SIGNATURE PERFORMANCE, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN
Measure | Date | Value |
---|
2020: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-06-01 | 341 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 0 |
Number of retired or separated participants receiving benefits | 2020-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-06-01 | 0 |
Total of all active and inactive participants | 2020-06-01 | 0 |
Number of employers contributing to the scheme | 2020-06-01 | 0 |
2019: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-06-01 | 276 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 359 |
Number of retired or separated participants receiving benefits | 2019-06-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2019-06-01 | 0 |
Total of all active and inactive participants | 2019-06-01 | 360 |
Number of employers contributing to the scheme | 2019-06-01 | 0 |
2018: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-06-01 | 266 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 276 |
Number of retired or separated participants receiving benefits | 2018-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-06-01 | 0 |
Total of all active and inactive participants | 2018-06-01 | 276 |
Number of employers contributing to the scheme | 2018-06-01 | 0 |
2017: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-06-01 | 221 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 266 |
Number of retired or separated participants receiving benefits | 2017-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-06-01 | 0 |
Total of all active and inactive participants | 2017-06-01 | 266 |
2016: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-06-01 | 195 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 202 |
Number of retired or separated participants receiving benefits | 2016-06-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2016-06-01 | 0 |
Total of all active and inactive participants | 2016-06-01 | 203 |
2015: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-06-01 | 135 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 195 |
Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
Total of all active and inactive participants | 2015-06-01 | 195 |
2014: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-06-01 | 124 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 132 |
Number of retired or separated participants receiving benefits | 2014-06-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2014-06-01 | 0 |
Total of all active and inactive participants | 2014-06-01 | 135 |
2013: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-06-01 | 134 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 123 |
Number of retired or separated participants receiving benefits | 2013-06-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2013-06-01 | 0 |
Total of all active and inactive participants | 2013-06-01 | 124 |
2012: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-06-01 | 173 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 132 |
Number of retired or separated participants receiving benefits | 2012-06-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2012-06-01 | 0 |
Total of all active and inactive participants | 2012-06-01 | 134 |
2011: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-06-01 | 160 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 172 |
Number of retired or separated participants receiving benefits | 2011-06-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2011-06-01 | 0 |
Total of all active and inactive participants | 2011-06-01 | 173 |
2009: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-06-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 119 |
Number of retired or separated participants receiving benefits | 2009-06-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2009-06-01 | 0 |
Total of all active and inactive participants | 2009-06-01 | 121 |
2020: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2020 form 5500 responses |
---|
2020-06-01 | Type of plan entity | Single employer plan |
2020-06-01 | This submission is the final filing | Yes |
2020-06-01 | Plan funding arrangement – Insurance | Yes |
2020-06-01 | Plan benefit arrangement – Insurance | Yes |
2019: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2019 form 5500 responses |
---|
2019-06-01 | Type of plan entity | Single employer plan |
2019-06-01 | Plan funding arrangement – Insurance | Yes |
2019-06-01 | Plan benefit arrangement – Insurance | Yes |
2018: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2018 form 5500 responses |
---|
2018-06-01 | Type of plan entity | Single employer plan |
2018-06-01 | Plan funding arrangement – Insurance | Yes |
2018-06-01 | Plan benefit arrangement – Insurance | Yes |
2017: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2017 form 5500 responses |
---|
2017-06-01 | Type of plan entity | Single employer plan |
2017-06-01 | Plan funding arrangement – Insurance | Yes |
2017-06-01 | Plan benefit arrangement – Insurance | Yes |
2016: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2016 form 5500 responses |
---|
2016-06-01 | Type of plan entity | Single employer plan |
2016-06-01 | Submission has been amended | No |
2016-06-01 | This submission is the final filing | No |
2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-06-01 | Plan is a collectively bargained plan | No |
2016-06-01 | Plan funding arrangement – Insurance | Yes |
2016-06-01 | Plan benefit arrangement – Insurance | Yes |
2015: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2015 form 5500 responses |
---|
2015-06-01 | Type of plan entity | Single employer plan |
2015-06-01 | Submission has been amended | No |
2015-06-01 | This submission is the final filing | No |
2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-06-01 | Plan is a collectively bargained plan | No |
2015-06-01 | Plan funding arrangement – Insurance | Yes |
2015-06-01 | Plan benefit arrangement – Insurance | Yes |
2014: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2014 form 5500 responses |
---|
2014-06-01 | Type of plan entity | Single employer plan |
2014-06-01 | Submission has been amended | No |
2014-06-01 | This submission is the final filing | No |
2014-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-06-01 | Plan is a collectively bargained plan | No |
2014-06-01 | Plan funding arrangement – Insurance | Yes |
2014-06-01 | Plan benefit arrangement – Insurance | Yes |
2013: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2013 form 5500 responses |
---|
2013-06-01 | Type of plan entity | Single employer plan |
2013-06-01 | Submission has been amended | Yes |
2013-06-01 | This submission is the final filing | No |
2013-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-06-01 | Plan is a collectively bargained plan | No |
2013-06-01 | Plan funding arrangement – Insurance | Yes |
2013-06-01 | Plan benefit arrangement – Insurance | Yes |
2012: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2012 form 5500 responses |
---|
2012-06-01 | Type of plan entity | Single employer plan |
2012-06-01 | Submission has been amended | No |
2012-06-01 | This submission is the final filing | No |
2012-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-06-01 | Plan is a collectively bargained plan | No |
2012-06-01 | Plan funding arrangement – Insurance | Yes |
2012-06-01 | Plan benefit arrangement – Insurance | Yes |
2011: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2011 form 5500 responses |
---|
2011-06-01 | Type of plan entity | Single employer plan |
2011-06-01 | Submission has been amended | No |
2011-06-01 | This submission is the final filing | No |
2011-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-06-01 | Plan is a collectively bargained plan | No |
2011-06-01 | Plan funding arrangement – Insurance | Yes |
2011-06-01 | Plan benefit arrangement – Insurance | Yes |
2009: SIGNATURE PERFORMANCE DENTAL INSURANCE PLAN 2009 form 5500 responses |
---|
2009-06-01 | Type of plan entity | Single employer plan |
2009-06-01 | First time form 5500 has been submitted | Yes |
2009-06-01 | Submission has been amended | Yes |
2009-06-01 | This submission is the final filing | No |
2009-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-06-01 | Plan is a collectively bargained plan | No |
2009-06-01 | Plan funding arrangement – Insurance | Yes |
2009-06-01 | Plan benefit arrangement – Insurance | Yes |
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 10-048040 |
Policy instance | 1 |
Insurance contract or identification number | 10-048040 | Number of Individuals Covered | 445 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $6,724 | Total amount of fees paid to insurance company | USD $190 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,885 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,724 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | FEES |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 10-048040 |
Policy instance | 1 |
Insurance contract or identification number | 10-048040 | Number of Individuals Covered | 362 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $3,615 | Total amount of fees paid to insurance company | USD $263 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,065 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,615 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | FEES |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-048040 |
Policy instance | 1 |
Insurance contract or identification number | 010-048040 | Number of Individuals Covered | 611 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $3,879 | Total amount of fees paid to insurance company | USD $4,165 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $161,691 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 4165 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUDS0APN3 |
Policy instance | 1 |
Insurance contract or identification number | GUDS0APN3 | Number of Individuals Covered | 262 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $4,143 | Total amount of fees paid to insurance company | USD $2,608 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $141,034 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,860 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUDS0APN3 |
Policy instance | 1 |
Insurance contract or identification number | GUDS0APN3 | Number of Individuals Covered | 429 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $3,337 | Total amount of fees paid to insurance company | USD $1,231 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 $94,943 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,337 | Amount paid for insurance broker fees | 1231 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 | Insurance broker name | SILVERSTONE GROUP INCORPORATED |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUDS0APN3 |
Policy instance | 1 |
Insurance contract or identification number | GUDS0APN3 | Number of Individuals Covered | 297 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $2,534 | Total amount of fees paid to insurance company | USD $662 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $50,436 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,534 | Amount paid for insurance broker fees | 662 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 | Insurance broker name | SILVERSTONE GROUP INCORPORATED |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUDS0APN3 |
Policy instance | 1 |
Insurance contract or identification number | GUDS0APN3 | Number of Individuals Covered | 273 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $2,840 | Total amount of fees paid to insurance company | USD $351 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 $66,555 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,840 | Amount paid for insurance broker fees | 351 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 | Insurance broker name | SILVERSTONE GROUP INCORPORATED |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-035257 |
Policy instance | 1 |
Insurance contract or identification number | 010-035257 | Number of Individuals Covered | 294 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $3,044 | Total amount of fees paid to insurance company | USD $1,470 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 $87,955 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,044 | Amount paid for insurance broker fees | 1470 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 | Insurance broker name | SILVERSTONE GROUP INCORPORATED |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-035257 |
Policy instance | 1 |
Insurance contract or identification number | 010-035257 | Number of Individuals Covered | 380 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $2,321 | Total amount of fees paid to insurance company | USD $1,996 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 $78,129 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-035257 |
Policy instance | 1 |
Insurance contract or identification number | 010-035257 | Number of Individuals Covered | 352 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $3,009 | Total amount of fees paid to insurance company | USD $1,564 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 $70,222 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|