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KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameKAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN
Plan identification number 501

KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

KAHLE S KITCHENS, INC. has sponsored the creation of one or more 401k plans.

Company Name:KAHLE S KITCHENS, INC.
Employer identification number (EIN):251719572
NAIC Classification:337000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01JEFF MCINTIRE
5012017-01-01JEFF MCINTIRE
5012016-12-01JEFF MCINTIRE
5012015-12-01JEFF MCINTIRE

Plan Statistics for KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0132
Total number of active participants reported on line 7a of the Form 55002022-01-0130
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0130
2021: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0137
Total number of active participants reported on line 7a of the Form 55002021-01-0132
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0132
2020: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0134
Total number of active participants reported on line 7a of the Form 55002020-01-0137
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0137
2019: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0133
Total number of active participants reported on line 7a of the Form 55002019-01-0134
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0134
2018: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0136
Total number of active participants reported on line 7a of the Form 55002018-01-0132
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0133
2017: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0141
Total number of active participants reported on line 7a of the Form 55002017-01-0135
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0136
2016: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-0141
Total number of active participants reported on line 7a of the Form 55002016-12-0140
Number of retired or separated participants receiving benefits2016-12-011
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-0141
2015: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-0141
Total number of active participants reported on line 7a of the Form 55002015-12-0140
Number of retired or separated participants receiving benefits2015-12-011
Number of other retired or separated participants entitled to future benefits2015-12-010
Total of all active and inactive participants2015-12-0141

Financial Data on KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2022 : KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$37,253
Total plan liabilities at beginning of year2022-12-31$31,049
Total income from all sources2022-12-31$553,695
Expenses. Total of all expenses incurred2022-12-31$518,038
Benefits paid (including direct rollovers)2022-12-31$271,005
Total plan assets at end of year2022-12-31$87,935
Total plan assets at beginning of year2022-12-31$46,074
Value of fidelity bond covering the plan2022-12-31$1,000,000
Total contributions received or receivable from participants2022-12-31$0
Expenses. Other expenses not covered elsewhere2022-12-31$231,768
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$0
Net income (gross income less expenses)2022-12-31$35,657
Net plan assets at end of year (total assets less liabilities)2022-12-31$50,682
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$15,025
Total contributions received or receivable from employer(s)2022-12-31$553,695
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$15,265
2021 : KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$31,049
Total plan liabilities at beginning of year2021-12-31$25,998
Total income from all sources2021-12-31$511,203
Expenses. Total of all expenses incurred2021-12-31$557,352
Benefits paid (including direct rollovers)2021-12-31$321,262
Total plan assets at end of year2021-12-31$46,074
Total plan assets at beginning of year2021-12-31$87,172
Value of fidelity bond covering the plan2021-12-31$1,000,000
Expenses. Other expenses not covered elsewhere2021-12-31$220,162
Net income (gross income less expenses)2021-12-31$-46,149
Net plan assets at end of year (total assets less liabilities)2021-12-31$15,025
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$61,174
Total contributions received or receivable from employer(s)2021-12-31$511,203
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$15,928
2020 : KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$25,998
Total plan liabilities at beginning of year2020-12-31$23,927
Total income from all sources2020-12-31$521,811
Expenses. Total of all expenses incurred2020-12-31$534,624
Benefits paid (including direct rollovers)2020-12-31$251,847
Total plan assets at end of year2020-12-31$87,172
Total plan assets at beginning of year2020-12-31$97,914
Value of fidelity bond covering the plan2020-12-31$1,000,000
Total contributions received or receivable from participants2020-12-31$0
Expenses. Other expenses not covered elsewhere2020-12-31$213,786
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$0
Net income (gross income less expenses)2020-12-31$-12,813
Net plan assets at end of year (total assets less liabilities)2020-12-31$61,174
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$73,987
Total contributions received or receivable from employer(s)2020-12-31$521,811
Value of corrective distributions2020-12-31$53,063
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$15,928
2019 : KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$23,927
Total plan liabilities at beginning of year2019-12-31$27,845
Total income from all sources2019-12-31$502,830
Expenses. Total of all expenses incurred2019-12-31$628,350
Benefits paid (including direct rollovers)2019-12-31$346,266
Total plan assets at end of year2019-12-31$97,914
Total plan assets at beginning of year2019-12-31$227,352
Value of fidelity bond covering the plan2019-12-31$1,000,000
Total contributions received or receivable from participants2019-12-31$0
Expenses. Other expenses not covered elsewhere2019-12-31$191,984
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$0
Net income (gross income less expenses)2019-12-31$-125,520
Net plan assets at end of year (total assets less liabilities)2019-12-31$73,987
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$199,507
Total contributions received or receivable from employer(s)2019-12-31$502,830
Value of corrective distributions2019-12-31$74,289
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$15,811
2018 : KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$27,845
Total plan liabilities at beginning of year2018-12-31$27,844
Total income from all sources2018-12-31$502,403
Expenses. Total of all expenses incurred2018-12-31$423,308
Benefits paid (including direct rollovers)2018-12-31$185,936
Total plan assets at end of year2018-12-31$227,352
Total plan assets at beginning of year2018-12-31$148,256
Value of fidelity bond covering the plan2018-12-31$1,000,000
Total contributions received or receivable from participants2018-12-31$0
Expenses. Other expenses not covered elsewhere2018-12-31$195,242
Contributions received from other sources (not participants or employers)2018-12-31$3,049
Net income (gross income less expenses)2018-12-31$79,095
Net plan assets at end of year (total assets less liabilities)2018-12-31$199,507
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$120,412
Total contributions received or receivable from employer(s)2018-12-31$499,354
Value of corrective distributions2018-12-31$26,248
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$15,882
2017 : KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$27,844
Total plan liabilities at beginning of year2017-12-31$29,563
Total income from all sources2017-12-31$568,414
Expenses. Total of all expenses incurred2017-12-31$544,435
Benefits paid (including direct rollovers)2017-12-31$301,823
Total plan assets at end of year2017-12-31$148,256
Total plan assets at beginning of year2017-12-31$125,996
Value of fidelity bond covering the plan2017-12-31$1,000,000
Expenses. Other expenses not covered elsewhere2017-12-31$188,643
Contributions received from other sources (not participants or employers)2017-12-31$18,006
Net income (gross income less expenses)2017-12-31$23,979
Net plan assets at end of year (total assets less liabilities)2017-12-31$120,412
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$96,433
Total contributions received or receivable from employer(s)2017-12-31$550,408
Value of corrective distributions2017-12-31$36,748
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$17,221
2016 : KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$29,563
Total plan liabilities at beginning of year2016-12-31$32,188
Total income from all sources2016-12-31$0
Expenses. Total of all expenses incurred2016-12-31$-381
Benefits paid (including direct rollovers)2016-12-31$-381
Total plan assets at end of year2016-12-31$125,996
Total plan assets at beginning of year2016-12-31$128,240
Total contributions received or receivable from participants2016-12-31$0
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Net income (gross income less expenses)2016-12-31$381
Net plan assets at end of year (total assets less liabilities)2016-12-31$96,433
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$96,052
Total contributions received or receivable from employer(s)2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$0
Total plan liabilities at end of year2016-11-30$32,188
Total plan liabilities at beginning of year2016-11-30$0
Total income from all sources2016-11-30$566,010
Expenses. Total of all expenses incurred2016-11-30$469,958
Benefits paid (including direct rollovers)2016-11-30$271,486
Total plan assets at end of year2016-11-30$128,240
Total plan assets at beginning of year2016-11-30$0
Total contributions received or receivable from participants2016-11-30$0
Expenses. Other expenses not covered elsewhere2016-11-30$181,157
Contributions received from other sources (not participants or employers)2016-11-30$443
Net income (gross income less expenses)2016-11-30$96,052
Net plan assets at end of year (total assets less liabilities)2016-11-30$96,052
Net plan assets at beginning of year (total assets less liabilities)2016-11-30$0
Total contributions received or receivable from employer(s)2016-11-30$565,567
Expenses. Administrative service providers (salaries,fees and commissions)2016-11-30$17,315

Form 5500 Responses for KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN

2022: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Submission has been amendedNo
2016-12-01This submission is the final filingNo
2016-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-12-01Plan is a collectively bargained planNo
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan funding arrangement – TrustYes
2016-12-01Plan benefit arrangement – InsuranceYes
2016-12-01Plan benefit arrangement - TrustYes
2015: KAHLE'S KITCHENS, INC. EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01First time form 5500 has been submittedYes
2015-12-01Submission has been amendedNo
2015-12-01This submission is the final filingNo
2015-12-01This return/report is a short plan year return/report (less than 12 months)No
2015-12-01Plan is a collectively bargained planNo
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan funding arrangement – TrustYes
2015-12-01Plan benefit arrangement – InsuranceYes
2015-12-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500160
Policy instance 1
Insurance contract or identification number30500160
Number of Individuals Covered30
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $213,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500160
Policy instance 1
Insurance contract or identification number30500160
Number of Individuals Covered32
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $200,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500160
Policy instance 1
Insurance contract or identification number30500160
Number of Individuals Covered37
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $193,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered34
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $172,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered32
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $175,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered36
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $166,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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