EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501)
401k plan membership statisitcs for EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501)
| Measure | Date | Value |
|---|
| 2022: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 22 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 22 |
| 2021: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-12-01 | 22 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 21 |
| Number of retired or separated participants receiving benefits | 2021-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-12-01 | 0 |
| Total of all active and inactive participants | 2021-12-01 | 21 |
| 2020: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-01 | 21 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 22 |
| Number of retired or separated participants receiving benefits | 2020-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-12-01 | 0 |
| Total of all active and inactive participants | 2020-12-01 | 22 |
| 2019: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-01 | 22 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 21 |
| Number of retired or separated participants receiving benefits | 2019-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-12-01 | 0 |
| Total of all active and inactive participants | 2019-12-01 | 21 |
| 2018: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-01 | 24 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 22 |
| Number of retired or separated participants receiving benefits | 2018-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-12-01 | 0 |
| Total of all active and inactive participants | 2018-12-01 | 22 |
| 2017: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-01 | 27 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 24 |
| Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
| Total of all active and inactive participants | 2017-12-01 | 24 |
| Measure | Date | Value |
|---|
| 2022 : EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2022 401k financial data |
|---|
| Total plan liabilities at end of year | 2022-12-31 | $45,254 |
| Total plan liabilities at beginning of year | 2022-12-31 | $0 |
| Total income from all sources | 2022-12-31 | $447,883 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $458,210 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $276,599 |
| Total plan assets at end of year | 2022-12-31 | $34,927 |
| Total plan assets at beginning of year | 2022-12-31 | $0 |
| Value of fidelity bond covering the plan | 2022-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $139,862 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $181,955 |
| Contributions received from other sources (not participants or employers) | 2022-12-31 | $5,340 |
| Other income received | 2022-12-31 | $46 |
| Net income (gross income less expenses) | 2022-12-31 | $-10,327 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $-10,327 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $302,635 |
| Value of corrective distributions | 2022-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $-344 |
| 2021 : EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-12-31 | $18,532 |
| Total plan liabilities at beginning of year | 2021-12-31 | $34,639 |
| Total income from all sources | 2021-12-31 | $18,292 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $19,264 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $12,154 |
| Total plan assets at end of year | 2021-12-31 | $1,621 |
| Total plan assets at beginning of year | 2021-12-31 | $18,700 |
| Value of fidelity bond covering the plan | 2021-12-31 | $80,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $2,122 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $6,242 |
| Other income received | 2021-12-31 | $1 |
| Net income (gross income less expenses) | 2021-12-31 | $-972 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $-16,911 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $-15,939 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $16,169 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $868 |
| Total plan liabilities at end of year | 2021-11-30 | $34,639 |
| Total plan liabilities at beginning of year | 2021-11-30 | $22,336 |
| Total income from all sources | 2021-11-30 | $236,881 |
| Expenses. Total of all expenses incurred | 2021-11-30 | $230,726 |
| Benefits paid (including direct rollovers) | 2021-11-30 | $139,717 |
| Total plan assets at end of year | 2021-11-30 | $18,700 |
| Total plan assets at beginning of year | 2021-11-30 | $242 |
| Value of fidelity bond covering the plan | 2021-11-30 | $80,000 |
| Total contributions received or receivable from participants | 2021-11-30 | $28,725 |
| Expenses. Other expenses not covered elsewhere | 2021-11-30 | $80,293 |
| Other income received | 2021-11-30 | $34 |
| Net income (gross income less expenses) | 2021-11-30 | $6,155 |
| Net plan assets at end of year (total assets less liabilities) | 2021-11-30 | $-15,939 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-11-30 | $-22,094 |
| Total contributions received or receivable from employer(s) | 2021-11-30 | $208,122 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-11-30 | $10,716 |
| 2020 : EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-11-30 | $22,336 |
| Total plan liabilities at beginning of year | 2020-11-30 | $38,548 |
| Total income from all sources | 2020-11-30 | $255,532 |
| Expenses. Total of all expenses incurred | 2020-11-30 | $243,616 |
| Benefits paid (including direct rollovers) | 2020-11-30 | $149,818 |
| Total plan assets at end of year | 2020-11-30 | $242 |
| Total plan assets at beginning of year | 2020-11-30 | $4,538 |
| Value of fidelity bond covering the plan | 2020-11-30 | $80,000 |
| Total contributions received or receivable from participants | 2020-11-30 | $42,858 |
| Expenses. Other expenses not covered elsewhere | 2020-11-30 | $83,210 |
| Contributions received from other sources (not participants or employers) | 2020-11-30 | $0 |
| Other income received | 2020-11-30 | $28 |
| Net income (gross income less expenses) | 2020-11-30 | $11,916 |
| Net plan assets at end of year (total assets less liabilities) | 2020-11-30 | $-22,094 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-11-30 | $-34,010 |
| Total contributions received or receivable from employer(s) | 2020-11-30 | $212,646 |
| Value of corrective distributions | 2020-11-30 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-11-30 | $10,588 |
| 2019 : EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-11-30 | $38,548 |
| Total plan liabilities at beginning of year | 2019-11-30 | $18,321 |
| Total income from all sources | 2019-11-30 | $221,703 |
| Expenses. Total of all expenses incurred | 2019-11-30 | $238,871 |
| Benefits paid (including direct rollovers) | 2019-11-30 | $150,329 |
| Total plan assets at end of year | 2019-11-30 | $4,538 |
| Total plan assets at beginning of year | 2019-11-30 | $1,479 |
| Value of fidelity bond covering the plan | 2019-11-30 | $80,000 |
| Total contributions received or receivable from participants | 2019-11-30 | $40,371 |
| Expenses. Other expenses not covered elsewhere | 2019-11-30 | $75,170 |
| Contributions received from other sources (not participants or employers) | 2019-11-30 | $0 |
| Other income received | 2019-11-30 | $20 |
| Net income (gross income less expenses) | 2019-11-30 | $-17,168 |
| Net plan assets at end of year (total assets less liabilities) | 2019-11-30 | $-34,010 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-11-30 | $-16,842 |
| Total contributions received or receivable from employer(s) | 2019-11-30 | $181,312 |
| Value of corrective distributions | 2019-11-30 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-11-30 | $13,372 |
| 2022: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2021 form 5500 responses |
|---|
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | Submission has been amended | No |
| 2021-12-01 | This submission is the final filing | No |
| 2021-12-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2021-12-01 | Plan is a collectively bargained plan | No |
| 2021-12-01 | Plan funding arrangement – Insurance | Yes |
| 2021-12-01 | Plan funding arrangement – Trust | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement - Trust | Yes |
| 2020: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2020 form 5500 responses |
|---|
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | Submission has been amended | No |
| 2020-12-01 | This submission is the final filing | No |
| 2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-12-01 | Plan is a collectively bargained plan | No |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan funding arrangement – Trust | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement - Trust | Yes |
| 2019: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2019 form 5500 responses |
|---|
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | Submission has been amended | No |
| 2019-12-01 | This submission is the final filing | No |
| 2019-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-12-01 | Plan is a collectively bargained plan | No |
| 2019-12-01 | Plan funding arrangement – Insurance | Yes |
| 2019-12-01 | Plan funding arrangement – Trust | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-12-01 | Plan benefit arrangement - Trust | Yes |
| 2018: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2018 form 5500 responses |
|---|
| 2018-12-01 | Type of plan entity | Single employer plan |
| 2018-12-01 | Submission has been amended | No |
| 2018-12-01 | This submission is the final filing | No |
| 2018-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-12-01 | Plan is a collectively bargained plan | No |
| 2018-12-01 | Plan funding arrangement – Insurance | Yes |
| 2018-12-01 | Plan funding arrangement – Trust | Yes |
| 2018-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-12-01 | Plan benefit arrangement - Trust | Yes |
| 2017: EVERHART & HOOVER POWER LINE CONSTRUCTION, INC. EMPLOYEE BENEFIT PLAN (501) 2017 form 5500 responses |
|---|
| 2017-12-01 | Type of plan entity | Single employer plan |
| 2017-12-01 | First time form 5500 has been submitted | Yes |
| 2017-12-01 | Submission has been amended | No |
| 2017-12-01 | This submission is the final filing | No |
| 2017-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-12-01 | Plan is a collectively bargained plan | No |
| 2017-12-01 | Plan funding arrangement – Insurance | Yes |
| 2017-12-01 | Plan funding arrangement – Trust | Yes |
| 2017-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-12-01 | Plan benefit arrangement - Trust | Yes |
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00526406 |
| Policy instance | 2 |
| Insurance contract or identification number | 00526406 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 | Yes | | 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 $3,923 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500319 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500319 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2022-12-01 | | Insurance policy end date | 2022-12-31 | | 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 | 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 $68,607 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00526406 |
| Policy instance | 2 |
| Insurance contract or identification number | 00526406 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2021-12-31 | | 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 | Yes | | 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 $385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500319 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500319 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2021-12-31 | | 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 | 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 $5,016 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500319 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500319 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $64,933 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00526406 |
| Policy instance | 2 |
| Insurance contract or identification number | 00526406 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | 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 $4,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500319 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500319 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $67,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00526406 |
| Policy instance | 2 |
| Insurance contract or identification number | 00526406 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | 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 $4,323 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00526406 |
| Policy instance | 2 |
| Insurance contract or identification number | 00526406 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | 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 $4,476 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 22 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $58,812 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00526406 |
| Policy instance | 2 |
| Insurance contract or identification number | 00526406 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | 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 $5,826 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 23 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $64,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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