EMPLOYER TEAMSTERS LOCAL 205 WELFARE FUND has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND
| Measure | Date | Value |
|---|
| 2023 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2023 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2023-04-30 | $10,308 |
| Total unrealized appreciation/depreciation of assets | 2023-04-30 | $10,308 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-04-30 | $580,972 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-04-30 | $672,208 |
| Total income from all sources (including contributions) | 2023-04-30 | $4,204,653 |
| Total of all expenses incurred | 2023-04-30 | $4,236,263 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-04-30 | $3,828,226 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-04-30 | $4,126,137 |
| Value of total assets at end of year | 2023-04-30 | $2,224,765 |
| Value of total assets at beginning of year | 2023-04-30 | $2,347,611 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-04-30 | $408,037 |
| Total income from rents | 2023-04-30 | $36,948 |
| Total interest from all sources | 2023-04-30 | $23,223 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-04-30 | $19,739 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2023-04-30 | $19,739 |
| Administrative expenses professional fees incurred | 2023-04-30 | $84,682 |
| Was this plan covered by a fidelity bond | 2023-04-30 | Yes |
| Value of fidelity bond cover | 2023-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2023-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-04-30 | No |
| Contributions received from participants | 2023-04-30 | $49,890 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-04-30 | $21,216 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-04-30 | $153,752 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-04-30 | $345,059 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-04-30 | $332,868 |
| Other income not declared elsewhere | 2023-04-30 | $348 |
| Administrative expenses (other) incurred | 2023-04-30 | $319,022 |
| Liabilities. Value of operating payables at end of year | 2023-04-30 | $40,918 |
| Liabilities. Value of operating payables at beginning of year | 2023-04-30 | $44,970 |
| Total non interest bearing cash at end of year | 2023-04-30 | $50,025 |
| Total non interest bearing cash at beginning of year | 2023-04-30 | $68,484 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-04-30 | No |
| Value of net income/loss | 2023-04-30 | $-31,610 |
| Value of net assets at end of year (total assets less liabilities) | 2023-04-30 | $1,643,793 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-04-30 | $1,675,403 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-04-30 | No |
| Investment advisory and management fees | 2023-04-30 | $4,333 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-04-30 | $353,041 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-04-30 | $608,706 |
| Interest earned on other investments | 2023-04-30 | $23,223 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-04-30 | $4,677 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-04-30 | $2,788 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-04-30 | $2,788 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2023-04-30 | $1,606,160 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2023-04-30 | $1,322,630 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-04-30 | $1,070,240 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2023-04-30 | $-12,050 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-04-30 | No |
| Contributions received in cash from employer | 2023-04-30 | $4,076,247 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-04-30 | $2,757,986 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2023-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2023-04-30 | $194,995 |
| Liabilities. Value of benefit claims payable at beginning of year | 2023-04-30 | $294,370 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2023-04-30 | $189,646 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2023-04-30 | $191,251 |
| Did the plan have assets held for investment | 2023-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-04-30 | Unqualified |
| Accountancy firm name | 2023-04-30 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2023-04-30 | 611436956 |
| 2022 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-04-30 | $-8,892 |
| Total unrealized appreciation/depreciation of assets | 2022-04-30 | $-8,892 |
| Total transfer of assets to this plan | 2022-04-30 | $307,269 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-04-30 | $672,208 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-04-30 | $1,222,343 |
| Total income from all sources (including contributions) | 2022-04-30 | $4,316,603 |
| Total loss/gain on sale of assets | 2022-04-30 | $-3,273 |
| Total of all expenses incurred | 2022-04-30 | $4,663,787 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-04-30 | $4,276,724 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-04-30 | $4,336,910 |
| Value of total assets at end of year | 2022-04-30 | $2,347,611 |
| Value of total assets at beginning of year | 2022-04-30 | $2,937,661 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-04-30 | $387,063 |
| Total income from rents | 2022-04-30 | $36,140 |
| Total interest from all sources | 2022-04-30 | $21,458 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-04-30 | $34,568 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-04-30 | $34,568 |
| Administrative expenses professional fees incurred | 2022-04-30 | $83,327 |
| Was this plan covered by a fidelity bond | 2022-04-30 | Yes |
| Value of fidelity bond cover | 2022-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-04-30 | No |
| Contributions received from participants | 2022-04-30 | $44,575 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-04-30 | $153,752 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-04-30 | $12,942 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-04-30 | $332,868 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-04-30 | $574,765 |
| Other income not declared elsewhere | 2022-04-30 | $1,683 |
| Administrative expenses (other) incurred | 2022-04-30 | $302,643 |
| Liabilities. Value of operating payables at end of year | 2022-04-30 | $44,970 |
| Liabilities. Value of operating payables at beginning of year | 2022-04-30 | $45,348 |
| Total non interest bearing cash at end of year | 2022-04-30 | $68,484 |
| Total non interest bearing cash at beginning of year | 2022-04-30 | $1,737,968 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-04-30 | No |
| Value of net income/loss | 2022-04-30 | $-347,184 |
| Value of net assets at end of year (total assets less liabilities) | 2022-04-30 | $1,675,403 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-04-30 | $1,715,318 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-04-30 | No |
| Investment advisory and management fees | 2022-04-30 | $1,093 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-04-30 | $608,706 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-04-30 | $377,713 |
| Interest earned on other investments | 2022-04-30 | $21,458 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-04-30 | $2,788 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-04-30 | $3,070 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-04-30 | $3,070 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2022-04-30 | $1,322,630 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2022-04-30 | $610,063 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-04-30 | $958,956 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-04-30 | $-101,991 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-04-30 | No |
| Contributions received in cash from employer | 2022-04-30 | $4,292,335 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-04-30 | $3,317,768 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2022-04-30 | $294,370 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-04-30 | $602,230 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2022-04-30 | $191,251 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2022-04-30 | $195,905 |
| Did the plan have assets held for investment | 2022-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-04-30 | No |
| Aggregate carrying amount (costs) on sale of assets | 2022-04-30 | $3,273 |
| Opinion of an independent qualified public accountant for this plan | 2022-04-30 | Unqualified |
| Accountancy firm name | 2022-04-30 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2022-04-30 | 611436956 |
| 2021 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-04-30 | $70,810 |
| Total unrealized appreciation/depreciation of assets | 2021-04-30 | $70,810 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-04-30 | $1,222,343 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-04-30 | $537,056 |
| Total income from all sources (including contributions) | 2021-04-30 | $4,722,427 |
| Total loss/gain on sale of assets | 2021-04-30 | $3,184 |
| Total of all expenses incurred | 2021-04-30 | $4,910,289 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-04-30 | $4,039,626 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-04-30 | $4,591,614 |
| Value of total assets at end of year | 2021-04-30 | $2,937,661 |
| Value of total assets at beginning of year | 2021-04-30 | $2,440,236 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-04-30 | $870,663 |
| Total income from rents | 2021-04-30 | $35,736 |
| Total interest from all sources | 2021-04-30 | $18,077 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-04-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-04-30 | No |
| Administrative expenses professional fees incurred | 2021-04-30 | $78,079 |
| Was this plan covered by a fidelity bond | 2021-04-30 | Yes |
| Value of fidelity bond cover | 2021-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-04-30 | No |
| Contributions received from participants | 2021-04-30 | $64,472 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-04-30 | $12,942 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-04-30 | $9,435 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-04-30 | $574,765 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-04-30 | $358,114 |
| Other income not declared elsewhere | 2021-04-30 | $3,006 |
| Administrative expenses (other) incurred | 2021-04-30 | $300,422 |
| Liabilities. Value of operating payables at end of year | 2021-04-30 | $45,348 |
| Liabilities. Value of operating payables at beginning of year | 2021-04-30 | $4,320 |
| Total non interest bearing cash at end of year | 2021-04-30 | $1,737,968 |
| Total non interest bearing cash at beginning of year | 2021-04-30 | $1,418,702 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-04-30 | No |
| Value of net income/loss | 2021-04-30 | $-187,862 |
| Value of net assets at end of year (total assets less liabilities) | 2021-04-30 | $1,715,318 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-04-30 | $1,903,180 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-04-30 | No |
| Investment advisory and management fees | 2021-04-30 | $3,088 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-04-30 | $377,713 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-04-30 | $319,623 |
| Income. Interest from US Government securities | 2021-04-30 | $18,077 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-04-30 | $3,070 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-04-30 | $2,718 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-04-30 | $2,718 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2021-04-30 | $610,063 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2021-04-30 | $479,522 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-04-30 | $3,417,920 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-04-30 | No |
| Contributions received in cash from employer | 2021-04-30 | $4,527,142 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-04-30 | $621,706 |
| Contract administrator fees | 2021-04-30 | $489,074 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2021-04-30 | $602,230 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-04-30 | $174,622 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2021-04-30 | $195,905 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2021-04-30 | $210,236 |
| Did the plan have assets held for investment | 2021-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-04-30 | No |
| Aggregate proceeds on sale of assets | 2021-04-30 | $18,082 |
| Aggregate carrying amount (costs) on sale of assets | 2021-04-30 | $14,898 |
| Opinion of an independent qualified public accountant for this plan | 2021-04-30 | Unqualified |
| Accountancy firm name | 2021-04-30 | ALBANESE SINCHAR SMITH & CO |
| Accountancy firm EIN | 2021-04-30 | 461686881 |
| 2020 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-04-30 | $-12,282 |
| Total unrealized appreciation/depreciation of assets | 2020-04-30 | $-12,282 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-04-30 | $537,056 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-04-30 | $806,701 |
| Total income from all sources (including contributions) | 2020-04-30 | $4,664,706 |
| Total loss/gain on sale of assets | 2020-04-30 | $15,235 |
| Total of all expenses incurred | 2020-04-30 | $3,997,491 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-04-30 | $3,160,656 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-04-30 | $4,596,484 |
| Value of total assets at end of year | 2020-04-30 | $2,440,236 |
| Value of total assets at beginning of year | 2020-04-30 | $2,042,666 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-04-30 | $836,835 |
| Total income from rents | 2020-04-30 | $35,736 |
| Total interest from all sources | 2020-04-30 | $29,461 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-04-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-04-30 | No |
| Administrative expenses professional fees incurred | 2020-04-30 | $102,880 |
| Was this plan covered by a fidelity bond | 2020-04-30 | Yes |
| Value of fidelity bond cover | 2020-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-04-30 | No |
| Contributions received from participants | 2020-04-30 | $67,700 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-04-30 | $9,435 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-04-30 | $9,435 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-04-30 | $358,114 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-04-30 | $398,214 |
| Other income not declared elsewhere | 2020-04-30 | $72 |
| Administrative expenses (other) incurred | 2020-04-30 | $289,341 |
| Liabilities. Value of operating payables at end of year | 2020-04-30 | $4,320 |
| Liabilities. Value of operating payables at beginning of year | 2020-04-30 | $43,041 |
| Total non interest bearing cash at end of year | 2020-04-30 | $1,418,702 |
| Total non interest bearing cash at beginning of year | 2020-04-30 | $406,315 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-04-30 | No |
| Value of net income/loss | 2020-04-30 | $667,215 |
| Value of net assets at end of year (total assets less liabilities) | 2020-04-30 | $1,903,180 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-04-30 | $1,235,965 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-04-30 | No |
| Investment advisory and management fees | 2020-04-30 | $4,247 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-04-30 | $319,623 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-04-30 | $608,434 |
| Income. Interest from US Government securities | 2020-04-30 | $29,461 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-04-30 | $2,718 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-04-30 | $4,487 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-04-30 | $4,487 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2020-04-30 | $479,522 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2020-04-30 | $789,400 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-04-30 | $2,596,873 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-04-30 | No |
| Contributions received in cash from employer | 2020-04-30 | $4,528,784 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-04-30 | $563,783 |
| Contract administrator fees | 2020-04-30 | $440,367 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2020-04-30 | $174,622 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-04-30 | $365,446 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2020-04-30 | $210,236 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2020-04-30 | $224,595 |
| Did the plan have assets held for investment | 2020-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-04-30 | No |
| Aggregate proceeds on sale of assets | 2020-04-30 | $323,345 |
| Aggregate carrying amount (costs) on sale of assets | 2020-04-30 | $308,110 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-04-30 | Unqualified |
| Accountancy firm name | 2020-04-30 | ALBANESE SINCHAR SMITH & CO |
| Accountancy firm EIN | 2020-04-30 | 461686881 |
| 2019 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-04-30 | $4,717 |
| Total unrealized appreciation/depreciation of assets | 2019-04-30 | $4,717 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-04-30 | $806,701 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-04-30 | $881,089 |
| Total income from all sources (including contributions) | 2019-04-30 | $5,007,106 |
| Total loss/gain on sale of assets | 2019-04-30 | $-7,675 |
| Total of all expenses incurred | 2019-04-30 | $4,719,675 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-04-30 | $3,816,849 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-04-30 | $4,927,173 |
| Value of total assets at end of year | 2019-04-30 | $2,042,666 |
| Value of total assets at beginning of year | 2019-04-30 | $1,829,623 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-04-30 | $902,826 |
| Total income from rents | 2019-04-30 | $35,736 |
| Total interest from all sources | 2019-04-30 | $46,742 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-04-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-04-30 | No |
| Administrative expenses professional fees incurred | 2019-04-30 | $82,928 |
| Was this plan covered by a fidelity bond | 2019-04-30 | Yes |
| Value of fidelity bond cover | 2019-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-04-30 | No |
| Contributions received from participants | 2019-04-30 | $63,039 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-04-30 | $9,435 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-04-30 | $10,624 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-04-30 | $398,214 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-04-30 | $347,525 |
| Other income not declared elsewhere | 2019-04-30 | $413 |
| Administrative expenses (other) incurred | 2019-04-30 | $336,901 |
| Liabilities. Value of operating payables at end of year | 2019-04-30 | $43,041 |
| Liabilities. Value of operating payables at beginning of year | 2019-04-30 | $53,060 |
| Total non interest bearing cash at end of year | 2019-04-30 | $406,315 |
| Total non interest bearing cash at beginning of year | 2019-04-30 | $202,435 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-04-30 | No |
| Value of net income/loss | 2019-04-30 | $287,431 |
| Value of net assets at end of year (total assets less liabilities) | 2019-04-30 | $1,235,965 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-04-30 | $948,534 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-04-30 | No |
| Investment advisory and management fees | 2019-04-30 | $5,852 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-04-30 | $608,434 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-04-30 | $590,876 |
| Income. Interest from US Government securities | 2019-04-30 | $46,742 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-04-30 | $4,487 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-04-30 | $4,135 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-04-30 | $4,135 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2019-04-30 | $789,400 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2019-04-30 | $784,803 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-04-30 | $3,126,458 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-04-30 | No |
| Contributions received in cash from employer | 2019-04-30 | $4,864,134 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-04-30 | $690,391 |
| Contract administrator fees | 2019-04-30 | $477,145 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2019-04-30 | $365,446 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-04-30 | $480,504 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2019-04-30 | $224,595 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-04-30 | $236,750 |
| Did the plan have assets held for investment | 2019-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-04-30 | No |
| Aggregate proceeds on sale of assets | 2019-04-30 | $609,436 |
| Aggregate carrying amount (costs) on sale of assets | 2019-04-30 | $617,111 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-04-30 | Unqualified |
| Accountancy firm name | 2019-04-30 | ALBANESE SINCHAR SMITH & CO |
| Accountancy firm EIN | 2019-04-30 | 461686881 |
| 2018 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-04-30 | $14,026 |
| Total unrealized appreciation/depreciation of assets | 2018-04-30 | $14,026 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-04-30 | $881,089 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-04-30 | $1,138,791 |
| Total income from all sources (including contributions) | 2018-04-30 | $6,551,761 |
| Total loss/gain on sale of assets | 2018-04-30 | $1,790 |
| Total of all expenses incurred | 2018-04-30 | $6,704,463 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-04-30 | $5,586,401 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-04-30 | $6,446,140 |
| Value of total assets at end of year | 2018-04-30 | $1,829,623 |
| Value of total assets at beginning of year | 2018-04-30 | $2,240,027 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-04-30 | $1,118,062 |
| Total income from rents | 2018-04-30 | $36,736 |
| Total interest from all sources | 2018-04-30 | $52,554 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-04-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-04-30 | No |
| Administrative expenses professional fees incurred | 2018-04-30 | $73,708 |
| Was this plan covered by a fidelity bond | 2018-04-30 | Yes |
| Value of fidelity bond cover | 2018-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-04-30 | No |
| Contributions received from participants | 2018-04-30 | $85,892 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-04-30 | $10,624 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-04-30 | $9,435 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-04-30 | $347,525 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-04-30 | $520,829 |
| Other income not declared elsewhere | 2018-04-30 | $515 |
| Administrative expenses (other) incurred | 2018-04-30 | $360,498 |
| Liabilities. Value of operating payables at end of year | 2018-04-30 | $53,060 |
| Liabilities. Value of operating payables at beginning of year | 2018-04-30 | $17,807 |
| Total non interest bearing cash at end of year | 2018-04-30 | $202,435 |
| Total non interest bearing cash at beginning of year | 2018-04-30 | $182,705 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-04-30 | No |
| Value of net income/loss | 2018-04-30 | $-152,702 |
| Value of net assets at end of year (total assets less liabilities) | 2018-04-30 | $948,534 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-04-30 | $1,101,236 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-04-30 | No |
| Investment advisory and management fees | 2018-04-30 | $6,475 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-04-30 | $590,876 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-04-30 | $555,990 |
| Income. Interest from US Government securities | 2018-04-30 | $52,554 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-04-30 | $4,135 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-04-30 | $2,708 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-04-30 | $2,708 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2018-04-30 | $784,803 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2018-04-30 | $1,259,221 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-04-30 | $4,908,451 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-04-30 | No |
| Contributions received in cash from employer | 2018-04-30 | $6,360,248 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-04-30 | $677,950 |
| Contract administrator fees | 2018-04-30 | $677,381 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2018-04-30 | $480,504 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-04-30 | $600,155 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2018-04-30 | $236,750 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2018-04-30 | $229,968 |
| Did the plan have assets held for investment | 2018-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-04-30 | No |
| Aggregate proceeds on sale of assets | 2018-04-30 | $38,857 |
| Aggregate carrying amount (costs) on sale of assets | 2018-04-30 | $37,067 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-04-30 | Unqualified |
| Accountancy firm name | 2018-04-30 | ALBANESE SINCHAR SMITH & CO. |
| Accountancy firm EIN | 2018-04-30 | 461686881 |
| 2017 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-04-30 | $34,623 |
| Total unrealized appreciation/depreciation of assets | 2017-04-30 | $34,623 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-04-30 | $1,138,791 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-04-30 | $1,534,046 |
| Total income from all sources (including contributions) | 2017-04-30 | $7,029,037 |
| Total loss/gain on sale of assets | 2017-04-30 | $-9,136 |
| Total of all expenses incurred | 2017-04-30 | $7,852,591 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-04-30 | $6,812,064 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-04-30 | $6,915,366 |
| Value of total assets at end of year | 2017-04-30 | $2,240,027 |
| Value of total assets at beginning of year | 2017-04-30 | $3,458,836 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-04-30 | $1,040,527 |
| Total income from rents | 2017-04-30 | $34,806 |
| Total interest from all sources | 2017-04-30 | $51,899 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-04-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-04-30 | No |
| Administrative expenses professional fees incurred | 2017-04-30 | $79,325 |
| Was this plan covered by a fidelity bond | 2017-04-30 | Yes |
| Value of fidelity bond cover | 2017-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-04-30 | No |
| Contributions received from participants | 2017-04-30 | $60,686 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-04-30 | $9,435 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-04-30 | $9,435 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-04-30 | $520,829 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-04-30 | $595,850 |
| Other income not declared elsewhere | 2017-04-30 | $1,479 |
| Administrative expenses (other) incurred | 2017-04-30 | $380,329 |
| Liabilities. Value of operating payables at end of year | 2017-04-30 | $17,807 |
| Liabilities. Value of operating payables at beginning of year | 2017-04-30 | $55,956 |
| Total non interest bearing cash at end of year | 2017-04-30 | $182,705 |
| Total non interest bearing cash at beginning of year | 2017-04-30 | $1,065,767 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-04-30 | No |
| Value of net income/loss | 2017-04-30 | $-823,554 |
| Value of net assets at end of year (total assets less liabilities) | 2017-04-30 | $1,101,236 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-04-30 | $1,924,790 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-04-30 | No |
| Investment advisory and management fees | 2017-04-30 | $5,976 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-04-30 | $555,990 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-04-30 | $515,644 |
| Income. Interest from US Government securities | 2017-04-30 | $51,899 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-04-30 | $2,708 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-04-30 | $3,803 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-04-30 | $3,803 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2017-04-30 | $1,259,221 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2017-04-30 | $1,627,912 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-04-30 | $6,134,812 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-04-30 | No |
| Contributions received in cash from employer | 2017-04-30 | $6,854,680 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-04-30 | $677,252 |
| Contract administrator fees | 2017-04-30 | $574,897 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2017-04-30 | $600,155 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-04-30 | $882,240 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2017-04-30 | $229,968 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2017-04-30 | $236,275 |
| Did the plan have assets held for investment | 2017-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-04-30 | No |
| Aggregate proceeds on sale of assets | 2017-04-30 | $34,795 |
| Aggregate carrying amount (costs) on sale of assets | 2017-04-30 | $43,931 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-04-30 | Unqualified |
| Accountancy firm name | 2017-04-30 | ALBANESE SINCHAR SMITH & CO. |
| Accountancy firm EIN | 2017-04-30 | 461686881 |
| 2016 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-04-30 | $1,534,046 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-04-30 | $1,032,459 |
| Total income from all sources (including contributions) | 2016-04-30 | $7,574,151 |
| Total loss/gain on sale of assets | 2016-04-30 | $-35,332 |
| Total of all expenses incurred | 2016-04-30 | $7,965,722 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-04-30 | $6,828,774 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-04-30 | $7,500,821 |
| Value of total assets at end of year | 2016-04-30 | $3,458,836 |
| Value of total assets at beginning of year | 2016-04-30 | $3,348,820 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-04-30 | $1,136,948 |
| Total income from rents | 2016-04-30 | $34,941 |
| Total interest from all sources | 2016-04-30 | $58,871 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-04-30 | No |
| Administrative expenses professional fees incurred | 2016-04-30 | $85,484 |
| Was this plan covered by a fidelity bond | 2016-04-30 | Yes |
| Value of fidelity bond cover | 2016-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-04-30 | No |
| Contributions received from participants | 2016-04-30 | $56,672 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-04-30 | $9,435 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-04-30 | $9,435 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-04-30 | $595,850 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-04-30 | $648,807 |
| Other income not declared elsewhere | 2016-04-30 | $9,884 |
| Administrative expenses (other) incurred | 2016-04-30 | $387,163 |
| Liabilities. Value of operating payables at end of year | 2016-04-30 | $55,956 |
| Liabilities. Value of operating payables at beginning of year | 2016-04-30 | $8,062 |
| Total non interest bearing cash at end of year | 2016-04-30 | $1,065,767 |
| Total non interest bearing cash at beginning of year | 2016-04-30 | $966,973 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-04-30 | No |
| Value of net income/loss | 2016-04-30 | $-391,571 |
| Value of net assets at end of year (total assets less liabilities) | 2016-04-30 | $1,924,790 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-04-30 | $2,316,361 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-04-30 | No |
| Investment advisory and management fees | 2016-04-30 | $8,628 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-04-30 | $515,644 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-04-30 | $729,766 |
| Income. Interest from US Government securities | 2016-04-30 | $58,871 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-04-30 | $3,803 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-04-30 | $624 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-04-30 | $624 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2016-04-30 | $1,627,912 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2016-04-30 | $1,390,807 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-04-30 | $6,153,073 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-04-30 | $4,966 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-04-30 | No |
| Contributions received in cash from employer | 2016-04-30 | $7,444,149 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-04-30 | $675,701 |
| Contract administrator fees | 2016-04-30 | $655,673 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2016-04-30 | $882,240 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-04-30 | $375,590 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2016-04-30 | $236,275 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2016-04-30 | $251,215 |
| Did the plan have assets held for investment | 2016-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-04-30 | No |
| Aggregate proceeds on sale of assets | 2016-04-30 | $621,859 |
| Aggregate carrying amount (costs) on sale of assets | 2016-04-30 | $657,191 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-04-30 | Unqualified |
| Accountancy firm name | 2016-04-30 | ALBANESE SINCHAR SMITH & CO. |
| Accountancy firm EIN | 2016-04-30 | 461686881 |
| 2015 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2015 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-04-30 | $1,032,459 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-04-30 | $1,543,703 |
| Total income from all sources (including contributions) | 2015-04-30 | $8,561,203 |
| Total loss/gain on sale of assets | 2015-04-30 | $-13,955 |
| Total of all expenses incurred | 2015-04-30 | $8,489,889 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-04-30 | $8,005,804 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-04-30 | $8,453,799 |
| Value of total assets at end of year | 2015-04-30 | $3,348,820 |
| Value of total assets at beginning of year | 2015-04-30 | $3,788,750 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-04-30 | $484,085 |
| Total income from rents | 2015-04-30 | $33,320 |
| Total interest from all sources | 2015-04-30 | $70,974 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-04-30 | No |
| Administrative expenses professional fees incurred | 2015-04-30 | $88,776 |
| Was this plan covered by a fidelity bond | 2015-04-30 | Yes |
| Value of fidelity bond cover | 2015-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-04-30 | No |
| Contributions received from participants | 2015-04-30 | $71,618 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-04-30 | $9,435 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-04-30 | $9,435 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-04-30 | $648,807 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-04-30 | $782,379 |
| Other income not declared elsewhere | 2015-04-30 | $4,808 |
| Administrative expenses (other) incurred | 2015-04-30 | $391,841 |
| Liabilities. Value of operating payables at end of year | 2015-04-30 | $8,062 |
| Liabilities. Value of operating payables at beginning of year | 2015-04-30 | $7,685 |
| Total non interest bearing cash at end of year | 2015-04-30 | $966,973 |
| Total non interest bearing cash at beginning of year | 2015-04-30 | $2,013,900 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-04-30 | No |
| Value of net income/loss | 2015-04-30 | $71,314 |
| Value of net assets at end of year (total assets less liabilities) | 2015-04-30 | $2,316,361 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-04-30 | $2,245,047 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-04-30 | No |
| Investment advisory and management fees | 2015-04-30 | $3,468 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-04-30 | $729,766 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-04-30 | $413,613 |
| Income. Interest from US Government securities | 2015-04-30 | $70,974 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-04-30 | $624 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-04-30 | $160,832 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-04-30 | $160,832 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2015-04-30 | $1,390,807 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2015-04-30 | $932,203 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-04-30 | $7,269,902 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-04-30 | $12,257 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-04-30 | No |
| Contributions received in cash from employer | 2015-04-30 | $8,382,181 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-04-30 | $735,902 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2015-04-30 | $375,590 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-04-30 | $753,639 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2015-04-30 | $251,215 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-04-30 | $258,767 |
| Did the plan have assets held for investment | 2015-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-04-30 | No |
| Aggregate proceeds on sale of assets | 2015-04-30 | $669,982 |
| Aggregate carrying amount (costs) on sale of assets | 2015-04-30 | $683,937 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-04-30 | Unqualified |
| Accountancy firm name | 2015-04-30 | ALBANESE SINCHAR SMITH & CO. |
| Accountancy firm EIN | 2015-04-30 | 461686881 |
| 2014 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2014 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2014-04-30 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-04-30 | $1,543,703 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-04-30 | $677,547 |
| Total income from all sources (including contributions) | 2014-04-30 | $9,883,019 |
| Total loss/gain on sale of assets | 2014-04-30 | $7,815 |
| Total of all expenses incurred | 2014-04-30 | $9,920,026 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-04-30 | $9,504,434 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-04-30 | $9,767,248 |
| Value of total assets at end of year | 2014-04-30 | $3,788,750 |
| Value of total assets at beginning of year | 2014-04-30 | $2,959,601 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-04-30 | $415,592 |
| Total income from rents | 2014-04-30 | $34,410 |
| Total interest from all sources | 2014-04-30 | $23,279 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-04-30 | $2,781 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-04-30 | $2,781 |
| Administrative expenses professional fees incurred | 2014-04-30 | $77,172 |
| Was this plan covered by a fidelity bond | 2014-04-30 | Yes |
| Value of fidelity bond cover | 2014-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-04-30 | No |
| Contributions received from participants | 2014-04-30 | $126,380 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-04-30 | $9,435 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-04-30 | $8,198 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-04-30 | $782,379 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-04-30 | $614,196 |
| Other income not declared elsewhere | 2014-04-30 | $12,871 |
| Administrative expenses (other) incurred | 2014-04-30 | $338,420 |
| Liabilities. Value of operating payables at end of year | 2014-04-30 | $7,685 |
| Liabilities. Value of operating payables at beginning of year | 2014-04-30 | $5,784 |
| Total non interest bearing cash at end of year | 2014-04-30 | $2,013,900 |
| Total non interest bearing cash at beginning of year | 2014-04-30 | $1,293,217 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-04-30 | No |
| Value of net income/loss | 2014-04-30 | $-37,007 |
| Value of net assets at end of year (total assets less liabilities) | 2014-04-30 | $2,245,047 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-04-30 | $2,282,054 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-04-30 | $413,613 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-04-30 | $375,892 |
| Interest earned on other investments | 2014-04-30 | $21,689 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-04-30 | $160,832 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-04-30 | $159,242 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-04-30 | $159,242 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-04-30 | $1,590 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2014-04-30 | $932,203 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2014-04-30 | $902,897 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-04-30 | $7,893,994 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-04-30 | $34,615 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-04-30 | No |
| Contributions received in cash from employer | 2014-04-30 | $9,640,868 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-04-30 | $1,610,440 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2014-04-30 | $753,639 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-04-30 | $57,567 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2014-04-30 | $258,767 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2014-04-30 | $220,155 |
| Did the plan have assets held for investment | 2014-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-04-30 | No |
| Aggregate proceeds on sale of assets | 2014-04-30 | $39,292 |
| Aggregate carrying amount (costs) on sale of assets | 2014-04-30 | $31,477 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-04-30 | Unqualified |
| Accountancy firm name | 2014-04-30 | EDWARD P OPST, CPA |
| Accountancy firm EIN | 2014-04-30 | 271671531 |
| 2013 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-04-30 | $-4,382 |
| Total unrealized appreciation/depreciation of assets | 2013-04-30 | $-4,382 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-04-30 | $677,547 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-04-30 | $845,781 |
| Total income from all sources (including contributions) | 2013-04-30 | $9,220,828 |
| Total loss/gain on sale of assets | 2013-04-30 | $1,253 |
| Total of all expenses incurred | 2013-04-30 | $8,533,395 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-04-30 | $8,118,570 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-04-30 | $9,155,334 |
| Value of total assets at end of year | 2013-04-30 | $2,959,601 |
| Value of total assets at beginning of year | 2013-04-30 | $2,440,402 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-04-30 | $414,825 |
| Total interest from all sources | 2013-04-30 | $25,976 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-04-30 | $6,243 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-04-30 | $6,243 |
| Administrative expenses professional fees incurred | 2013-04-30 | $65,064 |
| Was this plan covered by a fidelity bond | 2013-04-30 | Yes |
| Value of fidelity bond cover | 2013-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-04-30 | No |
| Contributions received from participants | 2013-04-30 | $120,757 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-04-30 | $8,198 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-04-30 | $14,601 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-04-30 | $614,196 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-04-30 | $752,236 |
| Other income not declared elsewhere | 2013-04-30 | $36,404 |
| Administrative expenses (other) incurred | 2013-04-30 | $349,761 |
| Liabilities. Value of operating payables at end of year | 2013-04-30 | $5,784 |
| Liabilities. Value of operating payables at beginning of year | 2013-04-30 | $6,336 |
| Total non interest bearing cash at end of year | 2013-04-30 | $1,293,217 |
| Total non interest bearing cash at beginning of year | 2013-04-30 | $753,523 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-04-30 | No |
| Value of net income/loss | 2013-04-30 | $687,433 |
| Value of net assets at end of year (total assets less liabilities) | 2013-04-30 | $2,282,054 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-04-30 | $1,594,621 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-04-30 | $375,892 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-04-30 | $356,608 |
| Interest earned on other investments | 2013-04-30 | $21,954 |
| Income. Interest from US Government securities | 2013-04-30 | $374 |
| Income. Interest from corporate debt instruments | 2013-04-30 | $2,064 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-04-30 | $159,242 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-04-30 | $168,891 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-04-30 | $168,891 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-04-30 | $1,584 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2013-04-30 | $902,897 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2013-04-30 | $896,301 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-04-30 | $7,388,848 |
| Asset value of US Government securities at beginning of year | 2013-04-30 | $22,701 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-04-30 | No |
| Contributions received in cash from employer | 2013-04-30 | $9,034,577 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-04-30 | $729,722 |
| Liabilities. Value of benefit claims payable at end of year | 2013-04-30 | $57,567 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-04-30 | $87,209 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2013-04-30 | $220,155 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2013-04-30 | $227,777 |
| Did the plan have assets held for investment | 2013-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-04-30 | No |
| Aggregate proceeds on sale of assets | 2013-04-30 | $1,253 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-04-30 | Unqualified |
| Accountancy firm name | 2013-04-30 | THEODORE A. JANICKI, CPA |
| Accountancy firm EIN | 2013-04-30 | 454535332 |
| 2012 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-04-30 | $-4,520 |
| Total unrealized appreciation/depreciation of assets | 2012-04-30 | $-4,520 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-04-30 | $845,781 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-04-30 | $838,528 |
| Total income from all sources (including contributions) | 2012-04-30 | $9,189,560 |
| Total of all expenses incurred | 2012-04-30 | $8,640,187 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-04-30 | $8,264,730 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-04-30 | $9,117,048 |
| Value of total assets at end of year | 2012-04-30 | $2,440,402 |
| Value of total assets at beginning of year | 2012-04-30 | $1,883,776 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-04-30 | $375,457 |
| Total interest from all sources | 2012-04-30 | $31,898 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-04-30 | $7,361 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-04-30 | $7,361 |
| Administrative expenses professional fees incurred | 2012-04-30 | $64,568 |
| Was this plan covered by a fidelity bond | 2012-04-30 | Yes |
| Value of fidelity bond cover | 2012-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-04-30 | No |
| Contributions received from participants | 2012-04-30 | $124,790 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-04-30 | $14,601 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-04-30 | $14,443 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-04-30 | $752,236 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-04-30 | $703,901 |
| Other income not declared elsewhere | 2012-04-30 | $37,773 |
| Administrative expenses (other) incurred | 2012-04-30 | $310,889 |
| Liabilities. Value of operating payables at end of year | 2012-04-30 | $6,336 |
| Liabilities. Value of operating payables at beginning of year | 2012-04-30 | $3,155 |
| Total non interest bearing cash at end of year | 2012-04-30 | $753,523 |
| Total non interest bearing cash at beginning of year | 2012-04-30 | $307,600 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-04-30 | No |
| Value of net income/loss | 2012-04-30 | $549,373 |
| Value of net assets at end of year (total assets less liabilities) | 2012-04-30 | $1,594,621 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-04-30 | $1,045,248 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-04-30 | $356,608 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-04-30 | $352,596 |
| Interest earned on other investments | 2012-04-30 | $28,481 |
| Income. Interest from US Government securities | 2012-04-30 | $1,812 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-04-30 | $168,891 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-04-30 | $256,598 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-04-30 | $256,598 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-04-30 | $1,605 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2012-04-30 | $896,301 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2012-04-30 | $692,820 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-04-30 | $7,583,695 |
| Asset value of US Government securities at end of year | 2012-04-30 | $22,701 |
| Asset value of US Government securities at beginning of year | 2012-04-30 | $30,324 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-04-30 | No |
| Contributions received in cash from employer | 2012-04-30 | $8,992,258 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-04-30 | $681,035 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-04-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2012-04-30 | $87,209 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-04-30 | $131,472 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2012-04-30 | $227,777 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-04-30 | $229,395 |
| Did the plan have assets held for investment | 2012-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-04-30 | Unqualified |
| Accountancy firm name | 2012-04-30 | THEODORE A. JANICKI |
| Accountancy firm EIN | 2012-04-30 | 454535332 |
| 2011 : EMPLOYER-TEAMSTERS LOCAL 205 WELFARE FUND 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-04-30 | $33,866 |
| Total unrealized appreciation/depreciation of assets | 2011-04-30 | $33,866 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-04-30 | $838,528 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-04-30 | $1,211,679 |
| Total income from all sources (including contributions) | 2011-04-30 | $8,319,988 |
| Total of all expenses incurred | 2011-04-30 | $8,024,701 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-04-30 | $7,652,550 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-04-30 | $8,207,420 |
| Value of total assets at end of year | 2011-04-30 | $1,883,776 |
| Value of total assets at beginning of year | 2011-04-30 | $1,961,640 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-04-30 | $372,151 |
| Total interest from all sources | 2011-04-30 | $13,882 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-04-30 | $5,215 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-04-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-04-30 | $5,215 |
| Administrative expenses professional fees incurred | 2011-04-30 | $63,390 |
| Was this plan covered by a fidelity bond | 2011-04-30 | Yes |
| Value of fidelity bond cover | 2011-04-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-04-30 | No |
| Contributions received from participants | 2011-04-30 | $145,792 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-04-30 | $14,443 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-04-30 | $9,683 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-04-30 | $703,901 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-04-30 | $720,151 |
| Other income not declared elsewhere | 2011-04-30 | $59,605 |
| Administrative expenses (other) incurred | 2011-04-30 | $308,761 |
| Liabilities. Value of operating payables at end of year | 2011-04-30 | $3,155 |
| Liabilities. Value of operating payables at beginning of year | 2011-04-30 | $4,724 |
| Total non interest bearing cash at end of year | 2011-04-30 | $307,600 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-04-30 | No |
| Value of net income/loss | 2011-04-30 | $295,287 |
| Value of net assets at end of year (total assets less liabilities) | 2011-04-30 | $1,045,248 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-04-30 | $749,961 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-04-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-04-30 | $352,596 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-04-30 | $429,983 |
| Interest earned on other investments | 2011-04-30 | $6,549 |
| Income. Interest from US Government securities | 2011-04-30 | $2,398 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-04-30 | $256,598 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-04-30 | $807,414 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-04-30 | $807,414 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-04-30 | $4,935 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-04-30 | $692,820 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-04-30 | $434,727 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-04-30 | $6,929,460 |
| Asset value of US Government securities at end of year | 2011-04-30 | $30,324 |
| Asset value of US Government securities at beginning of year | 2011-04-30 | $37,242 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-04-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-04-30 | No |
| Contributions received in cash from employer | 2011-04-30 | $8,061,628 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-04-30 | $723,090 |
| Liabilities. Value of benefit claims payable at end of year | 2011-04-30 | $131,472 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-04-30 | $486,804 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2011-04-30 | $229,395 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-04-30 | $242,591 |
| Did the plan have assets held for investment | 2011-04-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-04-30 | Unqualified |
| Accountancy firm name | 2011-04-30 | CRAMER, JANICKI & ASSOCIATES |
| Accountancy firm EIN | 2011-04-30 | 251589677 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 4 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $3,426 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,924 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,426 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 3 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1161 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $188,055 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 406857 0010 |
| Policy instance | 2 |
| Insurance contract or identification number | 406857 0010 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $509,626 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 1 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 488 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $68,221 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 1 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 682 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $119,465 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 3 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1191 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $345,064 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 406857 0010 |
| Policy instance | 2 |
| Insurance contract or identification number | 406857 0010 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $469,717 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 4 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $3,713 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,710 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3713 | | Insurance broker organization code? | 3 |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 1 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 710 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | 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 | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 $99,121 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 06144400 |
| Policy instance | 2 |
| Insurance contract or identification number | 06144400 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | 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 $3,239,772 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 3 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1309 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | 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 | 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 $213,259 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 4 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $2,997 | | 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 | Yes | | 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 $23,879 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,997 | | Insurance broker organization code? | 3 |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 1 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 746 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | 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 | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 $97,094 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 06144400 |
| Policy instance | 2 |
| Insurance contract or identification number | 06144400 | | Number of Individuals Covered | 194 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | 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 $2,844,984 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 3 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 85 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $3,412 | | 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,412 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 4 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1297 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | 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 | 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 $203,540 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 06144400 |
| Policy instance | 4 |
| Insurance contract or identification number | 06144400 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | 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 $3,299,334 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 3 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1232 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | 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 | 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 $196,196 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 2 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 713 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | 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 | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 $95,601 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 1 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 85 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $3,808 | | 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 | Yes | | 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 $31,891 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,808 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 1 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1205 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | 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 | 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 $194,927 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 06144400 |
| Policy instance | 4 |
| Insurance contract or identification number | 06144400 | | Number of Individuals Covered | 266 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | 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 $5,224,818 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 3 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 695 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | 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 | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $89,660 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 2 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $4,077 | | 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 5 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 572 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,754 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 01619490 |
| Policy instance | 4 |
| Insurance contract or identification number | 01619490 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2015-07-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $82,686 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 06144400 |
| Policy instance | 3 |
| Insurance contract or identification number | 06144400 | | Number of Individuals Covered | 514 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $5,589,163 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 2 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1217 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $198,558 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 1 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $3,638 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,815 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,638 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES B WALL |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 1 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $4,111 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,197 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,895 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES B WALL |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 2 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1259 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 5 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 528 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $83,601 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 01619490 |
| Policy instance | 4 |
| Insurance contract or identification number | 01619490 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $503,839 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 06144400 |
| Policy instance | 3 |
| Insurance contract or identification number | 06144400 | | Number of Individuals Covered | 524 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $5,758,046 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 1 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $3,881 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | 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 $30,250 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,607 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES B WALL |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 5 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 537 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD & D | | 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 $84,024 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 06144400 |
| Policy instance | 3 |
| Insurance contract or identification number | 06144400 | | Number of Individuals Covered | 1310 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $7,319,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 2 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1319 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 01619490 |
| Policy instance | 4 |
| Insurance contract or identification number | 01619490 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $488,200 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 1 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $3,783 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,497 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES B. WALL |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G-24908 |
| Policy instance | 5 |
| Insurance contract or identification number | G-24908 | | Number of Individuals Covered | 545 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 $84,541 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 01644400 |
| Policy instance | 4 |
| Insurance contract or identification number | 01644400 | | Number of Individuals Covered | 1312 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $6,601,896 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 3 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1333 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 05825390 |
| Policy instance | 2 |
| Insurance contract or identification number | 05825390 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $473,984 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 08869244 |
| Policy instance | 1 |
| Insurance contract or identification number | 08869244 | | Number of Individuals Covered | 1366 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $6,659,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 05825390 |
| Policy instance | 5 |
| Insurance contract or identification number | 05825390 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $405,586 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 4 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $3,528 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 3 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1391 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G24908 |
| Policy instance | 2 |
| Insurance contract or identification number | G24908 | | Number of Individuals Covered | 568 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | A D & D | | Welfare Benefit Premiums Paid to Carrier | USD $90,044 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12237141 |
| Policy instance | 1 |
| Insurance contract or identification number | 12237141 | | Number of Individuals Covered | 1534 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | G24908 |
| Policy instance | 5 |
| Insurance contract or identification number | G24908 | | Number of Individuals Covered | 570 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | A D & D | | Welfare Benefit Premiums Paid to Carrier | USD $88,963 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KEYSTONE HEALTH PLAN WEST, INC (National Association of Insurance Commissioners NAIC id number: 95048 ) |
| Policy contract number | 08869244 |
| Policy instance | 4 |
| Insurance contract or identification number | 08869244 | | Number of Individuals Covered | 1212 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $5,963,678 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KEYSTONE HEALTH PLAN WEST, INC (National Association of Insurance Commissioners NAIC id number: 95048 ) |
| Policy contract number | 05825390 |
| Policy instance | 3 |
| Insurance contract or identification number | 05825390 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $423,476 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 123682 |
| Policy instance | 2 |
| Insurance contract or identification number | 123682 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $3,342 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
