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IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan NameIH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number 501

IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

IH CREDIT UNION, INC. has sponsored the creation of one or more 401k plans.

Company Name:IH CREDIT UNION, INC.
Employer identification number (EIN):310502711
NAIC Classification:522130
NAIC Description:Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-02-01ROBB WHITE2024-11-01
5012022-02-01
5012022-02-01ROBB WHITE
5012020-02-01
5012019-02-01
5012018-02-01
5012017-02-01ROBB WHITE
5012016-02-01ROBB WHITE ROBB WHITE2017-08-03
5012015-02-01ROBB WHITE2016-08-04 ROBB WHITE2016-08-04
5012014-02-01ROBB WHITE2015-11-11 ROBB WHITE2015-11-12
5012013-02-01ROBB WHITE2014-11-14 ROBB WHITE2014-11-14
5012012-02-01JAMES KITCHEN2013-11-14 JAMES KITCHEN2013-11-14
5012011-02-01JAMES KITCHEN2012-11-14 JAMES KITCHEN2012-11-15
5012010-02-01JAMES KITCHEN2011-11-15 JAMES KITCHEN2011-11-15
5012009-02-01JAMES KITCHEN2010-11-15 JAMES KITCHEN2010-11-15

Financial Data on IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2024 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2024 401k financial data
Total income from all sources2024-01-31$622,184
Expenses. Total of all expenses incurred2024-01-31$629,632
Benefits paid (including direct rollovers)2024-01-31$232,824
Total plan assets at end of year2024-01-31$0
Total plan assets at beginning of year2024-01-31$7,448
Value of fidelity bond covering the plan2024-01-31$5,000,000
Total contributions received or receivable from participants2024-01-31$45,092
Expenses. Other expenses not covered elsewhere2024-01-31$365,181
Net income (gross income less expenses)2024-01-31$-7,448
Net plan assets at end of year (total assets less liabilities)2024-01-31$0
Net plan assets at beginning of year (total assets less liabilities)2024-01-31$7,448
Total contributions received or receivable from employer(s)2024-01-31$577,092
Expenses. Administrative service providers (salaries,fees and commissions)2024-01-31$31,627
2023 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2023 401k financial data
Total income from all sources2023-01-31$1,117,728
Expenses. Total of all expenses incurred2023-01-31$1,128,552
Benefits paid (including direct rollovers)2023-01-31$806,786
Total plan assets at end of year2023-01-31$7,448
Total plan assets at beginning of year2023-01-31$18,272
Value of fidelity bond covering the plan2023-01-31$5,000,000
Total contributions received or receivable from participants2023-01-31$74,078
Expenses. Other expenses not covered elsewhere2023-01-31$298,450
Contributions received from other sources (not participants or employers)2023-01-31$-37,632
Net income (gross income less expenses)2023-01-31$-10,824
Net plan assets at end of year (total assets less liabilities)2023-01-31$7,448
Net plan assets at beginning of year (total assets less liabilities)2023-01-31$18,272
Total contributions received or receivable from employer(s)2023-01-31$1,081,282
Expenses. Administrative service providers (salaries,fees and commissions)2023-01-31$23,316
2021 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k financial data
Total income from all sources2021-01-31$670,402
Expenses. Total of all expenses incurred2021-01-31$664,607
Benefits paid (including direct rollovers)2021-01-31$456,956
Total plan assets at end of year2021-01-31$13,078
Total plan assets at beginning of year2021-01-31$7,283
Value of fidelity bond covering the plan2021-01-31$5,000,000
Total contributions received or receivable from participants2021-01-31$61,599
Expenses. Other expenses not covered elsewhere2021-01-31$185,310
Other income received2021-01-31$28,187
Net income (gross income less expenses)2021-01-31$5,795
Net plan assets at end of year (total assets less liabilities)2021-01-31$13,078
Net plan assets at beginning of year (total assets less liabilities)2021-01-31$7,283
Total contributions received or receivable from employer(s)2021-01-31$580,616
Expenses. Administrative service providers (salaries,fees and commissions)2021-01-31$22,341
2020 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k financial data
Total income from all sources2020-01-31$464,556
Expenses. Total of all expenses incurred2020-01-31$481,631
Benefits paid (including direct rollovers)2020-01-31$298,875
Total plan assets at end of year2020-01-31$7,283
Total plan assets at beginning of year2020-01-31$24,358
Value of fidelity bond covering the plan2020-01-31$500,000
Expenses. Other expenses not covered elsewhere2020-01-31$159,852
Other income received2020-01-31$52,038
Net income (gross income less expenses)2020-01-31$-17,075
Net plan assets at end of year (total assets less liabilities)2020-01-31$7,283
Net plan assets at beginning of year (total assets less liabilities)2020-01-31$24,358
Total contributions received or receivable from employer(s)2020-01-31$412,518
Expenses. Administrative service providers (salaries,fees and commissions)2020-01-31$22,904
2019 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k financial data
Total income from all sources2019-01-31$536,693
Expenses. Total of all expenses incurred2019-01-31$523,627
Benefits paid (including direct rollovers)2019-01-31$355,834
Total plan assets at end of year2019-01-31$24,358
Total plan assets at beginning of year2019-01-31$11,292
Value of fidelity bond covering the plan2019-01-31$5,000,000
Expenses. Other expenses not covered elsewhere2019-01-31$145,674
Other income received2019-01-31$11,927
Net income (gross income less expenses)2019-01-31$13,066
Net plan assets at end of year (total assets less liabilities)2019-01-31$24,358
Net plan assets at beginning of year (total assets less liabilities)2019-01-31$11,292
Total contributions received or receivable from employer(s)2019-01-31$524,766
Expenses. Administrative service providers (salaries,fees and commissions)2019-01-31$22,119
2018 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k financial data
Total income from all sources2018-01-31$570,465
Expenses. Total of all expenses incurred2018-01-31$571,828
Benefits paid (including direct rollovers)2018-01-31$471,084
Total plan assets at end of year2018-01-31$11,292
Total plan assets at beginning of year2018-01-31$12,655
Value of fidelity bond covering the plan2018-01-31$5,000,000
Expenses. Other expenses not covered elsewhere2018-01-31$79,950
Other income received2018-01-31$6,206
Noncash contributions received2018-01-31$1
Net income (gross income less expenses)2018-01-31$-1,363
Net plan assets at end of year (total assets less liabilities)2018-01-31$11,292
Net plan assets at beginning of year (total assets less liabilities)2018-01-31$12,655
Total contributions received or receivable from employer(s)2018-01-31$564,258
Expenses. Administrative service providers (salaries,fees and commissions)2018-01-31$20,794
2017 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k financial data
Total income from all sources2017-01-31$401,178
Expenses. Total of all expenses incurred2017-01-31$408,031
Benefits paid (including direct rollovers)2017-01-31$291,875
Total plan assets at end of year2017-01-31$6,621
Total plan assets at beginning of year2017-01-31$13,474
Value of fidelity bond covering the plan2017-01-31$5,000,000
Expenses. Other expenses not covered elsewhere2017-01-31$99,184
Other income received2017-01-31$8,378
Net income (gross income less expenses)2017-01-31$-6,853
Net plan assets at end of year (total assets less liabilities)2017-01-31$6,621
Net plan assets at beginning of year (total assets less liabilities)2017-01-31$13,474
Total contributions received or receivable from employer(s)2017-01-31$392,800
Expenses. Administrative service providers (salaries,fees and commissions)2017-01-31$16,972
2016 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k financial data
Total income from all sources2016-01-31$367,653
Expenses. Total of all expenses incurred2016-01-31$385,579
Benefits paid (including direct rollovers)2016-01-31$281,162
Total plan assets at end of year2016-01-31$13,474
Total plan assets at beginning of year2016-01-31$31,400
Value of fidelity bond covering the plan2016-01-31$5,000,000
Expenses. Other expenses not covered elsewhere2016-01-31$89,156
Noncash contributions received2016-01-31$2,904
Net income (gross income less expenses)2016-01-31$-17,926
Net plan assets at end of year (total assets less liabilities)2016-01-31$13,474
Net plan assets at beginning of year (total assets less liabilities)2016-01-31$31,400
Total contributions received or receivable from employer(s)2016-01-31$364,749
Expenses. Administrative service providers (salaries,fees and commissions)2016-01-31$15,261
2015 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k financial data
Total income from all sources2015-01-31$384,421
Expenses. Total of all expenses incurred2015-01-31$401,459
Benefits paid (including direct rollovers)2015-01-31$270,982
Total plan assets at end of year2015-01-31$31,400
Total plan assets at beginning of year2015-01-31$48,438
Value of fidelity bond covering the plan2015-01-31$4,700,000
Expenses. Other expenses not covered elsewhere2015-01-31$115,847
Other income received2015-01-31$70,150
Net income (gross income less expenses)2015-01-31$-17,038
Net plan assets at end of year (total assets less liabilities)2015-01-31$31,400
Net plan assets at beginning of year (total assets less liabilities)2015-01-31$48,438
Total contributions received or receivable from employer(s)2015-01-31$314,271
Expenses. Administrative service providers (salaries,fees and commissions)2015-01-31$14,630
2014 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k financial data
Total income from all sources2014-01-31$466,138
Expenses. Total of all expenses incurred2014-01-31$496,270
Benefits paid (including direct rollovers)2014-01-31$265,962
Total plan assets at end of year2014-01-31$48,438
Total plan assets at beginning of year2014-01-31$78,570
Value of fidelity bond covering the plan2014-01-31$4,700,000
Expenses. Other expenses not covered elsewhere2014-01-31$230,308
Other income received2014-01-31$70,996
Net income (gross income less expenses)2014-01-31$-30,132
Net plan assets at end of year (total assets less liabilities)2014-01-31$48,438
Net plan assets at beginning of year (total assets less liabilities)2014-01-31$78,570
Total contributions received or receivable from employer(s)2014-01-31$395,142
2013 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k financial data
Total income from all sources2013-01-31$624,810
Expenses. Total of all expenses incurred2013-01-31$609,877
Benefits paid (including direct rollovers)2013-01-31$417,808
Total plan assets at end of year2013-01-31$78,570
Total plan assets at beginning of year2013-01-31$63,637
Value of fidelity bond covering the plan2013-01-31$1,000,000
Expenses. Other expenses not covered elsewhere2013-01-31$192,069
Other income received2013-01-31$112,490
Net income (gross income less expenses)2013-01-31$14,933
Net plan assets at end of year (total assets less liabilities)2013-01-31$78,570
Net plan assets at beginning of year (total assets less liabilities)2013-01-31$63,637
Total contributions received or receivable from employer(s)2013-01-31$512,320
2012 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k financial data
Total income from all sources2012-01-31$404,370
Expenses. Total of all expenses incurred2012-01-31$397,280
Benefits paid (including direct rollovers)2012-01-31$225,080
Total plan assets at end of year2012-01-31$63,637
Total plan assets at beginning of year2012-01-31$56,547
Value of fidelity bond covering the plan2012-01-31$1,000,000
Expenses. Other expenses not covered elsewhere2012-01-31$172,200
Other income received2012-01-31$29,211
Net income (gross income less expenses)2012-01-31$7,090
Net plan assets at end of year (total assets less liabilities)2012-01-31$63,637
Net plan assets at beginning of year (total assets less liabilities)2012-01-31$56,547
Total contributions received or receivable from employer(s)2012-01-31$375,159
2011 : IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k financial data
Total income from all sources2011-01-31$306,858
Expenses. Total of all expenses incurred2011-01-31$387,067
Benefits paid (including direct rollovers)2011-01-31$229,612
Total plan assets at end of year2011-01-31$56,547
Total plan assets at beginning of year2011-01-31$136,756
Value of fidelity bond covering the plan2011-01-31$1,000,000
Expenses. Other expenses not covered elsewhere2011-01-31$157,455
Other income received2011-01-31$48,631
Net income (gross income less expenses)2011-01-31$-80,209
Net plan assets at end of year (total assets less liabilities)2011-01-31$56,547
Net plan assets at beginning of year (total assets less liabilities)2011-01-31$136,756
Total contributions received or receivable from employer(s)2011-01-31$258,227

Form 5500 Responses for IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN

2023: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2023 form 5500 responses
2023-02-01Type of plan entitySingle employer plan
2023-02-01Submission has been amendedNo
2023-02-01This submission is the final filingNo
2023-02-01This return/report is a short plan year return/report (less than 12 months)No
2023-02-01Plan is a collectively bargained planNo
2023-02-01Plan funding arrangement – InsuranceYes
2023-02-01Plan funding arrangement – TrustYes
2023-02-01Plan benefit arrangement – InsuranceYes
2023-02-01Plan benefit arrangement - TrustYes
2022: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Submission has been amendedNo
2022-02-01This submission is the final filingNo
2022-02-01This return/report is a short plan year return/report (less than 12 months)No
2022-02-01Plan is a collectively bargained planNo
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan funding arrangement – TrustYes
2022-02-01Plan benefit arrangement – InsuranceYes
2022-02-01Plan benefit arrangement - TrustYes
2020: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Submission has been amendedNo
2020-02-01This submission is the final filingNo
2020-02-01This return/report is a short plan year return/report (less than 12 months)No
2020-02-01Plan is a collectively bargained planNo
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan funding arrangement – TrustYes
2020-02-01Plan benefit arrangement – InsuranceYes
2020-02-01Plan benefit arrangement - TrustYes
2019: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Submission has been amendedNo
2019-02-01This submission is the final filingNo
2019-02-01This return/report is a short plan year return/report (less than 12 months)No
2019-02-01Plan is a collectively bargained planNo
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan funding arrangement – TrustYes
2019-02-01Plan benefit arrangement – InsuranceYes
2019-02-01Plan benefit arrangement - TrustYes
2018: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Submission has been amendedNo
2018-02-01This submission is the final filingNo
2018-02-01This return/report is a short plan year return/report (less than 12 months)No
2018-02-01Plan is a collectively bargained planNo
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan funding arrangement – TrustYes
2018-02-01Plan benefit arrangement – InsuranceYes
2018-02-01Plan benefit arrangement - TrustYes
2017: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan funding arrangement – TrustYes
2017-02-01Plan benefit arrangement – InsuranceYes
2017-02-01Plan benefit arrangement - TrustYes
2016: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)No
2016-02-01Plan is a collectively bargained planNo
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan funding arrangement – TrustYes
2016-02-01Plan benefit arrangement – InsuranceYes
2016-02-01Plan benefit arrangement - TrustYes
2015: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)No
2015-02-01Plan is a collectively bargained planNo
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan funding arrangement – General assets of the sponsorYes
2015-02-01Plan benefit arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – General assets of the sponsorYes
2014: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01Submission has been amendedNo
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)No
2014-02-01Plan is a collectively bargained planNo
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan funding arrangement – TrustYes
2014-02-01Plan benefit arrangement – InsuranceYes
2014-02-01Plan benefit arrangement - TrustYes
2013: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01Submission has been amendedNo
2013-02-01This submission is the final filingNo
2013-02-01This return/report is a short plan year return/report (less than 12 months)No
2013-02-01Plan is a collectively bargained planNo
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan funding arrangement – TrustYes
2013-02-01Plan benefit arrangement – InsuranceYes
2013-02-01Plan benefit arrangement - TrustYes
2012: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01Submission has been amendedNo
2012-02-01This submission is the final filingNo
2012-02-01This return/report is a short plan year return/report (less than 12 months)No
2012-02-01Plan is a collectively bargained planNo
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan funding arrangement – TrustYes
2012-02-01Plan benefit arrangement – InsuranceYes
2012-02-01Plan benefit arrangement - TrustYes
2011: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01Submission has been amendedNo
2011-02-01This submission is the final filingNo
2011-02-01This return/report is a short plan year return/report (less than 12 months)No
2011-02-01Plan is a collectively bargained planNo
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan funding arrangement – TrustYes
2011-02-01Plan benefit arrangement – InsuranceYes
2011-02-01Plan benefit arrangement - TrustYes
2010: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2010 form 5500 responses
2010-02-01Type of plan entitySingle employer plan
2010-02-01Submission has been amendedNo
2010-02-01This submission is the final filingNo
2010-02-01This return/report is a short plan year return/report (less than 12 months)No
2010-02-01Plan is a collectively bargained planNo
2010-02-01Plan funding arrangement – InsuranceYes
2010-02-01Plan funding arrangement – TrustYes
2010-02-01Plan benefit arrangement – InsuranceYes
2010-02-01Plan benefit arrangement - TrustYes
2009: IH CREDIT UNION, INC. EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan funding arrangement – TrustYes
2009-02-01Plan benefit arrangement – InsuranceYes
2009-02-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 3
Insurance contract or identification number10142
Number of Individuals Covered36
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE NORTH RIVER INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 21105 )
Policy contract number10142
Policy instance 2
Insurance contract or identification number10142
Number of Individuals Covered36
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10142
Policy instance 1
Insurance contract or identification number10142
Number of Individuals Covered36
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $339,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
Insurance contract or identification number10142
Number of Individuals Covered35
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of fees paid to insurance companyUSD $128
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10142
Policy instance 1
Insurance contract or identification number10142
Number of Individuals Covered35
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $291,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 1
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10142
Policy instance 2
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10142
Policy instance 1
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10142
Policy instance 1
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10142
Policy instance 1
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10142
Policy instance 1
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 1
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10142
Policy instance 1
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10142
Policy instance 1
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10142
Policy instance 1
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10142
Policy instance 2
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10142
Policy instance 1

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