BOARD OF TRUSTEES I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND
401k plan membership statisitcs for I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND
| Measure | Date | Value |
|---|
| 2022 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-7,857,706 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-7,857,706 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $33,113,263 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $41,976,198 |
| Total income from all sources (including contributions) | 2022-12-31 | $378,323,040 |
| Total loss/gain on sale of assets | 2022-12-31 | $0 |
| Total of all expenses incurred | 2022-12-31 | $325,120,472 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $311,187,928 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $469,060,319 |
| Value of total assets at end of year | 2022-12-31 | $936,606,994 |
| Value of total assets at beginning of year | 2022-12-31 | $892,267,361 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $13,932,544 |
| Total interest from all sources | 2022-12-31 | $56,826 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $7,528,320 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $7,528,320 |
| Administrative expenses professional fees incurred | 2022-12-31 | $870,397 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $12,725,366 |
| Assets. Other investments not covered elsewhere at beginning of year | 2022-12-31 | $5,303,387 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $9,617,732 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $17,836,500 |
| Assets. Loans (other than to participants) at end of year | 2022-12-31 | $4,462,104 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $4,660,117 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $13,289,079 |
| Other income not declared elsewhere | 2022-12-31 | $419,544 |
| Administrative expenses (other) incurred | 2022-12-31 | $12,840,173 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $1,113,146 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $1,017,119 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $53,202,568 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $903,493,731 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $850,291,163 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $221,974 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $213,708,131 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $176,748,183 |
| Value of interest in common/collective trusts at end of year | 2022-12-31 | $618,558,222 |
| Value of interest in common/collective trusts at beginning of year | 2022-12-31 | $537,374,114 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $17,452,135 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $48,461,224 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $48,461,224 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $56,826 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $5,679,532 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-15,067,143 |
| Net investment gain or loss from common/collective trusts | 2022-12-31 | $-75,817,120 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $456,334,953 |
| Employer contributions (assets) at end of year | 2022-12-31 | $20,377,000 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $18,371,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $305,508,396 |
| Asset. Corporate debt instrument debt (other) at end of year | 2022-12-31 | $47,558,112 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2022-12-31 | $83,945,104 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $27,340,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $27,670,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2022-12-31 | $4,873,558 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2022-12-31 | $4,227,849 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2022-12-31 | 131577780 |
| 2021 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $3,558,417 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $3,558,417 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $41,976,198 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $32,709,886 |
| Total income from all sources (including contributions) | 2021-12-31 | $439,318,823 |
| Total loss/gain on sale of assets | 2021-12-31 | $0 |
| Total of all expenses incurred | 2021-12-31 | $291,223,210 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $279,197,770 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $384,079,119 |
| Value of total assets at end of year | 2021-12-31 | $892,267,361 |
| Value of total assets at beginning of year | 2021-12-31 | $734,905,436 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $12,025,440 |
| Total interest from all sources | 2021-12-31 | $29,640 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $1,938,996 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $1,938,996 |
| Administrative expenses professional fees incurred | 2021-12-31 | $837,272 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $6,044,964 |
| Assets. Other investments not covered elsewhere at end of year | 2021-12-31 | $5,303,387 |
| Assets. Other investments not covered elsewhere at beginning of year | 2021-12-31 | $4,794,574 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $17,836,500 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $15,229,770 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $13,289,079 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $2,669,454 |
| Other income not declared elsewhere | 2021-12-31 | $14,697,151 |
| Administrative expenses (other) incurred | 2021-12-31 | $10,935,373 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $1,017,119 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $1,230,432 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $148,095,613 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $850,291,163 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $702,195,550 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Investment advisory and management fees | 2021-12-31 | $252,795 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $176,748,183 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $152,540,930 |
| Value of interest in common/collective trusts at end of year | 2021-12-31 | $537,374,114 |
| Value of interest in common/collective trusts at beginning of year | 2021-12-31 | $445,626,870 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $48,461,224 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $25,876,529 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $25,876,529 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $29,640 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $5,604,408 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $-731,694 |
| Net investment gain or loss from common/collective trusts | 2021-12-31 | $35,747,194 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $378,034,155 |
| Employer contributions (assets) at end of year | 2021-12-31 | $18,371,000 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $5,636,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $273,593,362 |
| Asset. Corporate debt instrument debt (other) at end of year | 2021-12-31 | $83,945,104 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2021-12-31 | $81,837,187 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $27,670,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $28,810,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2021-12-31 | $4,227,849 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2021-12-31 | $3,363,576 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2021-12-31 | 131577780 |
| 2020 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $5,256,438 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $5,256,438 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $32,709,886 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $31,022,413 |
| Total income from all sources (including contributions) | 2020-12-31 | $251,399,764 |
| Total loss/gain on sale of assets | 2020-12-31 | $0 |
| Total of all expenses incurred | 2020-12-31 | $263,032,978 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $251,089,701 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $194,179,472 |
| Value of total assets at end of year | 2020-12-31 | $734,905,436 |
| Value of total assets at beginning of year | 2020-12-31 | $744,851,177 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $11,943,277 |
| Total interest from all sources | 2020-12-31 | $10,496 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $3,442,617 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $3,442,617 |
| Administrative expenses professional fees incurred | 2020-12-31 | $676,054 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $8,675,356 |
| Assets. Other investments not covered elsewhere at end of year | 2020-12-31 | $4,794,574 |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-12-31 | $6,011,454 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $15,229,770 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $17,492,308 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $2,669,454 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $7,984,075 |
| Other income not declared elsewhere | 2020-12-31 | $287,181 |
| Administrative expenses (other) incurred | 2020-12-31 | $10,981,971 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $1,230,432 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $1,638,338 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $-11,633,214 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $702,195,550 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $713,828,764 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Investment advisory and management fees | 2020-12-31 | $285,252 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $152,540,930 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $152,375,968 |
| Value of interest in common/collective trusts at end of year | 2020-12-31 | $445,626,870 |
| Value of interest in common/collective trusts at beginning of year | 2020-12-31 | $446,375,640 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $25,876,529 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $33,350,484 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $33,350,484 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $10,496 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $5,786,508 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $472,329 |
| Net investment gain or loss from common/collective trusts | 2020-12-31 | $47,751,231 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $185,504,116 |
| Employer contributions (assets) at end of year | 2020-12-31 | $5,636,000 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $13,351,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $245,303,193 |
| Asset. Corporate debt instrument debt (other) at end of year | 2020-12-31 | $81,837,187 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2020-12-31 | $73,477,255 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $28,810,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $21,400,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2020-12-31 | $3,363,576 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2020-12-31 | $2,417,068 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2020-12-31 | 131577780 |
| 2019 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $9,047,905 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $9,047,905 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $9,047,905 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $9,047,905 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $31,022,413 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $31,022,413 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $26,951,880 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $26,951,880 |
| Total income from all sources (including contributions) | 2019-12-31 | $407,491,504 |
| Total income from all sources (including contributions) | 2019-12-31 | $407,491,504 |
| Total loss/gain on sale of assets | 2019-12-31 | $0 |
| Total loss/gain on sale of assets | 2019-12-31 | $0 |
| Total of all expenses incurred | 2019-12-31 | $247,541,087 |
| Total of all expenses incurred | 2019-12-31 | $247,541,087 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $235,008,274 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $343,035,437 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $343,035,437 |
| Value of total assets at end of year | 2019-12-31 | $744,851,177 |
| Value of total assets at beginning of year | 2019-12-31 | $580,830,227 |
| Value of total assets at beginning of year | 2019-12-31 | $580,830,227 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $12,532,813 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $12,532,813 |
| Total interest from all sources | 2019-12-31 | $18,107 |
| Total interest from all sources | 2019-12-31 | $18,107 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $3,606,589 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $3,606,589 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $3,606,589 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $3,606,589 |
| Administrative expenses professional fees incurred | 2019-12-31 | $758,183 |
| Administrative expenses professional fees incurred | 2019-12-31 | $758,183 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $7,500,000 |
| Value of fidelity bond cover | 2019-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $15,239,493 |
| Contributions received from participants | 2019-12-31 | $15,239,493 |
| Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $6,011,454 |
| Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $6,011,454 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $2,274,628 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $2,274,628 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $17,492,308 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $17,492,308 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $19,482,482 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $19,482,482 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $7,984,075 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $7,984,075 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $4,030,715 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $4,030,715 |
| Other income not declared elsewhere | 2019-12-31 | $380,495 |
| Other income not declared elsewhere | 2019-12-31 | $380,495 |
| Administrative expenses (other) incurred | 2019-12-31 | $11,508,465 |
| Administrative expenses (other) incurred | 2019-12-31 | $11,508,465 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $1,638,338 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $1,638,338 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $2,291,165 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $2,291,165 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $159,950,417 |
| Value of net income/loss | 2019-12-31 | $159,950,417 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $713,828,764 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $713,828,764 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $553,878,347 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $553,878,347 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Investment advisory and management fees | 2019-12-31 | $266,165 |
| Investment advisory and management fees | 2019-12-31 | $266,165 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $152,375,968 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $152,375,968 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $119,881,816 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $119,881,816 |
| Value of interest in common/collective trusts at end of year | 2019-12-31 | $446,375,640 |
| Value of interest in common/collective trusts at end of year | 2019-12-31 | $446,375,640 |
| Value of interest in common/collective trusts at beginning of year | 2019-12-31 | $342,860,233 |
| Value of interest in common/collective trusts at beginning of year | 2019-12-31 | $342,860,233 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $33,350,484 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $33,350,484 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $22,850,879 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $22,850,879 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $22,850,879 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $22,850,879 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $18,107 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $18,107 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $5,040,342 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $5,040,342 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $1,387,564 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $1,387,564 |
| Net investment gain or loss from common/collective trusts | 2019-12-31 | $50,015,407 |
| Net investment gain or loss from common/collective trusts | 2019-12-31 | $50,015,407 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $327,795,944 |
| Contributions received in cash from employer | 2019-12-31 | $327,795,944 |
| Employer contributions (assets) at end of year | 2019-12-31 | $13,351,000 |
| Employer contributions (assets) at end of year | 2019-12-31 | $13,351,000 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $14,349,000 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $14,349,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $229,967,932 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $229,967,932 |
| Asset. Corporate debt instrument debt (other) at end of year | 2019-12-31 | $73,477,255 |
| Asset. Corporate debt instrument debt (other) at end of year | 2019-12-31 | $73,477,255 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-12-31 | $57,023,423 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-12-31 | $57,023,423 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $21,400,000 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $21,400,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $20,630,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $20,630,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2019-12-31 | $2,417,068 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2019-12-31 | $2,417,068 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-12-31 | $2,107,766 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-12-31 | $2,107,766 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm name | 2019-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2019-12-31 | 131577780 |
| 2018 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-1,090,258 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-1,090,258 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $26,951,880 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $23,006,599 |
| Total income from all sources (including contributions) | 2018-12-31 | $294,691,938 |
| Total loss/gain on sale of assets | 2018-12-31 | $0 |
| Total of all expenses incurred | 2018-12-31 | $214,826,227 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $203,290,928 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $301,995,170 |
| Value of total assets at end of year | 2018-12-31 | $580,830,227 |
| Value of total assets at beginning of year | 2018-12-31 | $497,019,235 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $11,535,299 |
| Total interest from all sources | 2018-12-31 | $3,695 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $3,534,331 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $3,534,331 |
| Administrative expenses professional fees incurred | 2018-12-31 | $813,207 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $16,082,835 |
| Assets. Other investments not covered elsewhere at end of year | 2018-12-31 | $2,274,628 |
| Assets. Other investments not covered elsewhere at beginning of year | 2018-12-31 | $1,929,388 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $19,482,482 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $11,793,476 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-12-31 | $4,030,715 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-12-31 | $5,780,754 |
| Other income not declared elsewhere | 2018-12-31 | $239,074 |
| Administrative expenses (other) incurred | 2018-12-31 | $10,495,003 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $2,291,165 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $685,845 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $79,865,711 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $553,878,347 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $474,012,636 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Investment advisory and management fees | 2018-12-31 | $227,089 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $119,881,816 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $100,384,359 |
| Value of interest in common/collective trusts at end of year | 2018-12-31 | $342,860,233 |
| Value of interest in common/collective trusts at beginning of year | 2018-12-31 | $288,313,432 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $22,850,879 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $27,733,602 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $27,733,602 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $3,695 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $5,183,504 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-12-31 | $-936,875 |
| Net investment gain or loss from common/collective trusts | 2018-12-31 | $-9,053,199 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $285,912,335 |
| Employer contributions (assets) at end of year | 2018-12-31 | $14,349,000 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $14,404,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $198,107,424 |
| Asset. Corporate debt instrument debt (other) at end of year | 2018-12-31 | $57,023,423 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2018-12-31 | $50,208,398 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $20,630,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $16,540,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2018-12-31 | $2,107,766 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2018-12-31 | $2,252,580 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2018-12-31 | 131577780 |
| 2017 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $2,875,561 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $2,875,561 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $23,006,599 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $22,967,705 |
| Total income from all sources (including contributions) | 2017-12-31 | $299,277,763 |
| Total loss/gain on sale of assets | 2017-12-31 | $0 |
| Total of all expenses incurred | 2017-12-31 | $200,205,012 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $189,510,560 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $271,088,397 |
| Value of total assets at end of year | 2017-12-31 | $497,019,235 |
| Value of total assets at beginning of year | 2017-12-31 | $397,907,590 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $10,694,452 |
| Total interest from all sources | 2017-12-31 | $572 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $2,693,710 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $2,693,710 |
| Administrative expenses professional fees incurred | 2017-12-31 | $641,925 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $16,358,107 |
| Assets. Other investments not covered elsewhere at end of year | 2017-12-31 | $1,929,388 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-12-31 | $2,057,001 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $11,793,476 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $9,910,465 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-12-31 | $5,780,754 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-12-31 | $4,493,281 |
| Other income not declared elsewhere | 2017-12-31 | $312,379 |
| Administrative expenses (other) incurred | 2017-12-31 | $9,856,122 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $685,845 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $1,394,424 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $99,072,751 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $474,012,636 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $374,939,885 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Investment advisory and management fees | 2017-12-31 | $196,405 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $100,384,359 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $90,927,043 |
| Value of interest in common/collective trusts at end of year | 2017-12-31 | $288,313,432 |
| Value of interest in common/collective trusts at beginning of year | 2017-12-31 | $235,019,895 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $27,733,602 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $5,846,113 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $5,846,113 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $572 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $4,364,176 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-12-31 | $-236,393 |
| Net investment gain or loss from common/collective trusts | 2017-12-31 | $22,543,537 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $254,730,290 |
| Employer contributions (assets) at end of year | 2017-12-31 | $14,404,000 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $12,461,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $185,146,384 |
| Asset. Corporate debt instrument debt (other) at end of year | 2017-12-31 | $50,208,398 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2017-12-31 | $39,136,673 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $16,540,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $17,080,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2017-12-31 | $2,252,580 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2017-12-31 | $2,549,400 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2017-12-31 | 131577780 |
| 2016 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2016 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $22,967,705 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $19,940,584 |
| Total income from all sources (including contributions) | 2016-12-31 | $254,237,559 |
| Total loss/gain on sale of assets | 2016-12-31 | $0 |
| Total of all expenses incurred | 2016-12-31 | $190,573,613 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $180,702,771 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $237,011,905 |
| Value of total assets at end of year | 2016-12-31 | $397,907,590 |
| Value of total assets at beginning of year | 2016-12-31 | $331,216,523 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $9,870,842 |
| Total interest from all sources | 2016-12-31 | $4,333,822 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $1,880,493 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-12-31 | $1,880,493 |
| Administrative expenses professional fees incurred | 2016-12-31 | $698,088 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $15,054,518 |
| Assets. Other investments not covered elsewhere at end of year | 2016-12-31 | $2,057,001 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-12-31 | $1,076,120 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $9,910,465 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $3,901,636 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-12-31 | $4,493,281 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-12-31 | $3,790,137 |
| Other income not declared elsewhere | 2016-12-31 | $507,560 |
| Administrative expenses (other) incurred | 2016-12-31 | $9,006,082 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $1,394,424 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $220,447 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $63,663,946 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $374,939,885 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $311,275,939 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $166,672 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $90,927,043 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $71,926,169 |
| Interest earned on other investments | 2016-12-31 | $4,333,822 |
| Value of interest in common/collective trusts at end of year | 2016-12-31 | $235,019,895 |
| Value of interest in common/collective trusts at beginning of year | 2016-12-31 | $186,636,497 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $5,846,113 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $24,084,770 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $24,084,770 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $3,883,751 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-12-31 | $120,381 |
| Net investment gain or loss from common/collective trusts | 2016-12-31 | $10,383,398 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $221,957,387 |
| Employer contributions (assets) at end of year | 2016-12-31 | $12,461,000 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $11,026,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $176,819,020 |
| Asset. Corporate debt instrument debt (other) at end of year | 2016-12-31 | $39,136,673 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2016-12-31 | $28,822,832 |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $17,080,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $15,930,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2016-12-31 | $2,549,400 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2016-12-31 | $3,742,499 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2016-12-31 | 131577780 |
| 2015 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2015 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $0 |
| Total transfer of assets to this plan | 2015-12-31 | $9,992,415 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $19,940,584 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $17,138,270 |
| Total income from all sources (including contributions) | 2015-12-31 | $213,917,746 |
| Total loss/gain on sale of assets | 2015-12-31 | $0 |
| Total of all expenses incurred | 2015-12-31 | $172,047,863 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $162,604,672 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $216,335,893 |
| Value of total assets at end of year | 2015-12-31 | $331,216,523 |
| Value of total assets at beginning of year | 2015-12-31 | $276,551,911 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $9,443,191 |
| Total interest from all sources | 2015-12-31 | $-1,110,667 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $1,162,653 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-12-31 | $1,162,653 |
| Administrative expenses professional fees incurred | 2015-12-31 | $840,316 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $13,970,838 |
| Assets. Other investments not covered elsewhere at end of year | 2015-12-31 | $1,076,120 |
| Assets. Other investments not covered elsewhere at beginning of year | 2015-12-31 | $1,360,924 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $3,901,636 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $3,622,041 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-12-31 | $3,790,137 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-12-31 | $3,804,990 |
| Other income not declared elsewhere | 2015-12-31 | $43,208 |
| Administrative expenses (other) incurred | 2015-12-31 | $8,452,544 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $220,447 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $913,280 |
| Total non interest bearing cash at end of year | 2015-12-31 | $0 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $650,920 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $41,869,883 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $311,275,939 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $259,413,641 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Investment advisory and management fees | 2015-12-31 | $150,331 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $71,926,169 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $57,142,146 |
| Interest earned on other investments | 2015-12-31 | $-1,110,785 |
| Value of interest in common/collective trusts at end of year | 2015-12-31 | $186,636,497 |
| Value of interest in common/collective trusts at beginning of year | 2015-12-31 | $163,771,208 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $24,084,770 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $14,283,811 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $14,283,811 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $118 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $3,072,789 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-12-31 | $-1,128,631 |
| Net investment gain or loss from common/collective trusts | 2015-12-31 | $-1,384,710 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $202,365,055 |
| Employer contributions (assets) at end of year | 2015-12-31 | $11,026,000 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $9,341,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $159,531,883 |
| Asset. Corporate debt instrument debt (other) at end of year | 2015-12-31 | $28,822,832 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2015-12-31 | $25,341,534 |
| Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $15,930,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $12,420,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2015-12-31 | $3,742,499 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-12-31 | $1,038,327 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | SCHULTHIES & PANETTIERI, LLP |
| Accountancy firm EIN | 2015-12-31 | 131577780 |
| 2014 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $525,083 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $525,083 |
| Total transfer of assets to this plan | 2014-12-31 | $3,377,325 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $17,138,270 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $13,192,060 |
| Total income from all sources (including contributions) | 2014-12-31 | $197,697,503 |
| Total loss/gain on sale of assets | 2014-12-31 | $0 |
| Total of all expenses incurred | 2014-12-31 | $152,090,364 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $143,819,295 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $189,015,229 |
| Value of total assets at end of year | 2014-12-31 | $276,551,911 |
| Value of total assets at beginning of year | 2014-12-31 | $223,621,237 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $8,271,069 |
| Total interest from all sources | 2014-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $1,621,036 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-12-31 | $1,621,036 |
| Administrative expenses professional fees incurred | 2014-12-31 | $638,551 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $13,546,582 |
| Assets. Other investments not covered elsewhere at end of year | 2014-12-31 | $1,360,924 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $3,622,041 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $7,226,976 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-12-31 | $3,804,990 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-12-31 | $2,814,863 |
| Other income not declared elsewhere | 2014-12-31 | $10,635 |
| Administrative expenses (other) incurred | 2014-12-31 | $7,468,649 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $913,280 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $461,197 |
| Total non interest bearing cash at end of year | 2014-12-31 | $650,920 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $45,607,139 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $259,413,641 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $210,429,177 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Assets. partnership/joint venture interests at beginning of year | 2014-12-31 | $23,573,124 |
| Investment advisory and management fees | 2014-12-31 | $163,869 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $57,142,146 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $48,903,970 |
| Value of interest in common/collective trusts at end of year | 2014-12-31 | $163,771,208 |
| Value of interest in common/collective trusts at beginning of year | 2014-12-31 | $121,212,828 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $14,283,811 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $13,488,584 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $13,488,584 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $2,591,265 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-12-31 | $-343,636 |
| Net investment gain or loss from common/collective trusts | 2014-12-31 | $6,869,156 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $175,468,647 |
| Employer contributions (assets) at end of year | 2014-12-31 | $9,341,000 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $8,052,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $141,228,030 |
| Asset. Corporate debt instrument debt (other) at end of year | 2014-12-31 | $25,341,534 |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $12,420,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $9,916,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2014-12-31 | $1,038,327 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2014-12-31 | $1,163,755 |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2014-12-31 | 131577780 |
| 2013 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $1,641,235 |
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $1,641,235 |
| Total transfer of assets to this plan | 2013-12-31 | $15,933,359 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $13,192,060 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $10,162,439 |
| Total income from all sources (including contributions) | 2013-12-31 | $162,198,280 |
| Total loss/gain on sale of assets | 2013-12-31 | $0 |
| Total of all expenses incurred | 2013-12-31 | $124,549,015 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $116,868,278 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $159,843,616 |
| Value of total assets at end of year | 2013-12-31 | $223,621,237 |
| Value of total assets at beginning of year | 2013-12-31 | $167,008,992 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $7,680,737 |
| Total interest from all sources | 2013-12-31 | $156 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $685,497 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-12-31 | $685,497 |
| Administrative expenses professional fees incurred | 2013-12-31 | $679,617 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $12,245,375 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $7,226,976 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $986,640 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-12-31 | $2,814,863 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-12-31 | $2,443,000 |
| Other income not declared elsewhere | 2013-12-31 | $2,995 |
| Administrative expenses (other) incurred | 2013-12-31 | $6,926,565 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $461,197 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $192,439 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $5,639,126 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $37,649,265 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $210,429,177 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $156,846,553 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Assets. partnership/joint venture interests at end of year | 2013-12-31 | $23,573,124 |
| Assets. partnership/joint venture interests at beginning of year | 2013-12-31 | $25,131,889 |
| Investment advisory and management fees | 2013-12-31 | $74,555 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $48,903,970 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $3,017,900 |
| Value of interest in common/collective trusts at end of year | 2013-12-31 | $121,212,828 |
| Value of interest in common/collective trusts at beginning of year | 2013-12-31 | $121,388,620 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $13,488,584 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $162,660 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $162,660 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $156 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $2,447,936 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-12-31 | $600,573 |
| Net investment gain or loss from common/collective trusts | 2013-12-31 | $-575,792 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $147,598,241 |
| Employer contributions (assets) at end of year | 2013-12-31 | $8,052,000 |
| Employer contributions (assets) at beginning of year | 2013-12-31 | $7,676,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $114,420,342 |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $9,916,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $7,527,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2013-12-31 | $1,163,755 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2013-12-31 | $3,006,157 |
| Did the plan have assets held for investment | 2013-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2013-12-31 | 131577780 |
| 2012 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $2,431,618 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $2,431,618 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $10,162,439 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $9,099,881 |
| Total income from all sources (including contributions) | 2012-12-31 | $139,928,018 |
| Total loss/gain on sale of assets | 2012-12-31 | $0 |
| Total of all expenses incurred | 2012-12-31 | $104,380,576 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $97,398,277 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $129,876,768 |
| Value of total assets at end of year | 2012-12-31 | $167,008,992 |
| Value of total assets at beginning of year | 2012-12-31 | $130,398,992 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $6,982,299 |
| Total interest from all sources | 2012-12-31 | $10,953 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $95,646 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $95,646 |
| Administrative expenses professional fees incurred | 2012-12-31 | $688,737 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $7,500,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $11,220,782 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $986,640 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $5,109,228 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-12-31 | $2,443,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-12-31 | $2,554,000 |
| Other income not declared elsewhere | 2012-12-31 | $13,884 |
| Administrative expenses (other) incurred | 2012-12-31 | $6,194,980 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $192,439 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $126,881 |
| Total non interest bearing cash at end of year | 2012-12-31 | $5,639,126 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $35,547,442 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $156,846,553 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $121,299,111 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Assets. partnership/joint venture interests at end of year | 2012-12-31 | $25,131,889 |
| Assets. partnership/joint venture interests at beginning of year | 2012-12-31 | $18,250,271 |
| Investment advisory and management fees | 2012-12-31 | $98,582 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $3,017,900 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $2,253,798 |
| Value of interest in common/collective trusts at end of year | 2012-12-31 | $121,388,620 |
| Value of interest in common/collective trusts at beginning of year | 2012-12-31 | $89,607,929 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $162,660 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $5,504,433 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $5,504,433 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $10,953 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $3,127,456 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-12-31 | $268,457 |
| Net investment gain or loss from common/collective trusts | 2012-12-31 | $7,230,692 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $118,655,986 |
| Employer contributions (assets) at end of year | 2012-12-31 | $7,676,000 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $7,486,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $94,270,821 |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $7,527,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $6,419,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2012-12-31 | $3,006,157 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-12-31 | $2,187,333 |
| Did the plan have assets held for investment | 2012-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2012-12-31 | 131577780 |
| 2011 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $844,001 |
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $844,001 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $9,099,881 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $10,113,074 |
| Total income from all sources (including contributions) | 2011-12-31 | $124,973,600 |
| Total loss/gain on sale of assets | 2011-12-31 | $0 |
| Total of all expenses incurred | 2011-12-31 | $92,934,206 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $86,426,949 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $118,123,209 |
| Value of total assets at end of year | 2011-12-31 | $130,398,992 |
| Value of total assets at beginning of year | 2011-12-31 | $99,372,791 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $6,507,257 |
| Total interest from all sources | 2011-12-31 | $13,888 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $103,106 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-12-31 | $103,106 |
| Administrative expenses professional fees incurred | 2011-12-31 | $553,664 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $11,961,831 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $5,109,228 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $5,438,003 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-12-31 | $2,554,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-12-31 | $2,657,000 |
| Other income not declared elsewhere | 2011-12-31 | $15,571 |
| Administrative expenses (other) incurred | 2011-12-31 | $5,872,641 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $126,881 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $160,074 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $32,039,394 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $121,299,111 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $89,259,717 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Assets. partnership/joint venture interests at end of year | 2011-12-31 | $18,250,271 |
| Assets. partnership/joint venture interests at beginning of year | 2011-12-31 | $13,076,270 |
| Investment advisory and management fees | 2011-12-31 | $80,952 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $2,253,798 |
| Value of interest in common/collective trusts at end of year | 2011-12-31 | $89,607,929 |
| Value of interest in common/collective trusts at beginning of year | 2011-12-31 | $67,034,794 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $5,504,433 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $4,086,525 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $4,086,525 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $13,888 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $3,735,957 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-12-31 | $-119,308 |
| Net investment gain or loss from common/collective trusts | 2011-12-31 | $5,993,133 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $106,161,378 |
| Employer contributions (assets) at end of year | 2011-12-31 | $7,486,000 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $6,328,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $82,690,992 |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $6,419,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $7,296,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2011-12-31 | $2,187,333 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-12-31 | $3,409,199 |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2011-12-31 | 131577780 |
| 2010 : I.A.T.S.E. NATIONAL HEALTH & WELFARE FUND 2010 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2010-12-31 | $1,263,362 |
| Total unrealized appreciation/depreciation of assets | 2010-12-31 | $1,263,362 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $10,113,074 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $8,250,444 |
| Total income from all sources (including contributions) | 2010-12-31 | $107,854,585 |
| Total loss/gain on sale of assets | 2010-12-31 | $0 |
| Total of all expenses incurred | 2010-12-31 | $84,932,797 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $78,918,294 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $102,227,660 |
| Value of total assets at end of year | 2010-12-31 | $99,372,791 |
| Value of total assets at beginning of year | 2010-12-31 | $74,588,373 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $6,014,503 |
| Total interest from all sources | 2010-12-31 | $3,051 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Administrative expenses professional fees incurred | 2010-12-31 | $617,236 |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $11,937,938 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2010-12-31 | $74,800,230 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $5,438,003 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $2,982,819 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2010-12-31 | $2,657,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2010-12-31 | $2,692,401 |
| Other income not declared elsewhere | 2010-12-31 | $109,009 |
| Administrative expenses (other) incurred | 2010-12-31 | $5,323,632 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $160,074 |
| Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $181,043 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $22,921,788 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $89,259,717 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $66,337,929 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Assets. partnership/joint venture interests at end of year | 2010-12-31 | $13,076,270 |
| Assets. partnership/joint venture interests at beginning of year | 2010-12-31 | $3,212,908 |
| Investment advisory and management fees | 2010-12-31 | $73,635 |
| Value of interest in common/collective trusts at end of year | 2010-12-31 | $67,034,794 |
| Value of interest in common/collective trusts at beginning of year | 2010-12-31 | $54,263,275 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $4,086,525 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $7,167,018 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $7,167,018 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $3,051 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $4,118,064 |
| Net investment gain or loss from common/collective trusts | 2010-12-31 | $4,251,503 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $90,289,722 |
| Employer contributions (assets) at end of year | 2010-12-31 | $6,328,000 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $4,534,000 |
| Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $7,296,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $5,377,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2010-12-31 | $3,409,199 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2010-12-31 | $2,428,353 |
| Did the plan have assets held for investment | 2010-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
| Accountancy firm name | 2010-12-31 | SCHULTHEIS & PANETTIERI, LLP |
| Accountancy firm EIN | 2010-12-31 | 131577780 |
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0004027 |
| Policy instance | 5 |
| Insurance contract or identification number | SP0004027 | | Number of Individuals Covered | 515 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MED, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 Carrier | USD $50,130 | | 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 number | 0173563 |
| Policy instance | 4 |
| Insurance contract or identification number | 0173563 | | Number of Individuals Covered | 28694 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $25 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $709,363 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 25 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0173565 |
| Policy instance | 3 |
| Insurance contract or identification number | 0173565 | | Number of Individuals Covered | 1130 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $25 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $41,371 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 25 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | G1921 |
| Policy instance | 2 |
| Insurance contract or identification number | G1921 | | Number of Individuals Covered | 26222 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $4,255,745 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 44610 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $475,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 38574 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $530,115 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | G1921 |
| Policy instance | 2 |
| Insurance contract or identification number | G1921 | | Number of Individuals Covered | 29724 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $4,341,602 | | 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 number | 0173565 |
| Policy instance | 3 |
| Insurance contract or identification number | 0173565 | | Number of Individuals Covered | 580 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $28 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $38,136 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 28 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0173563 |
| Policy instance | 4 |
| Insurance contract or identification number | 0173563 | | Number of Individuals Covered | 21465 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $28 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $657,765 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 28 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0004027 |
| Policy instance | 5 |
| Insurance contract or identification number | SP0004027 | | Number of Individuals Covered | 415 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MED, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 Carrier | USD $36,694 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 43940 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $589,629 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | G1921 |
| Policy instance | 2 |
| Insurance contract or identification number | G1921 | | Number of Individuals Covered | 26801 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $3,497,168 | | 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 number | 0173565 |
| Policy instance | 3 |
| Insurance contract or identification number | 0173565 | | Number of Individuals Covered | 1207 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $61 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $56,940 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 61 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0173563 |
| Policy instance | 4 |
| Insurance contract or identification number | 0173563 | | Number of Individuals Covered | 29333 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $61 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $756,451 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 61 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0004027 |
| Policy instance | 5 |
| Insurance contract or identification number | SP0004027 | | Number of Individuals Covered | 408 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MED, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 Carrier | USD $36,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 39783 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $511,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 63657 ) |
| Policy contract number | GSLIC-GRM3049 |
| Policy instance | 2 |
| Insurance contract or identification number | GSLIC-GRM3049 | | Number of Individuals Covered | 24699 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $4,241,991 | | 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 number | 0173565 |
| Policy instance | 3 |
| Insurance contract or identification number | 0173565 | | Number of Individuals Covered | 1173 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $82 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $57,056 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 82 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0004027 |
| Policy instance | 5 |
| Insurance contract or identification number | SP0004027 | | Number of Individuals Covered | 382 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MED, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 Carrier | USD $36,678 | | 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 number | 0173563 |
| Policy instance | 4 |
| Insurance contract or identification number | 0173563 | | Number of Individuals Covered | 26117 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $82 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $666,892 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 82 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | ERLL16100851003 |
| Policy instance | 1 |
| Insurance contract or identification number | ERLL16100851003 | | Number of Individuals Covered | 23021 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $98,659 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $3,288,633 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $98,659 | | Additional information about fees paid to insurance broker | INSURANCE BROKERAGE | | Insurance broker organization code? | 3 |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 2 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 36995 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $475,023 | | 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 number | 0173565 |
| Policy instance | 3 |
| Insurance contract or identification number | 0173565 | | Number of Individuals Covered | 1209 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $12 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $57,672 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 12 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0004027 |
| Policy instance | 5 |
| Insurance contract or identification number | SP0004027 | | Number of Individuals Covered | 387 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MED, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 Carrier | USD $33,449 | | 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 number | 0173563 |
| Policy instance | 4 |
| Insurance contract or identification number | 0173563 | | Number of Individuals Covered | 24190 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $12 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $620,403 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 12 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0004027 |
| Policy instance | 5 |
| Insurance contract or identification number | SP0004027 | | Number of Individuals Covered | 358 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MED, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 Carrier | USD $30,952 | | 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 number | 0173563 |
| Policy instance | 4 |
| Insurance contract or identification number | 0173563 | | Number of Individuals Covered | 22470 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $274 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $582,071 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 274 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | THE SEGAL CO EASTERN STATES INC |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0173565 |
| Policy instance | 3 |
| Insurance contract or identification number | 0173565 | | Number of Individuals Covered | 1184 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $274 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $55,468 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 274 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | THE SEGAL CO EASTERN STATES INC |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 2 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 34196 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $447,138 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | ERLL16100851003 |
| Policy instance | 1 |
| Insurance contract or identification number | ERLL16100851003 | | Number of Individuals Covered | 21939 | | Insurance policy start date | 2016-04-01 | | Insurance policy end date | 2017-03-31 | | Total amount of commissions paid to insurance broker | USD $93,266 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $3,108,862 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $93,266 | | Additional information about fees paid to insurance broker | INSURANCE BROKERAGE | | Insurance broker organization code? | 3 | | Insurance broker name | SEGAL SELECT INSURANCE SERVICES INC |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G255798 |
| Policy instance | 1 |
| Insurance contract or identification number | G255798 | | Number of Individuals Covered | 11119 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $500,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 3 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 25919 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $438,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0004027 |
| Policy instance | 4 |
| Insurance contract or identification number | SP0004027 | | Number of Individuals Covered | 351 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MED, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 Carrier | USD $30,125 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | ERLL14100851001 |
| Policy instance | 2 |
| Insurance contract or identification number | ERLL14100851001 | | Number of Individuals Covered | 17866 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $54,665 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $1,822,176 | | Commission paid to Insurance Broker | USD $54,665 | | Additional information about fees paid to insurance broker | INSURANCE BROKERAGE | | Insurance broker organization code? | 3 | | Insurance broker name | SEGAL SELECT INSURANCE SERVICES INC |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 26381 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $348,080 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 174549 |
| Policy instance | 3 |
| Insurance contract or identification number | 174549 | | Number of Individuals Covered | 25254 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $1,387,944 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0004027 |
| Policy instance | 2 |
| Insurance contract or identification number | SP0004027 | | Number of Individuals Covered | 341 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MEDICAL, TELECONSULTA, ORGAN AND TISSUE TRANSPLANT | | 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 Carrier | USD $28,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G255798 |
| Policy instance | 4 |
| Insurance contract or identification number | G255798 | | Number of Individuals Covered | 11173 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $482,603 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G255798 |
| Policy instance | 4 |
| Insurance contract or identification number | G255798 | | Number of Individuals Covered | 9319 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $440,206 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 23230 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $15,563 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $345,853 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 15563 | | Additional information about fees paid to insurance broker | FILING AND ADMINISTRATIVE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | HM LIFE INSURANCE COMPANY |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | 112125/SP4027 |
| Policy instance | 2 |
| Insurance contract or identification number | 112125/SP4027 | | Number of Individuals Covered | 294 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MEDICAL TELECONSULTA | | 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 Carrier | USD $26,236 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 174549 |
| Policy instance | 3 |
| Insurance contract or identification number | 174549 | | Number of Individuals Covered | 20946 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $1,982,224 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G2376 & C3561 |
| Policy instance | 2 |
| Insurance contract or identification number | G2376 & C3561 | | Number of Individuals Covered | 10000 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $433,501 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | 112125/SP4027 |
| Policy instance | 3 |
| Insurance contract or identification number | 112125/SP4027 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MEDICAL TELECONSULTA | | 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 Carrier | USD $21,420 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 20258 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $14,386 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $319,698 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 14386 | | Additional information about fees paid to insurance broker | FILING AND ADMINISTRATIVE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | HM LIFE INSURANCE COMPANY |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 174549 |
| Policy instance | 4 |
| Insurance contract or identification number | 174549 | | Number of Individuals Covered | 19800 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,925,684 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G255798 |
| Policy instance | 5 |
| Insurance contract or identification number | G255798 | | Number of Individuals Covered | 9319 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $68,491 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 18712 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $13,959 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $310,201 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 174549 |
| Policy instance | 4 |
| Insurance contract or identification number | 174549 | | Number of Individuals Covered | 16665 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,428,353 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | 112125/SP4027 |
| Policy instance | 3 |
| Insurance contract or identification number | 112125/SP4027 | | Number of Individuals Covered | 322 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MEDICAL TELECONSULTA | | 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 Carrier | USD $17,090 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G2376 & C3561 |
| Policy instance | 2 |
| Insurance contract or identification number | G2376 & C3561 | | Number of Individuals Covered | 9901 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $494,644 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 174549 |
| Policy instance | 4 |
| Insurance contract or identification number | 174549 | | Number of Individuals Covered | 16560 | | Insurance policy start date | 2009-04-01 | | Insurance policy end date | 2010-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,273,246 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) |
| Policy contract number | NY2430 |
| Policy instance | 5 |
| Insurance contract or identification number | NY2430 | | Number of Individuals Covered | 16935 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ADMINISTRATIVE SERVICES | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | 1-12125 |
| Policy instance | 3 |
| Insurance contract or identification number | 1-12125 | | Number of Individuals Covered | 311 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MAJOR MEDICAL | | 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 Carrier | USD $755,805 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G2376 & C3561 |
| Policy instance | 2 |
| Insurance contract or identification number | G2376 & C3561 | | Number of Individuals Covered | 9654 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $462,403 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | IAT001-007 |
| Policy instance | 1 |
| Insurance contract or identification number | IAT001-007 | | Number of Individuals Covered | 13641 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $13,701 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $376,062 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
