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CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameCARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN
Plan identification number 501

CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

THE CARMELITE SYSTEM, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE CARMELITE SYSTEM, INC.
Employer identification number (EIN):266896118
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about THE CARMELITE SYSTEM, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1999-01-07
Company Identification Number: 2332476
Legal Registered Office Address: CARMELITE SYS. FOR AGED/INFIRM
646 WOODS ROAD
GERMANTOWN
United States of America (USA)
125265639

More information about THE CARMELITE SYSTEM, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARMELITE SYSTEM, INC. HEALTH AND WELFARE 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
5012018-01-01PAUL MACGIFFERT
5012017-01-01PAUL MACGIFFERT
5012016-01-01PAUL MACGIFFERT
5012015-01-01PAUL MACGIFFERT
5012014-01-01PAUL MACGIFFERT
5012013-01-01PAUL MACGIFFERT
5012012-01-01PAUL MACGIFFERT
5012011-01-01PAUL MACGIFFERT
5012009-01-01PAUL MACGIFFERT

Plan Statistics for CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2022: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,419
Total number of active participants reported on line 7a of the Form 55002022-01-011,548
Number of retired or separated participants receiving benefits2022-01-0110
Number of other retired or separated participants entitled to future benefits2022-01-01220
Total of all active and inactive participants2022-01-011,778
2021: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,650
Total number of active participants reported on line 7a of the Form 55002021-01-011,291
Number of retired or separated participants receiving benefits2021-01-01128
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011,419
2020: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,346
Total number of active participants reported on line 7a of the Form 55002020-01-011,425
Number of retired or separated participants receiving benefits2020-01-01225
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-011,650
2019: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,412
Total number of active participants reported on line 7a of the Form 55002019-01-011,341
Number of retired or separated participants receiving benefits2019-01-015
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,346
2018: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,158
Total number of active participants reported on line 7a of the Form 55002018-01-011,401
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-011,401
2017: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,152
Total number of active participants reported on line 7a of the Form 55002017-01-011,089
Number of retired or separated participants receiving benefits2017-01-018
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-011,097
2016: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,130
Total number of active participants reported on line 7a of the Form 55002016-01-011,102
Number of retired or separated participants receiving benefits2016-01-018
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-011,110
2015: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,239
Total number of active participants reported on line 7a of the Form 55002015-01-011,122
Number of retired or separated participants receiving benefits2015-01-018
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-011,130
2014: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01939
Total number of active participants reported on line 7a of the Form 55002014-01-01874
Number of retired or separated participants receiving benefits2014-01-016
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01880
2013: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,197
Total number of active participants reported on line 7a of the Form 55002013-01-011,261
Number of retired or separated participants receiving benefits2013-01-014
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-011,265
2012: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,357
Total number of active participants reported on line 7a of the Form 55002012-01-011,270
Number of retired or separated participants receiving benefits2012-01-019
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-011,279
2011: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,431
Total number of active participants reported on line 7a of the Form 55002011-01-011,347
Number of retired or separated participants receiving benefits2011-01-0110
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-011,357
2009: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,344
Total number of active participants reported on line 7a of the Form 55002009-01-011,445
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,445

Financial Data on CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2019 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,857,671
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,236,865
Total income from all sources (including contributions)2019-12-31$16,311,606
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$19,652,166
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$16,410,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$16,289,210
Value of total assets at end of year2019-12-31$228,671
Value of total assets at beginning of year2019-12-31$3,948,425
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,241,866
Total interest from all sources2019-12-31$22,396
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$416,509
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$3,080,684
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$44,430
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$7,891
Administrative expenses (other) incurred2019-12-31$450
Liabilities. Value of operating payables at end of year2019-12-31$228,671
Liabilities. Value of operating payables at beginning of year2019-12-31$369,865
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$3,447,674
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-3,340,560
Value of net assets at end of year (total assets less liabilities)2019-12-31$-1,629,000
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,711,560
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$22,396
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$16,410,300
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$13,164,096
Employer contributions (assets) at end of year2019-12-31$228,671
Employer contributions (assets) at beginning of year2019-12-31$492,860
Contract administrator fees2019-12-31$2,824,907
Liabilities. Value of benefit claims payable at end of year2019-12-31$1,629,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,867,000
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31CLIFTONLARSONALLEN,LLP
Accountancy firm EIN2019-12-31410746749
2018 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,236,865
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,373,782
Total income from all sources (including contributions)2018-12-31$17,270,441
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$18,443,031
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$15,684,274
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$17,255,316
Value of total assets at end of year2018-12-31$3,948,425
Value of total assets at beginning of year2018-12-31$4,257,932
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$2,758,757
Total interest from all sources2018-12-31$15,125
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$427,200
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$2,961,162
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$69,689
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$7,891
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$6,147
Administrative expenses (other) incurred2018-12-31$7,781
Liabilities. Value of operating payables at end of year2018-12-31$369,865
Liabilities. Value of operating payables at beginning of year2018-12-31$198,405
Total non interest bearing cash at end of year2018-12-31$3,447,674
Total non interest bearing cash at beginning of year2018-12-31$4,251,785
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-1,172,590
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,711,560
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,884,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$15,125
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$15,684,274
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$14,224,465
Employer contributions (assets) at end of year2018-12-31$492,860
Employer contributions (assets) at beginning of year2018-12-31$0
Contract administrator fees2018-12-31$2,323,776
Liabilities. Value of benefit claims payable at end of year2018-12-31$1,867,000
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$1,175,377
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31CLIFTONLARSONALLEN,LLP
Accountancy firm EIN2018-12-31410746749
2017 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,373,782
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,095,178
Total income from all sources (including contributions)2017-12-31$15,038,164
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$14,097,535
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$11,468,153
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$14,980,356
Value of total assets at end of year2017-12-31$4,257,932
Value of total assets at beginning of year2017-12-31$3,038,699
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,629,382
Total interest from all sources2017-12-31$57,808
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$430,123
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$2,925,744
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$62,329
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$6,147
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$7,009
Administrative expenses (other) incurred2017-12-31$4,240
Liabilities. Value of operating payables at end of year2017-12-31$198,405
Liabilities. Value of operating payables at beginning of year2017-12-31$74,178
Total non interest bearing cash at end of year2017-12-31$4,251,785
Total non interest bearing cash at beginning of year2017-12-31$2,945,411
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$940,629
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,884,150
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,943,521
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$57,808
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$11,468,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$11,992,283
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$86,279
Contract administrator fees2017-12-31$2,195,019
Liabilities. Value of benefit claims payable at end of year2017-12-31$1,175,377
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$1,021,000
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31CLIFTONLARSONALLEN,LLP
Accountancy firm EIN2017-12-31410746749
2016 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,095,178
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$2,135,779
Total income from all sources (including contributions)2016-12-31$15,326,759
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$13,580,063
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$11,177,839
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$15,317,689
Value of total assets at end of year2016-12-31$3,038,699
Value of total assets at beginning of year2016-12-31$2,332,604
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,402,224
Total interest from all sources2016-12-31$9,070
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$433,890
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,881,678
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$7,950
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$67,190
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$7,009
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$1,851,260
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$1,087,610
Administrative expenses (other) incurred2016-12-31$47,389
Liabilities. Value of operating payables at end of year2016-12-31$74,178
Liabilities. Value of operating payables at beginning of year2016-12-31$14,169
Total non interest bearing cash at end of year2016-12-31$2,945,411
Total non interest bearing cash at beginning of year2016-12-31$269,730
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,746,696
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,943,521
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$196,825
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$9,070
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$11,177,839
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$12,368,821
Employer contributions (assets) at end of year2016-12-31$86,279
Employer contributions (assets) at beginning of year2016-12-31$203,664
Contract administrator fees2016-12-31$1,920,945
Liabilities. Value of benefit claims payable at end of year2016-12-31$1,021,000
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$1,034,000
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31CLIFTONLARSONALLEN,LLP
Accountancy firm EIN2016-12-31410746749
2015 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,135,779
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,528,442
Total income from all sources (including contributions)2015-12-31$14,825,904
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$14,300,238
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$12,165,864
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$14,825,904
Value of total assets at end of year2015-12-31$2,332,604
Value of total assets at beginning of year2015-12-31$2,199,601
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,134,374
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$417,120
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31Yes
Amount of non-exempt transactions with any party-in-interest2015-12-31$2,000,000
Contributions received from participants2015-12-31$2,715,250
Participant contributions at end of year2015-12-31$7,950
Participant contributions at beginning of year2015-12-31$8,687
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$81,415
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$1,851,260
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$458
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$1,087,610
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$1,087,610
Administrative expenses (other) incurred2015-12-31$76,159
Liabilities. Value of operating payables at end of year2015-12-31$14,169
Liabilities. Value of operating payables at beginning of year2015-12-31$98,675
Total non interest bearing cash at end of year2015-12-31$269,730
Total non interest bearing cash at beginning of year2015-12-31$1,936,941
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$525,666
Value of net assets at end of year (total assets less liabilities)2015-12-31$196,825
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-328,841
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$12,165,864
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$12,029,239
Employer contributions (assets) at end of year2015-12-31$203,664
Employer contributions (assets) at beginning of year2015-12-31$253,515
Contract administrator fees2015-12-31$1,641,095
Liabilities. Value of benefit claims payable at end of year2015-12-31$1,034,000
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$1,342,157
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31CLIFTONLARSONALLEN,LLP
Accountancy firm EIN2015-12-31410746749
2014 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,528,442
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,174,021
Total income from all sources (including contributions)2014-12-31$15,437,813
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$14,275,949
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$12,209,984
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$15,437,813
Value of total assets at end of year2014-12-31$2,199,601
Value of total assets at beginning of year2014-12-31$683,316
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,065,965
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$414,122
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$2,596,664
Participant contributions at end of year2014-12-31$8,687
Participant contributions at beginning of year2014-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$63,686
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$458
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$7,880
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$1,087,610
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$1,087,610
Administrative expenses (other) incurred2014-12-31$112,366
Liabilities. Value of operating payables at end of year2014-12-31$98,675
Liabilities. Value of operating payables at beginning of year2014-12-31$106,189
Total non interest bearing cash at end of year2014-12-31$1,936,941
Total non interest bearing cash at beginning of year2014-12-31$675,436
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,161,864
Value of net assets at end of year (total assets less liabilities)2014-12-31$-328,841
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-1,490,705
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$12,209,984
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$12,777,463
Employer contributions (assets) at end of year2014-12-31$253,515
Employer contributions (assets) at beginning of year2014-12-31$0
Contract administrator fees2014-12-31$1,539,477
Liabilities. Value of benefit claims payable at end of year2014-12-31$1,342,157
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$980,222
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31CLIFTONLARSONALLEN,LLP
Accountancy firm EIN2014-12-31410746749
2013 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$1,193,799
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,040,849
Total income from all sources (including contributions)2013-12-31$14,458,097
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$13,614,837
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$11,720,296
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$14,410,971
Value of total assets at end of year2013-12-31$683,316
Value of total assets at beginning of year2013-12-31$687,106
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,894,541
Total interest from all sources2013-12-31$47,126
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$407,370
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$2,417,965
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$6,754
Assets. Other investments not covered elsewhere at end of year2013-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$80,344
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$7,880
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$677,206
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$1,087,610
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$1,737,610
Administrative expenses (other) incurred2013-12-31$1,466
Liabilities. Value of operating payables at end of year2013-12-31$106,189
Liabilities. Value of operating payables at beginning of year2013-12-31$303,239
Total non interest bearing cash at end of year2013-12-31$675,436
Total non interest bearing cash at beginning of year2013-12-31$652
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$843,260
Value of net assets at end of year (total assets less liabilities)2013-12-31$-510,483
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-1,353,743
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$47,126
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$11,720,296
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$11,912,662
Employer contributions (assets) at end of year2013-12-31$0
Employer contributions (assets) at beginning of year2013-12-31$2,494
Contract administrator fees2013-12-31$1,485,705
Liabilities. Value of benefit claims payable at end of year2013-12-31$980,222
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$0
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31CLIFTONLARSONALLEN,LLP
Accountancy firm EIN2013-12-31410746749
2012 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,040,849
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,775,228
Total income from all sources (including contributions)2012-12-31$13,797,601
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$12,766,429
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$11,127,969
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$13,778,020
Value of total assets at end of year2012-12-31$687,106
Value of total assets at beginning of year2012-12-31$390,313
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,638,460
Total interest from all sources2012-12-31$19,581
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$409,299
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$2,378,291
Participant contributions at end of year2012-12-31$6,754
Participant contributions at beginning of year2012-12-31$3,680
Assets. Other investments not covered elsewhere at end of year2012-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$60,000
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$677,206
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$261,434
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$1,737,610
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$2,671,610
Administrative expenses (other) incurred2012-12-31$1,318
Liabilities. Value of operating payables at end of year2012-12-31$303,239
Liabilities. Value of operating payables at beginning of year2012-12-31$103,618
Total non interest bearing cash at end of year2012-12-31$652
Total non interest bearing cash at beginning of year2012-12-31$64,063
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,031,172
Value of net assets at end of year (total assets less liabilities)2012-12-31$-1,353,743
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-2,384,915
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$19,581
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$11,127,969
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$11,399,729
Employer contributions (assets) at end of year2012-12-31$2,494
Employer contributions (assets) at beginning of year2012-12-31$1,136
Contract administrator fees2012-12-31$1,227,843
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31O'CONNOR DAVIES, LLP
Accountancy firm EIN2012-12-31271728945
2011 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,775,228
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,289,286
Total income from all sources (including contributions)2011-12-31$13,804,815
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$15,177,789
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$13,570,895
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$13,802,942
Value of total assets at end of year2011-12-31$390,313
Value of total assets at beginning of year2011-12-31$277,345
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,606,894
Total interest from all sources2011-12-31$1,873
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$408,996
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$2,151,179
Participant contributions at end of year2011-12-31$1,136
Participant contributions at beginning of year2011-12-31$3,126
Assets. Other investments not covered elsewhere at end of year2011-12-31$60,000
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$261,434
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$267,036
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$2,671,610
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$1,149,940
Administrative expenses (other) incurred2011-12-31$13,769
Liabilities. Value of operating payables at end of year2011-12-31$103,618
Liabilities. Value of operating payables at beginning of year2011-12-31$139,346
Total non interest bearing cash at end of year2011-12-31$64,063
Total non interest bearing cash at beginning of year2011-12-31$1,211
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-1,372,974
Value of net assets at end of year (total assets less liabilities)2011-12-31$-2,384,915
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-1,011,941
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,873
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$13,570,895
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$11,651,763
Employer contributions (assets) at end of year2011-12-31$3,680
Employer contributions (assets) at beginning of year2011-12-31$5,972
Contract administrator fees2011-12-31$1,184,129
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31O'CONNOR DAVIES, LLP
Accountancy firm EIN2011-12-31271728945
2010 : CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,289,286
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$598,614
Expenses. Interest paid2010-12-31$1,667
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022010-12-31$1,667
Total income from all sources (including contributions)2010-12-31$12,781,578
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$13,735,682
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$12,194,941
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$12,781,234
Value of total assets at end of year2010-12-31$277,345
Value of total assets at beginning of year2010-12-31$540,777
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,539,074
Total interest from all sources2010-12-31$344
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$1,539,074
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$2,084,800
Participant contributions at end of year2010-12-31$6,330
Participant contributions at beginning of year2010-12-31$4,980
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$267,036
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$104,382
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$1,149,940
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$346,000
Liabilities. Value of operating payables at end of year2010-12-31$139,346
Liabilities. Value of operating payables at beginning of year2010-12-31$252,614
Total non interest bearing cash at end of year2010-12-31$1,211
Total non interest bearing cash at beginning of year2010-12-31$173,135
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-954,104
Value of net assets at end of year (total assets less liabilities)2010-12-31$-1,011,941
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-57,837
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$253,440
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$253,440
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$344
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$10,696,434
Employer contributions (assets) at end of year2010-12-31$2,768
Employer contributions (assets) at beginning of year2010-12-31$4,840
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$12,194,941
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31OCONNOR DAVIES MUNNS & DOBBINS, LLP
Accountancy firm EIN2010-12-31133385019

Form 5500 Responses for CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN

2022: CARMELITE SYSTEM, INC. HEALTH AND WELFARE 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 – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: CARMELITE SYSTEM, INC. HEALTH AND WELFARE 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 – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: CARMELITE SYSTEM, INC. HEALTH AND WELFARE 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 – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: CARMELITE SYSTEM, INC. HEALTH AND WELFARE 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: CARMELITE SYSTEM, INC. HEALTH AND WELFARE 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: CARMELITE SYSTEM, INC. HEALTH AND WELFARE 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: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: CARMELITE SYSTEM, INC. HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141135
Policy instance 4
Insurance contract or identification number0141135
Number of Individuals Covered2556
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,810
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $477,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2270
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 78697 )
Policy contract number10196431001*
Policy instance 3
Insurance contract or identification number10196431001*
Number of Individuals Covered1323
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 BenefitYes
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 $81,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0212237
Policy instance 2
Insurance contract or identification number0212237
Number of Individuals Covered372
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 BenefitYes
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 $78,133
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: 47029 )
Policy contract number12207473
Policy instance 1
Insurance contract or identification number12207473
Number of Individuals Covered182
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $1,226
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $68,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,226
Insurance broker organization code?3
AETNA EMPLOYEE ASSISTANCE PLAN (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number567003
Policy instance 1
Insurance contract or identification number567003
Number of Individuals Covered1776
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
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
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 $28,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141135
Policy instance 2
Insurance contract or identification number0141135
Number of Individuals Covered2348
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $13,616
Total amount of fees paid to insurance companyUSD $3,974
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $460,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,616
Amount paid for insurance broker fees1889
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12207473
Policy instance 3
Insurance contract or identification number12207473
Number of Individuals Covered233
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $2,216
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $80,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,216
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0212237
Policy instance 4
Insurance contract or identification number0212237
Number of Individuals Covered477
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 BenefitYes
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 $88,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 78697 )
Policy contract number10196431001*
Policy instance 5
Insurance contract or identification number10196431001*
Number of Individuals Covered1154
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 BenefitYes
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 $72,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0212237
Policy instance 5
Insurance contract or identification number0212237
Number of Individuals Covered529
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 BenefitYes
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 $28,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141135
Policy instance 4
Insurance contract or identification number0141135
Number of Individuals Covered2753
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,443
Total amount of fees paid to insurance companyUSD $5,585
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $407,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,443
Amount paid for insurance broker fees3656
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION
Insurance broker organization code?3
AETNA EMPLOYEE ASSISTANCE PLAN (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number567003
Policy instance 3
Insurance contract or identification number567003
Number of Individuals Covered2207
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
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
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 $33,558
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: 47029 )
Policy contract number12207473
Policy instance 2
Insurance contract or identification number12207473
Number of Individuals Covered270
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $2,488
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $92,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,488
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 78697 )
Policy contract number10196431001*
Policy instance 1
Insurance contract or identification number10196431001*
Number of Individuals Covered1222
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 BenefitYes
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 $75,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA0467
Policy instance 2
Insurance contract or identification numberA0467
Number of Individuals Covered1346
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number469819-SL
Policy instance 1
Insurance contract or identification number469819-SL
Number of Individuals Covered1346
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 $1,983,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA0467
Policy instance 2
Insurance contract or identification numberA0467
Number of Individuals Covered1401
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number469819-SL
Policy instance 1
Insurance contract or identification number469819-SL
Number of Individuals Covered1401
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 $1,599,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number469819-SL
Policy instance 1
Insurance contract or identification number469819-SL
Number of Individuals Covered1098
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 $1,509,453
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number469819-SL
Policy instance 1
Insurance contract or identification number469819-SL
Number of Individuals Covered1138
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare 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 $1,201,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number469819-SL
Policy instance 1
Insurance contract or identification number469819-SL
Number of Individuals Covered1223
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare 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 $1,043,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number469819-SL
Policy instance 1
Insurance contract or identification number469819-SL
Number of Individuals Covered1281
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare 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 $1,001,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60213 )
Policy contract number404033 0010
Policy instance 1
Insurance contract or identification number404033 0010
Number of Individuals Covered1309
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare 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 $696,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number080257
Policy instance 1
Insurance contract or identification number080257
Number of Individuals Covered1360
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare 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 $575,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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