total plan assets at end of year2012-12-31$0
Total plan assets at beginning of year2012-12-31$43,923
Total contributions received or receivable from participants2012-12-31$129,427
Other income received2012-12-31$25
Net income (gross income less expenses)2012-12-31$-19,811
Net plan assets at end of year (total assets less liabilities)2012-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$19,811
Total contributions received or receivable from employer(s)2012-12-31$164,875
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$36,723
2011 : PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$24,112
Total income from all sources2011-12-31$113,384
Expenses. Total of all expenses incurred2011-12-31$93,573
Benefits paid (including direct rollovers)2011-12-31$51,704
Total plan assets at end of year2011-12-31$43,923
Total contributions received or receivable from participants2011-12-31$53,673
Expenses. Other expenses not covered elsewhere2011-12-31$33,936
Other income received2011-12-31$1
Net income (gross income less expenses)2011-12-31$19,811
Net plan assets at end of year (total assets less liabilities)2011-12-31$19,811
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$59,710
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$7,933

Form 5500 Responses for PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN

2022: PERSON DIRECTED SUPPORTS, 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 – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: PERSON DIRECTED SUPPORTS, 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 – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PERSON DIRECTED SUPPORTS, 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 – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: PERSON DIRECTED SUPPORTS, 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: PERSON DIRECTED SUPPORTS, 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: PERSON DIRECTED SUPPORTS, 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: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PERSON DIRECTED SUPPORTS, INC. GROUP HEALTH PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan funding arrangement – TrustYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500413
Policy instance 1
Insurance contract or identification number30500413
Number of Individuals Covered152
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 $670,337
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 number30500413
Policy instance 1
Insurance contract or identification number30500413
Number of Individuals Covered203
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 $722,182
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 number30500413
Policy instance 1
Insurance contract or identification number30500413
Number of Individuals Covered162
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 $571,099
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 number30500413
Policy instance 1
Insurance contract or identification number30500413
Number of Individuals Covered169
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 $629,259
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 numberEAGLE
Policy instance 1
Insurance contract or identification numberEAGLE
Number of Individuals Covered129
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 $399,227
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 numberEAGLE
Policy instance 1
Insurance contract or identification numberEAGLE
Number of Individuals Covered103
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 $328,677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberEAGLE
Policy instance 2
Insurance contract or identification numberEAGLE
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $-1,259
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 numberEAGLE
Policy instance 1
Insurance contract or identification numberEAGLE
Number of Individuals Covered52
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $132,372
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 numberEAGLE
Policy instance 1
Insurance contract or identification numberEAGLE
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $108,946
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 numberEAGLE
Policy instance 1
Insurance contract or identification numberEAGLE
Number of Individuals Covered52
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $85,008
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 numberEAGLE HIT
Policy instance 1
Insurance contract or identification numberEAGLE HIT
Number of Individuals Covered49
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $70,352
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 numberEAGLE HIT
Policy instance 1
Insurance contract or identification numberEAGLE HIT
Number of Individuals Covered34
Insurance policy start date2011-09-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $27,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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