RAVN AIR GROUP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan RAVN AIR GROUP HEALTH CARE TRUST
| Measure | Date | Value |
|---|
| 2021 : RAVN AIR GROUP HEALTH CARE TRUST 2021 401k financial data |
|---|
| Total transfer of assets to this plan | 2021-08-18 | $0 |
| Total transfer of assets from this plan | 2021-08-18 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-08-18 | $442,969 |
| Total income from all sources (including contributions) | 2021-08-18 | $501 |
| Total of all expenses incurred | 2021-08-18 | $59,778 |
| Value of total assets at end of year | 2021-08-18 | $0 |
| Value of total assets at beginning of year | 2021-08-18 | $502,246 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-08-18 | $59,778 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-08-18 | Yes |
| Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan | 2021-08-18 | $59,778 |
| Was this plan covered by a fidelity bond | 2021-08-18 | Yes |
| Value of fidelity bond cover | 2021-08-18 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-08-18 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-08-18 | No |
| Assets. Other investments not covered elsewhere at beginning of year | 2021-08-18 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-08-18 | $113,000 |
| Other income not declared elsewhere | 2021-08-18 | $501 |
| Administrative expenses (other) incurred | 2021-08-18 | $59,778 |
| Liabilities. Value of operating payables at beginning of year | 2021-08-18 | $78,660 |
| Total non interest bearing cash at end of year | 2021-08-18 | $0 |
| Total non interest bearing cash at beginning of year | 2021-08-18 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-08-18 | No |
| Value of net income/loss | 2021-08-18 | $-59,277 |
| Value of net assets at end of year (total assets less liabilities) | 2021-08-18 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-08-18 | $59,277 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-08-18 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-08-18 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-08-18 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-08-18 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-08-18 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-08-18 | No |
| Employer contributions (assets) at beginning of year | 2021-08-18 | $389,246 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-08-18 | $364,309 |
| Did the plan have assets held for investment | 2021-08-18 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-08-18 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-08-18 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-08-18 | Unqualified |
| Accountancy firm name | 2021-08-18 | FARBER HASS HURLEY LLP |
| Accountancy firm EIN | 2021-08-18 | 204207759 |
| 2020 : RAVN AIR GROUP HEALTH CARE TRUST 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $442,969 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $948,260 |
| Total income from all sources (including contributions) | 2020-12-31 | $3,272,437 |
| Total of all expenses incurred | 2020-12-31 | $2,580,667 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $2,496,059 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $3,272,204 |
| Value of total assets at end of year | 2020-12-31 | $502,246 |
| Value of total assets at beginning of year | 2020-12-31 | $315,767 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $84,608 |
| Total interest from all sources | 2020-12-31 | $233 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | Yes |
| Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan | 2020-12-31 | $0 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $973,374 |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-12-31 | $113,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $113,000 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $0 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $78,660 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $18,673 |
| Total non interest bearing cash at end of year | 2020-12-31 | $0 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $691,770 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $59,277 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $-632,493 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $202,767 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $202,767 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $233 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $397,223 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $2,298,830 |
| Employer contributions (assets) at end of year | 2020-12-31 | $389,246 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $2,098,836 |
| Contract administrator fees | 2020-12-31 | $84,608 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $364,309 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $929,587 |
| Did the plan have assets held for investment | 2020-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | FARBER HASS HURLEY LLP |
| Accountancy firm EIN | 2020-12-31 | 204207759 |
| 2019 : RAVN AIR GROUP HEALTH CARE TRUST 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $948,260 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $753,122 |
| Total income from all sources (including contributions) | 2019-12-31 | $6,798,574 |
| Total of all expenses incurred | 2019-12-31 | $6,740,166 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $6,517,823 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $6,796,800 |
| Value of total assets at end of year | 2019-12-31 | $315,767 |
| Value of total assets at beginning of year | 2019-12-31 | $62,221 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $222,343 |
| Total interest from all sources | 2019-12-31 | $1,774 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $2,228,915 |
| Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $113,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $0 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $18,673 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $0 |
| Total non interest bearing cash at end of year | 2019-12-31 | $0 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $58,408 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $-632,493 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $-690,901 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $202,767 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $62,221 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $62,221 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $1,774 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $1,071,407 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $4,567,885 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $5,446,416 |
| Contract administrator fees | 2019-12-31 | $222,343 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $929,587 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $753,122 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | FARBER HASS HURLEY LLP |
| Accountancy firm EIN | 2019-12-31 | 204207759 |
| 2018 : RAVN AIR GROUP HEALTH CARE TRUST 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $753,122 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $840,962 |
| Total income from all sources (including contributions) | 2018-12-31 | $4,161,709 |
| Total of all expenses incurred | 2018-12-31 | $4,717,577 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $4,518,638 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $4,159,123 |
| Value of total assets at end of year | 2018-12-31 | $62,221 |
| Value of total assets at beginning of year | 2018-12-31 | $705,929 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $198,939 |
| Total interest from all sources | 2018-12-31 | $2,586 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Administrative expenses professional fees incurred | 2018-12-31 | $198,939 |
| Was this plan covered by a fidelity bond | 2018-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $1,510,482 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $302,824 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $0 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $0 |
| Total non interest bearing cash at end of year | 2018-12-31 | $0 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $18,190 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $-555,868 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $-690,901 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $-135,033 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $62,221 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $384,915 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $384,915 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $2,586 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $867,028 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $2,648,641 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $3,651,610 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $753,122 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $840,962 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | ALTMAN, ROGERS AND COMPANY |
| Accountancy firm EIN | 2018-12-31 | 920143182 |
| 2017 : RAVN AIR GROUP HEALTH CARE TRUST 2017 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $840,962 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $588,178 |
| Total income from all sources (including contributions) | 2017-12-31 | $5,481,255 |
| Total loss/gain on sale of assets | 2017-12-31 | $0 |
| Total of all expenses incurred | 2017-12-31 | $5,845,036 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $5,612,063 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $5,477,712 |
| Value of total assets at end of year | 2017-12-31 | $705,929 |
| Value of total assets at beginning of year | 2017-12-31 | $816,926 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $232,973 |
| Total interest from all sources | 2017-12-31 | $3,543 |
| 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 year | 2017-12-31 | No |
| Administrative expenses professional fees incurred | 2017-12-31 | $232,973 |
| Was this plan covered by a fidelity bond | 2017-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $1,689,130 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-12-31 | $58,317 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $302,824 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $71,641 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $266,645 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $72,178 |
| Total non interest bearing cash at end of year | 2017-12-31 | $403,105 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $816,926 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $-363,781 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $-135,033 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $228,748 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $384,915 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $739,600 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $739,600 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $3,543 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $1,131,112 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $3,788,582 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $4,422,634 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $574,317 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $516,000 |
| Did the plan have assets held for investment | 2017-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | ALTMAN, ROGERS AND COMPANY |
| Accountancy firm EIN | 2017-12-31 | 920143182 |
| 2016 : RAVN AIR GROUP HEALTH CARE TRUST 2016 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $588,178 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $699,759 |
| Total income from all sources (including contributions) | 2016-12-31 | $6,046,206 |
| Total loss/gain on sale of assets | 2016-12-31 | $0 |
| Total of all expenses incurred | 2016-12-31 | $6,315,610 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $6,086,216 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $6,044,830 |
| Value of total assets at end of year | 2016-12-31 | $816,926 |
| Value of total assets at beginning of year | 2016-12-31 | $1,197,911 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $229,394 |
| Total interest from all sources | 2016-12-31 | $1,376 |
| 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 year | 2016-12-31 | No |
| Administrative expenses professional fees incurred | 2016-12-31 | $229,394 |
| Was this plan covered by a fidelity bond | 2016-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $1,763,820 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-12-31 | $183,759 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $72,178 |
| Total non interest bearing cash at end of year | 2016-12-31 | $816,926 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $1,197,911 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $-269,404 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $228,748 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $498,152 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $1,376 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $1,429,376 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $4,281,010 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $4,473,081 |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $516,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $699,759 |
| Did the plan have assets held for investment | 2016-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | ALTMAN, ROGERS AND COMPANY |
| Accountancy firm EIN | 2016-12-31 | 920143182 |
| 2015 : RAVN AIR GROUP HEALTH CARE TRUST 2015 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $699,759 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $259,658 |
| Total income from all sources (including contributions) | 2015-12-31 | $5,737,098 |
| Total loss/gain on sale of assets | 2015-12-31 | $0 |
| Total of all expenses incurred | 2015-12-31 | $5,874,395 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $5,651,694 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $5,736,506 |
| Value of total assets at end of year | 2015-12-31 | $1,197,911 |
| Value of total assets at beginning of year | 2015-12-31 | $895,107 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $222,701 |
| Total interest from all sources | 2015-12-31 | $592 |
| 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 year | 2015-12-31 | No |
| Was this plan covered by a fidelity bond | 2015-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $1,773,309 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $58 |
| Total non interest bearing cash at end of year | 2015-12-31 | $1,197,911 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $895,107 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $-137,297 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $498,152 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $635,449 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $592 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $1,310,760 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $3,963,197 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $4,340,934 |
| Contract administrator fees | 2015-12-31 | $222,701 |
| Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $699,759 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $259,600 |
| Did the plan have assets held for investment | 2015-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | ALTMAN, ROGERS AND COMPANY |
| Accountancy firm EIN | 2015-12-31 | 920143182 |
| 2014 : RAVN AIR GROUP HEALTH CARE TRUST 2014 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $259,658 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $260,414 |
| Total income from all sources (including contributions) | 2014-12-31 | $4,297,613 |
| Total loss/gain on sale of assets | 2014-12-31 | $0 |
| Total of all expenses incurred | 2014-12-31 | $4,252,826 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $4,028,161 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $4,296,942 |
| Value of total assets at end of year | 2014-12-31 | $895,107 |
| Value of total assets at beginning of year | 2014-12-31 | $851,076 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $224,665 |
| Total interest from all sources | 2014-12-31 | $671 |
| 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 year | 2014-12-31 | No |
| Was this plan covered by a fidelity bond | 2014-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $1,614,055 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $0 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $58 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $1,614 |
| Total non interest bearing cash at end of year | 2014-12-31 | $895,107 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $851,076 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $44,787 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $635,449 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $590,662 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $671 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $1,142,175 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $2,682,887 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $2,885,986 |
| Contract administrator fees | 2014-12-31 | $224,665 |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $259,600 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $258,800 |
| Did the plan have assets held for investment | 2014-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | ALTMAN, ROGERS AND COMPANY |
| Accountancy firm EIN | 2014-12-31 | 920143182 |
| 2013 : RAVN AIR GROUP HEALTH CARE TRUST 2013 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $260,414 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $1,184,188 |
| Total income from all sources (including contributions) | 2013-12-31 | $4,268,497 |
| Total loss/gain on sale of assets | 2013-12-31 | $0 |
| Total of all expenses incurred | 2013-12-31 | $3,355,792 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $3,223,013 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $4,268,034 |
| Value of total assets at end of year | 2013-12-31 | $851,076 |
| Value of total assets at beginning of year | 2013-12-31 | $862,145 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $132,779 |
| Total interest from all sources | 2013-12-31 | $463 |
| 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 year | 2013-12-31 | No |
| Was this plan covered by a fidelity bond | 2013-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $1,514,179 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $492,900 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $1,614 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $727,090 |
| Total non interest bearing cash at end of year | 2013-12-31 | $851,076 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $369,245 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $912,705 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $590,662 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $-322,043 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $463 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $1,125,212 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $2,753,855 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $2,097,801 |
| Contract administrator fees | 2013-12-31 | $132,779 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $258,800 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $457,098 |
| Did the plan have assets held for investment | 2013-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | ALTMAN, ROGERS AND COMPANY |
| Accountancy firm EIN | 2013-12-31 | 920143182 |
| 2012 : RAVN AIR GROUP HEALTH CARE TRUST 2012 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $1,184,188 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $464,410 |
| Total income from all sources (including contributions) | 2012-12-31 | $4,020,780 |
| Total loss/gain on sale of assets | 2012-12-31 | $0 |
| Total of all expenses incurred | 2012-12-31 | $4,379,057 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $4,263,017 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $4,020,477 |
| Value of total assets at end of year | 2012-12-31 | $862,145 |
| Value of total assets at beginning of year | 2012-12-31 | $500,644 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $116,040 |
| Total interest from all sources | 2012-12-31 | $303 |
| 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 year | 2012-12-31 | No |
| Was this plan covered by a fidelity bond | 2012-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $1,242,383 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $492,900 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $727,090 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $39,705 |
| Total non interest bearing cash at end of year | 2012-12-31 | $369,245 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $500,644 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-358,277 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $-322,043 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $36,234 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $303 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $829,134 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $2,778,094 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $3,433,883 |
| Contract administrator fees | 2012-12-31 | $116,040 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $457,098 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $424,705 |
| Did the plan have assets held for investment | 2012-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | ALTMAN, ROGERS AND COMPANY |
| Accountancy firm EIN | 2012-12-31 | 920143182 |
| 2011 : RAVN AIR GROUP HEALTH CARE TRUST 2011 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $464,410 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $320,464 |
| Total income from all sources (including contributions) | 2011-12-31 | $3,667,705 |
| Total loss/gain on sale of assets | 2011-12-31 | $0 |
| Total of all expenses incurred | 2011-12-31 | $3,778,747 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $3,673,650 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $3,667,705 |
| Value of total assets at end of year | 2011-12-31 | $500,644 |
| Value of total assets at beginning of year | 2011-12-31 | $467,740 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $105,097 |
| Total interest from all sources | 2011-12-31 | $0 |
| 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 year | 2011-12-31 | No |
| Was this plan covered by a fidelity bond | 2011-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $1,106,680 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $39,705 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $100,485 |
| Total non interest bearing cash at end of year | 2011-12-31 | $500,644 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $467,740 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $-111,042 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $36,234 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $147,276 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-12-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $649,142 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $2,561,025 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $3,024,508 |
| Contract administrator fees | 2011-12-31 | $105,097 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $424,705 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $219,979 |
| Did the plan have assets held for investment | 2011-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | ALTMAN, ROGERS AND COMPANY |
| Accountancy firm EIN | 2011-12-31 | 920143182 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 0101769800 |
| Policy instance | 3 |
| Insurance contract or identification number | 0101769800 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $1,294 | | Total amount of fees paid to insurance company | USD $3,279 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $32,015 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,294 | | Amount paid for insurance broker fees | 3279 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 ) |
| Policy contract number | AK201347 |
| Policy instance | 2 |
| Insurance contract or identification number | AK201347 | | Number of Individuals Covered | 581 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $52,529 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $318,563 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52,529 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 1 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 2329 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $7,836 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 1 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 2329 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $14,714 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 ) |
| Policy contract number | AK201347 |
| Policy instance | 2 |
| Insurance contract or identification number | AK201347 | | Number of Individuals Covered | 534 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,070,773 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 0101769800 |
| Policy instance | 3 |
| Insurance contract or identification number | 0101769800 | | Number of Individuals Covered | 1120 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $6,320 | | Total amount of fees paid to insurance company | USD $4,586 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $158,035 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 2973 | | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS | | Insurance broker organization code? | 3 |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 1 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 2329 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM, SELF-FUNDED BENEFIT | | Welfare Benefit Premiums Paid to Carrier | USD $11,700 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 ) |
| Policy contract number | AK201347 |
| Policy instance | 2 |
| Insurance contract or identification number | AK201347 | | Number of Individuals Covered | 459 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $867,662 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 01 017698 00 |
| Policy instance | 3 |
| Insurance contract or identification number | 01 017698 00 | | Number of Individuals Covered | 914 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $5,121 | | Total amount of fees paid to insurance company | USD $1,486 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $127,966 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,121 | | Amount paid for insurance broker fees | 3 | | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 4545 |
| Policy instance | 2 |
| Insurance contract or identification number | 4545 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | Total amount of commissions paid to insurance broker | USD $1,244 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL 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 Carrier | USD $25,568 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,244 | | Insurance broker organization code? | 3 | | Insurance broker name | FEJES AND ASSOCIATES INC. |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL16908 |
| Policy instance | 1 |
| Insurance contract or identification number | HCL16908 | | Number of Individuals Covered | 422 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $11,309 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,130,898 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 11309 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MERITAIN HEALTH |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 3 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 685 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE 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 Carrier | USD $11,700 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 3 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 2329 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE 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 Carrier | USD $11,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 4545 |
| Policy instance | 2 |
| Insurance contract or identification number | 4545 | | Number of Individuals Covered | 790 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $3,198 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL 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 Carrier | USD $80,817 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,198 | | Insurance broker organization code? | 3 | | Insurance broker name | FEJES AND ASSOCIATES INC. |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL16908 |
| Policy instance | 1 |
| Insurance contract or identification number | HCL16908 | | Number of Individuals Covered | 442 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $13,089 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,308,897 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 13089 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MERITAIN HEALTH |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 3 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 1644 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE 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 Carrier | USD $10,172 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL16908 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL16908 | | Number of Individuals Covered | 433 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $11,426 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,143,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 11426 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MERITAIN HEALTH |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 4545 |
| Policy instance | 1 |
| Insurance contract or identification number | 4545 | | Number of Individuals Covered | 748 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $2,927 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL 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 Carrier | USD $76,669 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,927 | | Insurance broker organization code? | 3 | | Insurance broker name | FEJES AND ASSOCIATES INC. |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 4545 |
| Policy instance | 1 |
| Insurance contract or identification number | 4545 | | Number of Individuals Covered | 705 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $2,933 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL 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 Carrier | USD $73,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,933 | | Insurance broker organization code? | 3 | | Insurance broker name | FEJES AND ASSOCIATES INC. |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 3 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 1644 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE 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 Carrier | USD $12,022 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL16908 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL16908 | | Number of Individuals Covered | 393 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $10,611 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,060,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 10611 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MERITAIN HEALTH |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 3 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 959 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE 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 Carrier | USD $11,096 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 04545 |
| Policy instance | 1 |
| Insurance contract or identification number | 04545 | | Number of Individuals Covered | 679 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $2,686 | | Total amount of fees paid to insurance company | USD $1,365 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL 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 Carrier | USD $67,995 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,686 | | Amount paid for insurance broker fees | 1365 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | FEJES AND ASSOCIATES INC. |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL16908 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL16908 | | Number of Individuals Covered | 389 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $7,730 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $772,059 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 7730 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MERITAIN HEALTH |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERAA0-001 |
| Policy instance | 3 |
| Insurance contract or identification number | ERAA0-001 | | Number of Individuals Covered | 684 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE 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 Carrier | USD $10,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL16908 |
| Policy instance | 1 |
| Insurance contract or identification number | HCL16908 | | Number of Individuals Covered | 332 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,529 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $629,286 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 04545 |
| Policy instance | 2 |
| Insurance contract or identification number | 04545 | | Number of Individuals Covered | 694 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $2,691 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL 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 Carrier | USD $69,145 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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