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VOLUNTARY EMPLOYEES BENEFICIARY TR 401k Plan overview

Plan NameVOLUNTARY EMPLOYEES BENEFICIARY TR
Plan identification number 505

VOLUNTARY EMPLOYEES BENEFICIARY TR Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

HSTA VOLUNTARY EMPLOYEES' BENEFICIARY TRUST has sponsored the creation of one or more 401k plans.

Company Name:HSTA VOLUNTARY EMPLOYEES' BENEFICIARY TRUST
Employer identification number (EIN):237296050
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VOLUNTARY EMPLOYEES BENEFICIARY TR

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052021-09-01
5052020-09-01
5052019-09-01AMBER RIEL2021-05-25
5052019-09-01ROGER TAKABAYASHI2022-02-22
5052018-09-01ROGER TAKABAYASHI2020-07-01
5052017-09-01ROGER TAKABAYASHI2019-05-02
5052016-09-01
5052016-09-01ROGER TAKABAYASHI2018-06-14

Plan Statistics for VOLUNTARY EMPLOYEES BENEFICIARY TR

401k plan membership statisitcs for VOLUNTARY EMPLOYEES BENEFICIARY TR

Measure Date Value
2021: VOLUNTARY EMPLOYEES BENEFICIARY TR 2021 401k membership
Total participants, beginning-of-year2021-09-018,183
Total number of active participants reported on line 7a of the Form 55002021-09-013,609
Number of retired or separated participants receiving benefits2021-09-014,384
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-017,993
Total participants2021-09-017,993
2020: VOLUNTARY EMPLOYEES BENEFICIARY TR 2020 401k membership
Total participants, beginning-of-year2020-09-018,255
Total number of active participants reported on line 7a of the Form 55002020-09-013,876
Number of retired or separated participants receiving benefits2020-09-014,307
Total of all active and inactive participants2020-09-018,183
Total participants2020-09-018,183
2019: VOLUNTARY EMPLOYEES BENEFICIARY TR 2019 401k membership
Total participants, beginning-of-year2019-09-018,373
Total number of active participants reported on line 7a of the Form 55002019-09-014,057
Number of retired or separated participants receiving benefits2019-09-014,198
Total of all active and inactive participants2019-09-018,255
2018: VOLUNTARY EMPLOYEES BENEFICIARY TR 2018 401k membership
Total participants, beginning-of-year2018-09-018,429
Total number of active participants reported on line 7a of the Form 55002018-09-014,231
Number of retired or separated participants receiving benefits2018-09-014,142
Total of all active and inactive participants2018-09-018,373
2017: VOLUNTARY EMPLOYEES BENEFICIARY TR 2017 401k membership
Total participants, beginning-of-year2017-09-018,377
Total number of active participants reported on line 7a of the Form 55002017-09-014,320
Number of retired or separated participants receiving benefits2017-09-014,109
Total of all active and inactive participants2017-09-018,429
2016: VOLUNTARY EMPLOYEES BENEFICIARY TR 2016 401k membership
Total participants, beginning-of-year2016-09-018,518
Total number of active participants reported on line 7a of the Form 55002016-09-014,373
Number of retired or separated participants receiving benefits2016-09-014,004
Total of all active and inactive participants2016-09-018,377

Financial Data on VOLUNTARY EMPLOYEES BENEFICIARY TR

Measure Date Value
2022 : VOLUNTARY EMPLOYEES BENEFICIARY TR 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-08-31$-1,870,993
Total unrealized appreciation/depreciation of assets2022-08-31$-1,870,993
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-08-31$473,482
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-08-31$511,008
Total income from all sources (including contributions)2022-08-31$2,727,949
Total loss/gain on sale of assets2022-08-31$-348,872
Total of all expenses incurred2022-08-31$6,357,054
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-08-31$5,508,319
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-08-31$5,219,046
Value of total assets at end of year2022-08-31$23,380,215
Value of total assets at beginning of year2022-08-31$27,046,846
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-08-31$848,735
Total interest from all sources2022-08-31$61,069
Total dividends received (eg from common stock, registered investment company shares)2022-08-31$644,633
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-08-31$558,191
Administrative expenses professional fees incurred2022-08-31$114,959
Was this plan covered by a fidelity bond2022-08-31Yes
Value of fidelity bond cover2022-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-08-31No
Contributions received from participants2022-08-31$5,219,046
Participant contributions at end of year2022-08-31$368,200
Participant contributions at beginning of year2022-08-31$442,718
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-08-31$2,128,638
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-08-31$1,770,501
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-08-31$470,897
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-08-31$487,208
Other income not declared elsewhere2022-08-31$47,360
Administrative expenses (other) incurred2022-08-31$173,432
Liabilities. Value of operating payables at end of year2022-08-31$2,585
Liabilities. Value of operating payables at beginning of year2022-08-31$23,800
Total non interest bearing cash at end of year2022-08-31$252,675
Total non interest bearing cash at beginning of year2022-08-31$161,347
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-08-31No
Value of net income/loss2022-08-31$-3,629,105
Value of net assets at end of year (total assets less liabilities)2022-08-31$22,906,733
Value of net assets at beginning of year (total assets less liabilities)2022-08-31$26,535,838
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-08-31No
Were any leases to which the plan was party in default or uncollectible2022-08-31No
Investment advisory and management fees2022-08-31$86,522
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-08-31$13,613,577
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-08-31$16,364,525
Income. Interest from US Government securities2022-08-31$14,388
Income. Interest from corporate debt instruments2022-08-31$46,661
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-08-31$260,167
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-08-31$214,791
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-08-31$214,791
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-08-31$20
Expenses. Payments to insurance carriers foe the provision of benefits2022-08-31$5,508,319
Asset value of US Government securities at end of year2022-08-31$1,441,330
Asset value of US Government securities at beginning of year2022-08-31$1,204,970
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-08-31$-1,024,294
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-08-31No
Was there a failure to transmit to the plan any participant contributions2022-08-31No
Has the plan failed to provide any benefit when due under the plan2022-08-31No
Income. Dividends from common stock2022-08-31$86,442
Asset. Corporate debt instrument preferred debt at end of year2022-08-31$1,430,287
Asset. Corporate debt instrument preferred debt at beginning of year2022-08-31$1,917,044
Contract administrator fees2022-08-31$473,822
Assets. Corporate common stocks other than exployer securities at end of year2022-08-31$3,885,341
Assets. Corporate common stocks other than exployer securities at beginning of year2022-08-31$4,970,950
Did the plan have assets held for investment2022-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-08-31No
Aggregate proceeds on sale of assets2022-08-31$3,483,804
Aggregate carrying amount (costs) on sale of assets2022-08-31$3,832,676
Opinion of an independent qualified public accountant for this plan2022-08-31Unqualified
Accountancy firm name2022-08-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2022-08-31952036255
2021 : VOLUNTARY EMPLOYEES BENEFICIARY TR 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-08-31$1,582,962
Total unrealized appreciation/depreciation of assets2021-08-31$1,582,962
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-08-31$511,008
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-08-31$459,611
Total income from all sources (including contributions)2021-08-31$9,434,291
Total loss/gain on sale of assets2021-08-31$197,901
Total of all expenses incurred2021-08-31$5,847,602
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-08-31$5,059,015
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-08-31$5,014,464
Value of total assets at end of year2021-08-31$27,046,846
Value of total assets at beginning of year2021-08-31$23,408,760
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-08-31$788,587
Total interest from all sources2021-08-31$72,404
Total dividends received (eg from common stock, registered investment company shares)2021-08-31$495,881
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-08-31$408,605
Administrative expenses professional fees incurred2021-08-31$124,847
Was this plan covered by a fidelity bond2021-08-31Yes
Value of fidelity bond cover2021-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-08-31No
Contributions received from participants2021-08-31$5,014,464
Participant contributions at end of year2021-08-31$442,718
Participant contributions at beginning of year2021-08-31$259,894
Assets. Other investments not covered elsewhere at end of year2021-08-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-08-31$5,522,237
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-08-31$1,770,501
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-08-31$1,473,288
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-08-31$487,208
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-08-31$433,611
Other income not declared elsewhere2021-08-31$43,891
Administrative expenses (other) incurred2021-08-31$118,684
Liabilities. Value of operating payables at end of year2021-08-31$23,800
Liabilities. Value of operating payables at beginning of year2021-08-31$26,000
Total non interest bearing cash at end of year2021-08-31$161,347
Total non interest bearing cash at beginning of year2021-08-31$83,321
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-08-31No
Value of net income/loss2021-08-31$3,586,689
Value of net assets at end of year (total assets less liabilities)2021-08-31$26,535,838
Value of net assets at beginning of year (total assets less liabilities)2021-08-31$22,949,149
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-08-31No
Were any leases to which the plan was party in default or uncollectible2021-08-31No
Investment advisory and management fees2021-08-31$84,810
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-08-31$16,364,525
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-08-31$7,781,949
Income. Interest from US Government securities2021-08-31$11,820
Income. Interest from corporate debt instruments2021-08-31$60,546
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-08-31$214,791
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-08-31$592,861
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-08-31$592,861
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-08-31$38
Expenses. Payments to insurance carriers foe the provision of benefits2021-08-31$5,059,015
Asset value of US Government securities at end of year2021-08-31$1,204,970
Asset value of US Government securities at beginning of year2021-08-31$739,785
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-08-31$2,026,788
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-08-31Yes
Was there a failure to transmit to the plan any participant contributions2021-08-31No
Has the plan failed to provide any benefit when due under the plan2021-08-31No
Income. Dividends from common stock2021-08-31$87,276
Asset. Corporate debt instrument preferred debt at end of year2021-08-31$1,917,044
Asset. Corporate debt instrument preferred debt at beginning of year2021-08-31$2,371,746
Contract administrator fees2021-08-31$460,246
Assets. Corporate common stocks other than exployer securities at end of year2021-08-31$4,970,950
Assets. Corporate common stocks other than exployer securities at beginning of year2021-08-31$4,583,679
Did the plan have assets held for investment2021-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-08-31No
Aggregate proceeds on sale of assets2021-08-31$5,337,703
Aggregate carrying amount (costs) on sale of assets2021-08-31$5,139,802
Opinion of an independent qualified public accountant for this plan2021-08-31Unqualified
Accountancy firm name2021-08-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2021-08-31952036255
2020 : VOLUNTARY EMPLOYEES BENEFICIARY TR 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-08-31$2,789,374
Total unrealized appreciation/depreciation of assets2020-08-31$2,789,374
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-08-31$459,611
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-08-31$388,329
Total income from all sources (including contributions)2020-08-31$5,952,399
Total of all expenses incurred2020-08-31$5,620,370
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-08-31$4,770,193
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-08-31$4,291,960
Value of total assets at end of year2020-08-31$23,408,760
Value of total assets at beginning of year2020-08-31$23,005,449
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-08-31$850,177
Total interest from all sources2020-08-31$145,731
Total dividends received (eg from common stock, registered investment company shares)2020-08-31$487,755
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-08-31$389,254
Administrative expenses professional fees incurred2020-08-31$138,201
Was this plan covered by a fidelity bond2020-08-31Yes
Value of fidelity bond cover2020-08-31$2,181,396
If this is an individual account plan, was there a blackout period2020-08-31No
Were there any nonexempt tranactions with any party-in-interest2020-08-31No
Contributions received from participants2020-08-31$4,291,960
Participant contributions at end of year2020-08-31$259,894
Participant contributions at beginning of year2020-08-31$227,097
Assets. Other investments not covered elsewhere at end of year2020-08-31$5,522,237
Assets. Other investments not covered elsewhere at beginning of year2020-08-31$1,586,541
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-08-31$1,473,288
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-08-31$2,228,062
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-08-31$433,611
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-08-31$385,880
Other income not declared elsewhere2020-08-31$278,245
Administrative expenses (other) incurred2020-08-31$179,241
Liabilities. Value of operating payables at end of year2020-08-31$26,000
Liabilities. Value of operating payables at beginning of year2020-08-31$2,449
Total non interest bearing cash at end of year2020-08-31$83,321
Total non interest bearing cash at beginning of year2020-08-31$157,049
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-08-31No
Value of net income/loss2020-08-31$332,029
Value of net assets at end of year (total assets less liabilities)2020-08-31$22,949,149
Value of net assets at beginning of year (total assets less liabilities)2020-08-31$22,617,120
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-08-31No
Were any leases to which the plan was party in default or uncollectible2020-08-31No
Investment advisory and management fees2020-08-31$83,085
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-08-31$7,781,949
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-08-31$10,552,549
Interest earned on other investments2020-08-31$56,835
Income. Interest from US Government securities2020-08-31$12,549
Income. Interest from corporate debt instruments2020-08-31$75,459
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-08-31$592,861
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-08-31$478,119
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-08-31$478,119
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-08-31$888
Expenses. Payments to insurance carriers foe the provision of benefits2020-08-31$4,770,193
Asset value of US Government securities at end of year2020-08-31$739,785
Asset value of US Government securities at beginning of year2020-08-31$450,469
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-08-31$-2,040,666
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-08-31Yes
Was there a failure to transmit to the plan any participant contributions2020-08-31No
Has the plan failed to provide any benefit when due under the plan2020-08-31No
Income. Dividends from common stock2020-08-31$98,501
Asset. Corporate debt instrument preferred debt at end of year2020-08-31$2,371,746
Asset. Corporate debt instrument preferred debt at beginning of year2020-08-31$2,503,376
Contract administrator fees2020-08-31$449,650
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-08-31No
Assets. Corporate common stocks other than exployer securities at end of year2020-08-31$4,583,679
Assets. Corporate common stocks other than exployer securities at beginning of year2020-08-31$4,822,187
Did the plan have assets held for investment2020-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-08-31No
Opinion of an independent qualified public accountant for this plan2020-08-31Unqualified
Accountancy firm name2020-08-31EIDE BAILLY LLP
Accountancy firm EIN2020-08-31450250958
2019 : VOLUNTARY EMPLOYEES BENEFICIARY TR 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-08-31$783,236
Total unrealized appreciation/depreciation of assets2019-08-31$783,236
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-08-31$388,329
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-08-31$362,381
Total income from all sources (including contributions)2019-08-31$4,819,545
Total of all expenses incurred2019-08-31$5,051,316
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-08-31$4,192,527
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-08-31$3,668,137
Value of total assets at end of year2019-08-31$23,005,449
Value of total assets at beginning of year2019-08-31$23,211,272
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-08-31$858,789
Total interest from all sources2019-08-31$121,249
Total dividends received (eg from common stock, registered investment company shares)2019-08-31$419,024
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-08-31$316,336
Administrative expenses professional fees incurred2019-08-31$157,947
Was this plan covered by a fidelity bond2019-08-31Yes
Value of fidelity bond cover2019-08-31$2,181,396
If this is an individual account plan, was there a blackout period2019-08-31No
Were there any nonexempt tranactions with any party-in-interest2019-08-31No
Contributions received from participants2019-08-31$3,668,137
Participant contributions at end of year2019-08-31$227,097
Participant contributions at beginning of year2019-08-31$240,151
Assets. Other investments not covered elsewhere at end of year2019-08-31$1,586,541
Assets. Other investments not covered elsewhere at beginning of year2019-08-31$1,120,621
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-08-31$2,228,062
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-08-31$2,098,151
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-08-31$385,880
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-08-31$359,904
Other income not declared elsewhere2019-08-31$520,711
Administrative expenses (other) incurred2019-08-31$171,457
Liabilities. Value of operating payables at end of year2019-08-31$2,449
Liabilities. Value of operating payables at beginning of year2019-08-31$2,477
Total non interest bearing cash at end of year2019-08-31$157,049
Total non interest bearing cash at beginning of year2019-08-31$119,862
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-08-31No
Value of net income/loss2019-08-31$-231,771
Value of net assets at end of year (total assets less liabilities)2019-08-31$22,617,120
Value of net assets at beginning of year (total assets less liabilities)2019-08-31$22,848,891
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-08-31No
Were any leases to which the plan was party in default or uncollectible2019-08-31No
Investment advisory and management fees2019-08-31$90,565
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-08-31$10,552,549
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-08-31$11,372,107
Interest earned on other investments2019-08-31$29,419
Income. Interest from US Government securities2019-08-31$8,811
Income. Interest from corporate debt instruments2019-08-31$80,633
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-08-31$478,119
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-08-31$306,154
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-08-31$306,154
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-08-31$2,386
Expenses. Payments to insurance carriers foe the provision of benefits2019-08-31$4,192,527
Asset value of US Government securities at end of year2019-08-31$450,469
Asset value of US Government securities at beginning of year2019-08-31$612,205
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-08-31$-692,812
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-08-31Yes
Was there a failure to transmit to the plan any participant contributions2019-08-31No
Has the plan failed to provide any benefit when due under the plan2019-08-31No
Income. Dividends from common stock2019-08-31$102,688
Asset. Corporate debt instrument preferred debt at end of year2019-08-31$2,503,376
Asset. Corporate debt instrument preferred debt at beginning of year2019-08-31$2,654,753
Contract administrator fees2019-08-31$438,820
Assets. Corporate common stocks other than exployer securities at end of year2019-08-31$4,822,187
Assets. Corporate common stocks other than exployer securities at beginning of year2019-08-31$4,687,268
Did the plan have assets held for investment2019-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-08-31No
Opinion of an independent qualified public accountant for this plan2019-08-31Unqualified
Accountancy firm name2019-08-31EIDE BAILLY LLP
Accountancy firm EIN2019-08-31450250958
2018 : VOLUNTARY EMPLOYEES BENEFICIARY TR 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-08-31$820,263
Total unrealized appreciation/depreciation of assets2018-08-31$820,263
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-08-31$362,381
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-08-31$368,785
Total income from all sources (including contributions)2018-08-31$5,082,086
Total of all expenses incurred2018-08-31$4,870,677
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-08-31$4,011,043
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-08-31$3,541,371
Value of total assets at end of year2018-08-31$23,211,272
Value of total assets at beginning of year2018-08-31$23,006,267
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-08-31$859,634
Total interest from all sources2018-08-31$116,861
Total dividends received (eg from common stock, registered investment company shares)2018-08-31$385,013
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-08-31$280,450
Administrative expenses professional fees incurred2018-08-31$153,710
Was this plan covered by a fidelity bond2018-08-31Yes
Value of fidelity bond cover2018-08-31$2,181,396
If this is an individual account plan, was there a blackout period2018-08-31No
Were there any nonexempt tranactions with any party-in-interest2018-08-31No
Contributions received from participants2018-08-31$3,541,371
Participant contributions at end of year2018-08-31$240,151
Participant contributions at beginning of year2018-08-31$239,031
Assets. Other investments not covered elsewhere at end of year2018-08-31$1,120,621
Assets. Other investments not covered elsewhere at beginning of year2018-08-31$915,713
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-08-31$2,098,151
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-08-31$1,745,077
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-08-31$359,904
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-08-31$366,361
Other income not declared elsewhere2018-08-31$388,405
Administrative expenses (other) incurred2018-08-31$186,241
Liabilities. Value of operating payables at end of year2018-08-31$2,477
Liabilities. Value of operating payables at beginning of year2018-08-31$2,424
Total non interest bearing cash at end of year2018-08-31$119,862
Total non interest bearing cash at beginning of year2018-08-31$124,611
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-08-31No
Value of net income/loss2018-08-31$211,409
Value of net assets at end of year (total assets less liabilities)2018-08-31$22,848,891
Value of net assets at beginning of year (total assets less liabilities)2018-08-31$22,637,482
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-08-31No
Were any leases to which the plan was party in default or uncollectible2018-08-31No
Investment advisory and management fees2018-08-31$86,050
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-08-31$11,372,107
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-08-31$11,818,237
Interest earned on other investments2018-08-31$18,235
Income. Interest from US Government securities2018-08-31$12,383
Income. Interest from corporate debt instruments2018-08-31$84,749
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-08-31$306,154
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-08-31$453,617
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-08-31$453,617
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-08-31$1,494
Expenses. Payments to insurance carriers foe the provision of benefits2018-08-31$4,011,043
Asset value of US Government securities at end of year2018-08-31$612,205
Asset value of US Government securities at beginning of year2018-08-31$633,382
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-08-31$-169,827
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-08-31Yes
Was there a failure to transmit to the plan any participant contributions2018-08-31No
Has the plan failed to provide any benefit when due under the plan2018-08-31No
Income. Dividends from common stock2018-08-31$104,563
Asset. Corporate debt instrument preferred debt at end of year2018-08-31$2,654,753
Asset. Corporate debt instrument preferred debt at beginning of year2018-08-31$2,739,695
Contract administrator fees2018-08-31$433,633
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-08-31No
Assets. Corporate common stocks other than exployer securities at end of year2018-08-31$4,687,268
Assets. Corporate common stocks other than exployer securities at beginning of year2018-08-31$4,336,904
Did the plan have assets held for investment2018-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-08-31No
Opinion of an independent qualified public accountant for this plan2018-08-31Unqualified
Accountancy firm name2018-08-31VAVRINEK, TRINE, DAY & CO., LLP
Accountancy firm EIN2018-08-31952648289
2017 : VOLUNTARY EMPLOYEES BENEFICIARY TR 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-08-31$543,654
Total unrealized appreciation/depreciation of assets2017-08-31$543,654
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-08-31$368,785
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-08-31$370,632
Total income from all sources (including contributions)2017-08-31$5,592,921
Total of all expenses incurred2017-08-31$4,769,405
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-08-31$3,950,246
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-08-31$3,489,223
Value of total assets at end of year2017-08-31$23,006,267
Value of total assets at beginning of year2017-08-31$22,184,598
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-08-31$819,159
Total interest from all sources2017-08-31$107,788
Total dividends received (eg from common stock, registered investment company shares)2017-08-31$385,920
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-08-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-08-31$243,625
Administrative expenses professional fees incurred2017-08-31$141,950
Was this plan covered by a fidelity bond2017-08-31Yes
Value of fidelity bond cover2017-08-31$2,221,149
If this is an individual account plan, was there a blackout period2017-08-31No
Were there any nonexempt tranactions with any party-in-interest2017-08-31No
Contributions received from participants2017-08-31$3,489,223
Participant contributions at end of year2017-08-31$239,031
Participant contributions at beginning of year2017-08-31$229,284
Assets. Other investments not covered elsewhere at end of year2017-08-31$915,713
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-08-31$1,745,077
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-08-31$1,404,849
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-08-31$366,361
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-08-31$367,939
Other income not declared elsewhere2017-08-31$433,829
Administrative expenses (other) incurred2017-08-31$142,711
Liabilities. Value of operating payables at end of year2017-08-31$2,424
Liabilities. Value of operating payables at beginning of year2017-08-31$2,693
Total non interest bearing cash at end of year2017-08-31$124,611
Total non interest bearing cash at beginning of year2017-08-31$55,540
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-08-31No
Value of net income/loss2017-08-31$823,516
Value of net assets at end of year (total assets less liabilities)2017-08-31$22,637,482
Value of net assets at beginning of year (total assets less liabilities)2017-08-31$21,813,966
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-08-31No
Were any leases to which the plan was party in default or uncollectible2017-08-31No
Investment advisory and management fees2017-08-31$107,273
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-08-31$11,818,237
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-08-31$9,045,423
Interest earned on other investments2017-08-31$13,117
Income. Interest from US Government securities2017-08-31$11,195
Income. Interest from corporate debt instruments2017-08-31$83,096
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-08-31$453,617
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-08-31$428,910
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-08-31$428,910
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-08-31$380
Expenses. Payments to insurance carriers foe the provision of benefits2017-08-31$3,950,246
Asset value of US Government securities at end of year2017-08-31$633,382
Asset value of US Government securities at beginning of year2017-08-31$511,012
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-08-31$632,507
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-08-31Yes
Was there a failure to transmit to the plan any participant contributions2017-08-31No
Has the plan failed to provide any benefit when due under the plan2017-08-31No
Income. Dividends from common stock2017-08-31$142,295
Asset. Corporate debt instrument preferred debt at end of year2017-08-31$2,739,695
Asset. Corporate debt instrument preferred debt at beginning of year2017-08-31$2,785,700
Contract administrator fees2017-08-31$427,225
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-08-31No
Assets. Corporate common stocks other than exployer securities at end of year2017-08-31$4,336,904
Assets. Corporate common stocks other than exployer securities at beginning of year2017-08-31$7,723,880
Did the plan have assets held for investment2017-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-08-31No
Opinion of an independent qualified public accountant for this plan2017-08-31Unqualified
Accountancy firm name2017-08-31VAVRINEK, TRINE, DAY & CO., LLP
Accountancy firm EIN2017-08-31952648289

Form 5500 Responses for VOLUNTARY EMPLOYEES BENEFICIARY TR

2021: VOLUNTARY EMPLOYEES BENEFICIARY TR 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: VOLUNTARY EMPLOYEES BENEFICIARY TR 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: VOLUNTARY EMPLOYEES BENEFICIARY TR 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedYes
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: VOLUNTARY EMPLOYEES BENEFICIARY TR 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: VOLUNTARY EMPLOYEES BENEFICIARY TR 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: VOLUNTARY EMPLOYEES BENEFICIARY TR 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedYes
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0776732
Policy instance 6
Insurance contract or identification numberR0776732
Number of Individuals Covered259
Insurance policy start date2021-01-01
Insurance policy end date2022-12-31
Other welfare benefits providedACCIDENTAL INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $47,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0154147
Policy instance 5
Insurance contract or identification number0154147
Number of Individuals Covered615
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $392,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number89513
Policy instance 4
Insurance contract or identification number89513
Number of Individuals Covered328
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number41000
Policy instance 3
Insurance contract or identification number41000
Number of Individuals Covered8081
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Life Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number204902G
Policy instance 2
Insurance contract or identification number204902G
Number of Individuals Covered511
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $142,171
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number536134
Policy instance 1
Insurance contract or identification number536134
Number of Individuals Covered7803
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $226,159
Total amount of fees paid to insurance companyUSD $45,232
Other welfare benefits providedGROUP: LONG TERM CARE, INVID. LTC
Welfare Benefit Premiums Paid to CarrierUSD $4,462,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $226,159
Insurance broker organization code?3
Amount paid for insurance broker fees45232
Additional information about fees paid to insurance brokerADMINISTRATION FEES
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number536134
Policy instance 1
Insurance contract or identification number536134
Number of Individuals Covered7976
Insurance policy start date2020-08-31
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $212,142
Total amount of fees paid to insurance companyUSD $42,428
Other welfare benefits providedGROUP: LONG TERM CARE, INVID. LTC
Welfare Benefit Premiums Paid to CarrierUSD $4,288,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $212,142
Insurance broker organization code?3
Amount paid for insurance broker fees42428
Additional information about fees paid to insurance brokerADMINISTRATION FEES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number204902G
Policy instance 2
Insurance contract or identification number204902G
Number of Individuals Covered537
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $153,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number41000
Policy instance 3
Insurance contract or identification number41000
Number of Individuals Covered8321
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Life Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number89513
Policy instance 4
Insurance contract or identification number89513
Number of Individuals Covered319
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0154147
Policy instance 5
Insurance contract or identification number0154147
Number of Individuals Covered624
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $384,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0154147
Policy instance 5
Insurance contract or identification number0154147
Number of Individuals Covered1030
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $360,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number89513
Policy instance 4
Insurance contract or identification number89513
Number of Individuals Covered261
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number41000
Policy instance 3
Insurance contract or identification number41000
Number of Individuals Covered8210
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number204902G
Policy instance 2
Insurance contract or identification number204902G
Number of Individuals Covered567
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $874
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees874
Additional information about fees paid to insurance brokerBONUS PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number536134
Policy instance 1
Insurance contract or identification number536134
Number of Individuals Covered8018
Insurance policy start date2019-08-31
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $170,630
Total amount of fees paid to insurance companyUSD $34,113
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $3,487,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $170,630
Insurance broker organization code?3
Amount paid for insurance broker fees34113
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number204902G
Policy instance 2
Insurance contract or identification number204902G
Number of Individuals Covered504
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $156,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number536134
Policy instance 1
Insurance contract or identification number536134
Number of Individuals Covered888
Insurance policy start date2018-08-31
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $2,948,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?8
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number41000
Policy instance 3
Insurance contract or identification number41000
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number89513
Policy instance 4
Insurance contract or identification number89513
Number of Individuals Covered418
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0154147
Policy instance 5
Insurance contract or identification number0154147
Number of Individuals Covered969
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $345,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number89513
Policy instance 4
Insurance contract or identification number89513
Number of Individuals Covered181
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0154147
Policy instance 5
Insurance contract or identification number0154147
Number of Individuals Covered803
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $295,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number41000
Policy instance 3
Insurance contract or identification number41000
Number of Individuals Covered8563
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number536134
Policy instance 1
Insurance contract or identification number536134
Number of Individuals Covered6994
Insurance policy start date2017-08-31
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $153,614
Total amount of fees paid to insurance companyUSD $30,723
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $3,049,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number204902G
Policy instance 2
Insurance contract or identification number204902G
Number of Individuals Covered523
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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