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GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 401k Plan overview

Plan NameGROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES
Plan identification number 503

GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES Benefits

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

401k Sponsoring company profile

KRAFT HEINZ FOODS COMPANY has sponsored the creation of one or more 401k plans.

Company Name:KRAFT HEINZ FOODS COMPANY
Employer identification number (EIN):250542520
NAIC Classification:424400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032016-01-01STEVE CRUCITT
5032015-01-01STEVE CRUCITT
5032014-05-01STEVE CRUCITT STEVE CRUCITT2015-10-15
5032013-05-01TERRANCE BROWN TERRANCE BROWN2015-02-17
5032012-05-01MICHELLE MACCAGNAN MICHELLE MACCAGNAN2014-01-21
5032011-05-01MICHAEL ADAMCYK MICHAEL ADAMCYK2012-11-12
5032010-05-01MICHAEL ADAMCYK MICHAEL ADAMCYK2012-01-05

Plan Statistics for GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES

401k plan membership statisitcs for GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES

Measure Date Value
2016: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2016 401k membership
Total participants, beginning-of-year2016-01-011,977
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
2015: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2015 401k membership
Total participants, beginning-of-year2015-01-012,083
Total number of active participants reported on line 7a of the Form 55002015-01-011,832
Number of retired or separated participants receiving benefits2015-01-0154
Number of other retired or separated participants entitled to future benefits2015-01-0191
Total of all active and inactive participants2015-01-011,977
2014: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2014 401k membership
Total participants, beginning-of-year2014-05-011,950
Total number of active participants reported on line 7a of the Form 55002014-05-012,083
Total of all active and inactive participants2014-05-012,083
2013: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2013 401k membership
Total participants, beginning-of-year2013-05-012,046
Total number of active participants reported on line 7a of the Form 55002013-05-011,950
Total of all active and inactive participants2013-05-011,950
2012: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2012 401k membership
Total participants, beginning-of-year2012-05-012,030
Total number of active participants reported on line 7a of the Form 55002012-05-012,046
Total of all active and inactive participants2012-05-012,046
2011: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2011 401k membership
Total participants, beginning-of-year2011-05-012,553
Total number of active participants reported on line 7a of the Form 55002011-05-012,030
Total of all active and inactive participants2011-05-012,030
2010: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2010 401k membership
Total participants, beginning-of-year2010-05-012,617
Total number of active participants reported on line 7a of the Form 55002010-05-012,553
Total of all active and inactive participants2010-05-012,553
Total participants2010-05-010

Financial Data on GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES

Measure Date Value
2016 : GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets from this plan2016-12-31$1,866,941
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$23,748,805
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$24,011,151
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$22,313,835
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$23,742,014
Value of total assets at end of year2016-12-31$0
Value of total assets at beginning of year2016-12-31$2,129,287
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,697,316
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$403,336
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,211,448
Administrative expenses (other) incurred2016-12-31$1,268,845
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-262,346
Value of net assets at end of year (total assets less liabilities)2016-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,129,287
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,129,287
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$2,890,795
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$6,791
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$22,530,566
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$19,423,040
Contract administrator fees2016-12-31$25,135
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31CROWE HORWATH LLP
Accountancy firm EIN2016-12-31350921680
2015 : GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$32,113,803
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$30,389,068
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$28,660,024
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$32,111,778
Value of total assets at end of year2015-12-31$2,129,287
Value of total assets at beginning of year2015-12-31$404,552
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,729,044
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$496,388
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,643,885
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$0
Administrative expenses (other) incurred2015-12-31$3,370
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$1,724,735
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,129,287
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$404,552
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,129,287
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$404,552
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$4,015,467
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$2,025
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$30,467,893
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$24,644,557
Contract administrator fees2015-12-31$1,229,286
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31SCHNEIDER DOWNS & CO., INC.
Accountancy firm EIN2015-12-31251408703
2014 : GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$20,048,610
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$19,969,494
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$18,925,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$20,048,382
Value of total assets at end of year2014-12-31$404,552
Value of total assets at beginning of year2014-12-31$325,436
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$1,043,550
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,081,925
Administrative expenses (other) incurred2014-12-31$1,026,237
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$79,116
Value of net assets at end of year (total assets less liabilities)2014-12-31$404,552
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$325,436
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$404,552
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$325,436
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$18,925,944
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$228
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$18,966,457
Contract administrator fees2014-12-31$17,313
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31SCHNEIDER DOWNS & CO., INC.
Accountancy firm EIN2014-12-31251408703
Total unrealized appreciation/depreciation of assets2014-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-04-30$0
Total income from all sources (including contributions)2014-04-30$27,848,044
Total loss/gain on sale of assets2014-04-30$0
Total of all expenses incurred2014-04-30$27,891,565
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-04-30$25,580,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-04-30$27,847,679
Value of total assets at end of year2014-04-30$325,436
Value of total assets at beginning of year2014-04-30$368,957
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-04-30$2,311,429
Total interest from all sources2014-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2014-04-30$365
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2014-04-30$365
Administrative expenses professional fees incurred2014-04-30$331,178
Was this plan covered by a fidelity bond2014-04-30Yes
Value of fidelity bond cover2014-04-30$500,000
Were there any nonexempt tranactions with any party-in-interest2014-04-30No
Contributions received from participants2014-04-30$1,764,776
Administrative expenses (other) incurred2014-04-30$1,657,052
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-04-30No
Value of net income/loss2014-04-30$-43,521
Value of net assets at end of year (total assets less liabilities)2014-04-30$325,436
Value of net assets at beginning of year (total assets less liabilities)2014-04-30$368,957
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-04-30No
Were any leases to which the plan was party in default or uncollectible2014-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-04-30$325,436
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-04-30$368,957
Expenses. Payments to insurance carriers foe the provision of benefits2014-04-30$25,580,136
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-04-30Yes
Was there a failure to transmit to the plan any participant contributions2014-04-30No
Has the plan failed to provide any benefit when due under the plan2014-04-30No
Contributions received in cash from employer2014-04-30$26,082,903
Contract administrator fees2014-04-30$323,199
Did the plan have assets held for investment2014-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-04-30No
Opinion of an independent qualified public accountant for this plan2014-04-30Unqualified
Accountancy firm name2014-04-30BDO USA, LLP
Accountancy firm EIN2014-04-30135381590
2013 : GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-04-30$0
Total income from all sources (including contributions)2013-04-30$25,676,921
Total loss/gain on sale of assets2013-04-30$0
Total of all expenses incurred2013-04-30$26,282,513
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-04-30$23,120,558
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-04-30$25,675,860
Value of total assets at end of year2013-04-30$368,957
Value of total assets at beginning of year2013-04-30$974,549
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-04-30$3,161,955
Total interest from all sources2013-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2013-04-30$1,061
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-04-30$1,061
Administrative expenses professional fees incurred2013-04-30$473,502
Was this plan covered by a fidelity bond2013-04-30Yes
Value of fidelity bond cover2013-04-30$500,000
Were there any nonexempt tranactions with any party-in-interest2013-04-30No
Contributions received from participants2013-04-30$1,408,771
Administrative expenses (other) incurred2013-04-30$2,494,495
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Value of net income/loss2013-04-30$-605,592
Value of net assets at end of year (total assets less liabilities)2013-04-30$368,957
Value of net assets at beginning of year (total assets less liabilities)2013-04-30$974,549
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-04-30No
Were any leases to which the plan was party in default or uncollectible2013-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-04-30$368,957
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-04-30$974,549
Expenses. Payments to insurance carriers foe the provision of benefits2013-04-30$23,120,558
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-04-30Yes
Was there a failure to transmit to the plan any participant contributions2013-04-30No
Has the plan failed to provide any benefit when due under the plan2013-04-30No
Contributions received in cash from employer2013-04-30$24,267,089
Contract administrator fees2013-04-30$193,958
Did the plan have assets held for investment2013-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-04-30No
Opinion of an independent qualified public accountant for this plan2013-04-30Unqualified
Accountancy firm name2013-04-30ALPERN ROSENTHAL
Accountancy firm EIN2013-04-30251724342
2012 : GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-04-30$0
Total income from all sources (including contributions)2012-04-30$30,505,363
Total loss/gain on sale of assets2012-04-30$0
Total of all expenses incurred2012-04-30$30,366,379
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-04-30$27,477,627
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-04-30$30,504,641
Value of total assets at end of year2012-04-30$974,549
Value of total assets at beginning of year2012-04-30$835,565
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-04-30$2,888,752
Total interest from all sources2012-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2012-04-30$722
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-04-30$722
Administrative expenses professional fees incurred2012-04-30$717,894
Was this plan covered by a fidelity bond2012-04-30Yes
Value of fidelity bond cover2012-04-30$500,000
Were there any nonexempt tranactions with any party-in-interest2012-04-30No
Contributions received from participants2012-04-30$1,110,293
Administrative expenses (other) incurred2012-04-30$1,985,666
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Value of net income/loss2012-04-30$138,984
Value of net assets at end of year (total assets less liabilities)2012-04-30$974,549
Value of net assets at beginning of year (total assets less liabilities)2012-04-30$835,565
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-04-30No
Were any leases to which the plan was party in default or uncollectible2012-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-04-30$974,549
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-04-30$835,565
Expenses. Payments to insurance carriers foe the provision of benefits2012-04-30$23,144,215
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-04-30Yes
Was there a failure to transmit to the plan any participant contributions2012-04-30No
Has the plan failed to provide any benefit when due under the plan2012-04-30No
Contributions received in cash from employer2012-04-30$29,394,348
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-04-30$4,333,412
Contract administrator fees2012-04-30$185,192
Did the plan have assets held for investment2012-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-04-30No
Opinion of an independent qualified public accountant for this plan2012-04-30Unqualified
Accountancy firm name2012-04-30ALPERN ROSENTHAL
Accountancy firm EIN2012-04-30251724342
2011 : GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-04-30$0
Total transfer of assets to this plan2011-04-30$401,966
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-04-30$0
Total income from all sources (including contributions)2011-04-30$25,911,897
Total loss/gain on sale of assets2011-04-30$0
Total of all expenses incurred2011-04-30$25,478,298
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-04-30$22,528,536
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-04-30$25,910,730
Value of total assets at end of year2011-04-30$835,565
Value of total assets at beginning of year2011-04-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-04-30$2,949,762
Total interest from all sources2011-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2011-04-30$1,167
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2011-04-30$1,167
Administrative expenses professional fees incurred2011-04-30$654,229
Was this plan covered by a fidelity bond2011-04-30Yes
Value of fidelity bond cover2011-04-30$500,000
Were there any nonexempt tranactions with any party-in-interest2011-04-30No
Contributions received from participants2011-04-30$886,796
Administrative expenses (other) incurred2011-04-30$2,027,966
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Value of net income/loss2011-04-30$433,599
Value of net assets at end of year (total assets less liabilities)2011-04-30$835,565
Value of net assets at beginning of year (total assets less liabilities)2011-04-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-04-30No
Were any leases to which the plan was party in default or uncollectible2011-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-04-30$835,565
Expenses. Payments to insurance carriers foe the provision of benefits2011-04-30$22,517,896
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-04-30Yes
Was there a failure to transmit to the plan any participant contributions2011-04-30No
Has the plan failed to provide any benefit when due under the plan2011-04-30No
Contributions received in cash from employer2011-04-30$25,023,934
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-04-30$10,640
Contract administrator fees2011-04-30$267,567
Did the plan have assets held for investment2011-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-04-30No
Opinion of an independent qualified public accountant for this plan2011-04-30Unqualified
Accountancy firm name2011-04-30ALPERN ROSENTHAL
Accountancy firm EIN2011-04-30251724342

Form 5500 Responses for GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES

2016: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-05-01Plan is a collectively bargained planYes
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan funding arrangement – General assets of the sponsorYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2014-05-01Plan benefit arrangement – General assets of the sponsorYes
2013: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planYes
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan funding arrangement – General assets of the sponsorYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2013-05-01Plan benefit arrangement – General assets of the sponsorYes
2012: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planYes
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan funding arrangement – General assets of the sponsorYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2012-05-01Plan benefit arrangement – General assets of the sponsorYes
2011: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planYes
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan funding arrangement – General assets of the sponsorYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes
2011-05-01Plan benefit arrangement – General assets of the sponsorYes
2010: GROUP BENEFITS PROGRAM FOR COLLECTIVELY-BARGAINED ACTIVE EMPLOYEES 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01First time form 5500 has been submittedYes
2010-05-01Submission has been amendedNo
2010-05-01This submission is the final filingNo
2010-05-01This return/report is a short plan year return/report (less than 12 months)No
2010-05-01Plan is a collectively bargained planYes
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan funding arrangement – TrustYes
2010-05-01Plan funding arrangement – General assets of the sponsorYes
2010-05-01Plan benefit arrangement – InsuranceYes
2010-05-01Plan benefit arrangement - TrustYes
2010-05-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number16732
Policy instance 1
Insurance contract or identification number16732
Number of Individuals Covered5050
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $9,524
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $507,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,524
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL, INC.
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3-880-004065
Policy instance 2
Insurance contract or identification numberGF3-880-004065
Number of Individuals Covered2219
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $544,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3-880-004065
Policy instance 2
Insurance contract or identification numberGF3-880-004065
Number of Individuals Covered654
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $165,567
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number16732
Policy instance 1
Insurance contract or identification number16732
Number of Individuals Covered2521
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $141,476
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL, INC.
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number16732
Policy instance 1
Insurance contract or identification number16732
Number of Individuals Covered2566
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,337
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $148,046
Commission paid to Insurance BrokerUSD $3,337
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL, INC.
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3-880-004065
Policy instance 2
Insurance contract or identification numberGF3-880-004065
Number of Individuals Covered724
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $176,901
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3-880-004065
Policy instance 2
Insurance contract or identification numberGF3-880-004065
Number of Individuals Covered723
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $0
Insurance broker name
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number16732
Policy instance 1
Insurance contract or identification number16732
Number of Individuals Covered2601
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,396
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $154,346
Commission paid to Insurance BrokerUSD $3,396
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL, INC.
SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number16
Policy instance 4
Insurance contract or identification number16
Number of Individuals Covered0
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $126,634
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number16732
Policy instance 3
Insurance contract or identification number16732
Number of Individuals Covered2774
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,356
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $163,750
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGF3-880-004065
Policy instance 2
Insurance contract or identification numberGF3-880-004065
Number of Individuals Covered719
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $208,522
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number64498
Policy instance 1
Insurance contract or identification number64498
Number of Individuals Covered0
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $459,300
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number251883-101 & SU
Policy instance 5
Insurance contract or identification number251883-101 & SU
Number of Individuals Covered0
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number251883-101 & SU
Policy instance 5
Insurance contract or identification number251883-101 & SU
Number of Individuals Covered26
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number16
Policy instance 4
Insurance contract or identification number16
Number of Individuals Covered609
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $710,055
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number16732
Policy instance 3
Insurance contract or identification number16732
Number of Individuals Covered3402
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,072
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $204,185
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number64498
Policy instance 1
Insurance contract or identification number64498
Number of Individuals Covered79
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $827,751
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number880-004065
Policy instance 2
Insurance contract or identification number880-004065
Number of Individuals Covered998
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $373,223

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