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LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 401k Plan overview

Plan NameLERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST
Plan identification number 601

LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST Benefits

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

401k Sponsoring company profile

LERNER, SAMPSON, & ROTHFUSS, L.P.A. has sponsored the creation of one or more 401k plans.

Company Name:LERNER, SAMPSON, & ROTHFUSS, L.P.A.
Employer identification number (EIN):310864957
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
6012020-03-01JANIS M. LONGBOTTOM2021-12-13
6012019-03-01JANIS M. LONGBOTTOM2020-12-07
6012018-03-01JANIS M. DORGAN2019-12-12
6012017-03-01
6012016-03-01
6012015-03-01
6012014-03-01JANIS DORGAN JANIS DORGAN2015-12-11
6012013-03-01JANIS DORGAN JANIS DORGAN2014-12-10
6012012-03-01JANIS DORGAN JANIS DORGAN2013-12-12
6012011-03-01JANIS DORGAN JANIS DORGAN2012-12-17
6012009-03-01JANIS DORGAN JANIS DORGAN2010-12-14

Plan Statistics for LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST

401k plan membership statisitcs for LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST

Measure Date Value
2020: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2020 401k membership
Total participants, beginning-of-year2020-03-01141
Total number of active participants reported on line 7a of the Form 55002020-03-01101
Total of all active and inactive participants2020-03-01101
2019: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2019 401k membership
Total participants, beginning-of-year2019-03-01160
Total number of active participants reported on line 7a of the Form 55002019-03-01141
Total of all active and inactive participants2019-03-01141
2018: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2018 401k membership
Total participants, beginning-of-year2018-03-01183
Total number of active participants reported on line 7a of the Form 55002018-03-01160
Total of all active and inactive participants2018-03-01160
2017: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2017 401k membership
Total participants, beginning-of-year2017-03-01194
Total number of active participants reported on line 7a of the Form 55002017-03-01183
Total of all active and inactive participants2017-03-01183
2016: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2016 401k membership
Total participants, beginning-of-year2016-03-01218
Total number of active participants reported on line 7a of the Form 55002016-03-01194
Total of all active and inactive participants2016-03-01194
2015: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2015 401k membership
Total participants, beginning-of-year2015-03-01268
Total number of active participants reported on line 7a of the Form 55002015-03-01216
Number of retired or separated participants receiving benefits2015-03-012
Total of all active and inactive participants2015-03-01218
2014: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2014 401k membership
Total participants, beginning-of-year2014-03-01376
Total number of active participants reported on line 7a of the Form 55002014-03-01268
Number of retired or separated participants receiving benefits2014-03-010
Number of other retired or separated participants entitled to future benefits2014-03-010
Total of all active and inactive participants2014-03-01268
2013: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2013 401k membership
Total participants, beginning-of-year2013-03-01440
Total number of active participants reported on line 7a of the Form 55002013-03-01376
Number of retired or separated participants receiving benefits2013-03-010
Total of all active and inactive participants2013-03-01376
2012: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2012 401k membership
Total participants, beginning-of-year2012-03-01506
Total number of active participants reported on line 7a of the Form 55002012-03-01440
Number of retired or separated participants receiving benefits2012-03-010
Total of all active and inactive participants2012-03-01440
2011: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2011 401k membership
Total participants, beginning-of-year2011-03-01553
Total number of active participants reported on line 7a of the Form 55002011-03-01506
Number of retired or separated participants receiving benefits2011-03-010
Total of all active and inactive participants2011-03-01506
2009: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year2009-03-01617
Total number of active participants reported on line 7a of the Form 55002009-03-01578
Number of retired or separated participants receiving benefits2009-03-011
Total of all active and inactive participants2009-03-01579

Financial Data on LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST

Measure Date Value
2021 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-02-28$10,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-02-28$18,000
Total income from all sources (including contributions)2021-02-28$351,097
Total of all expenses incurred2021-02-28$594,469
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-02-28$551,333
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-02-28$351,097
Value of total assets at end of year2021-02-28$15,723
Value of total assets at beginning of year2021-02-28$267,095
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-02-28$43,136
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-02-28No
Was this plan covered by a fidelity bond2021-02-28Yes
Value of fidelity bond cover2021-02-28$2,500,000
If this is an individual account plan, was there a blackout period2021-02-28No
Were there any nonexempt tranactions with any party-in-interest2021-02-28No
Contributions received from participants2021-02-28$250,379
Total non interest bearing cash at end of year2021-02-28$15,723
Total non interest bearing cash at beginning of year2021-02-28$267,095
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-28No
Value of net income/loss2021-02-28$-243,372
Value of net assets at end of year (total assets less liabilities)2021-02-28$5,723
Value of net assets at beginning of year (total assets less liabilities)2021-02-28$249,095
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2021-02-28No
Were any leases to which the plan was party in default or uncollectible2021-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2021-02-28$143,396
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-02-28No
Was there a failure to transmit to the plan any participant contributions2021-02-28No
Has the plan failed to provide any benefit when due under the plan2021-02-28No
Contributions received in cash from employer2021-02-28$100,718
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-02-28$407,937
Contract administrator fees2021-02-28$43,136
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-02-28No
Liabilities. Value of benefit claims payable at end of year2021-02-28$10,000
Liabilities. Value of benefit claims payable at beginning of year2021-02-28$18,000
Did the plan have assets held for investment2021-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-02-28No
Opinion of an independent qualified public accountant for this plan2021-02-28Unqualified
Accountancy firm name2021-02-28BARNES DENNIG & CO., LTD.
Accountancy firm EIN2021-02-28311119890
2020 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-02-29$18,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-02-29$90,000
Total income from all sources (including contributions)2020-02-29$1,330,858
Total of all expenses incurred2020-02-29$1,225,427
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-02-29$1,163,456
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-02-29$1,330,858
Value of total assets at end of year2020-02-29$267,095
Value of total assets at beginning of year2020-02-29$233,664
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-02-29$61,971
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-02-29No
Was this plan covered by a fidelity bond2020-02-29Yes
Value of fidelity bond cover2020-02-29$2,500,000
If this is an individual account plan, was there a blackout period2020-02-29No
Were there any nonexempt tranactions with any party-in-interest2020-02-29No
Contributions received from participants2020-02-29$290,913
Total non interest bearing cash at end of year2020-02-29$267,095
Total non interest bearing cash at beginning of year2020-02-29$233,664
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-02-29No
Value of net income/loss2020-02-29$105,431
Value of net assets at end of year (total assets less liabilities)2020-02-29$249,095
Value of net assets at beginning of year (total assets less liabilities)2020-02-29$143,664
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2020-02-29No
Were any leases to which the plan was party in default or uncollectible2020-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2020-02-29$215,354
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-02-29No
Was there a failure to transmit to the plan any participant contributions2020-02-29No
Has the plan failed to provide any benefit when due under the plan2020-02-29No
Contributions received in cash from employer2020-02-29$1,039,945
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-02-29$948,102
Contract administrator fees2020-02-29$61,971
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-02-29No
Liabilities. Value of benefit claims payable at end of year2020-02-29$18,000
Liabilities. Value of benefit claims payable at beginning of year2020-02-29$90,000
Did the plan have assets held for investment2020-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-02-29No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-02-29No
Opinion of an independent qualified public accountant for this plan2020-02-29Unqualified
Accountancy firm name2020-02-29BARNES DENNIG & CO., LTD
Accountancy firm EIN2020-02-29311119890
2018 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-02-28$40,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-02-28$15,000
Total income from all sources (including contributions)2018-02-28$1,004,906
Total of all expenses incurred2018-02-28$1,037,803
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-02-28$968,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-02-28$1,004,906
Value of total assets at end of year2018-02-28$154,868
Value of total assets at beginning of year2018-02-28$162,765
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-02-28$68,960
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-02-28No
Administrative expenses professional fees incurred2018-02-28$0
Was this plan covered by a fidelity bond2018-02-28Yes
Value of fidelity bond cover2018-02-28$2,500,000
If this is an individual account plan, was there a blackout period2018-02-28No
Were there any nonexempt tranactions with any party-in-interest2018-02-28No
Contributions received from participants2018-02-28$340,615
Total non interest bearing cash at end of year2018-02-28$154,868
Total non interest bearing cash at beginning of year2018-02-28$162,765
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Value of net income/loss2018-02-28$-32,897
Value of net assets at end of year (total assets less liabilities)2018-02-28$114,868
Value of net assets at beginning of year (total assets less liabilities)2018-02-28$147,765
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2018-02-28No
Were any leases to which the plan was party in default or uncollectible2018-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2018-02-28$195,099
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-02-28No
Was there a failure to transmit to the plan any participant contributions2018-02-28No
Has the plan failed to provide any benefit when due under the plan2018-02-28No
Contributions received in cash from employer2018-02-28$664,291
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-02-28$773,744
Contract administrator fees2018-02-28$68,960
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-02-28No
Liabilities. Value of benefit claims payable at end of year2018-02-28$40,000
Liabilities. Value of benefit claims payable at beginning of year2018-02-28$15,000
Did the plan have assets held for investment2018-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-02-28No
Opinion of an independent qualified public accountant for this plan2018-02-28Unqualified
Accountancy firm name2018-02-28BARNES, DENNIG, & CO., LTD
Accountancy firm EIN2018-02-28311119890
2017 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-02-28$15,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-02-28$40,314
Total income from all sources (including contributions)2017-02-28$1,464,501
Total of all expenses incurred2017-02-28$1,289,578
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-02-28$1,209,792
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-02-28$1,464,501
Value of total assets at end of year2017-02-28$162,765
Value of total assets at beginning of year2017-02-28$13,156
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-02-28$79,786
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-02-28No
Administrative expenses professional fees incurred2017-02-28$4,961
Was this plan covered by a fidelity bond2017-02-28Yes
Value of fidelity bond cover2017-02-28$2,500,000
If this is an individual account plan, was there a blackout period2017-02-28No
Were there any nonexempt tranactions with any party-in-interest2017-02-28No
Contributions received from participants2017-02-28$395,703
Total non interest bearing cash at end of year2017-02-28$162,765
Total non interest bearing cash at beginning of year2017-02-28$13,156
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Value of net income/loss2017-02-28$174,923
Value of net assets at end of year (total assets less liabilities)2017-02-28$147,765
Value of net assets at beginning of year (total assets less liabilities)2017-02-28$-27,158
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2017-02-28No
Were any leases to which the plan was party in default or uncollectible2017-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2017-02-28$192,602
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-02-28No
Was there a failure to transmit to the plan any participant contributions2017-02-28No
Has the plan failed to provide any benefit when due under the plan2017-02-28No
Contributions received in cash from employer2017-02-28$1,068,798
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-02-28$1,017,190
Contract administrator fees2017-02-28$74,825
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-02-28No
Liabilities. Value of benefit claims payable at end of year2017-02-28$15,000
Liabilities. Value of benefit claims payable at beginning of year2017-02-28$40,314
Did the plan have assets held for investment2017-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-02-28No
Opinion of an independent qualified public accountant for this plan2017-02-28Unqualified
Accountancy firm name2017-02-28BARNES, DENNIG, & CO., LTD
Accountancy firm EIN2017-02-28311119890
2016 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-02-29$40,314
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-02-29$218,736
Total income from all sources (including contributions)2016-02-29$1,171,827
Total of all expenses incurred2016-02-29$1,134,598
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-02-29$1,045,826
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-02-29$1,171,827
Value of total assets at end of year2016-02-29$13,156
Value of total assets at beginning of year2016-02-29$154,349
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-02-29$88,772
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-02-29No
Administrative expenses professional fees incurred2016-02-29$2,363
Was this plan covered by a fidelity bond2016-02-29Yes
Value of fidelity bond cover2016-02-29$2,500,000
If this is an individual account plan, was there a blackout period2016-02-29No
Were there any nonexempt tranactions with any party-in-interest2016-02-29No
Contributions received from participants2016-02-29$415,300
Total non interest bearing cash at end of year2016-02-29$13,156
Total non interest bearing cash at beginning of year2016-02-29$154,349
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-29No
Value of net income/loss2016-02-29$37,229
Value of net assets at end of year (total assets less liabilities)2016-02-29$-27,158
Value of net assets at beginning of year (total assets less liabilities)2016-02-29$-64,387
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2016-02-29No
Were any leases to which the plan was party in default or uncollectible2016-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2016-02-29$189,552
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-02-29No
Was there a failure to transmit to the plan any participant contributions2016-02-29No
Has the plan failed to provide any benefit when due under the plan2016-02-29No
Contributions received in cash from employer2016-02-29$756,527
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-02-29$856,274
Contract administrator fees2016-02-29$86,409
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-02-29No
Liabilities. Value of benefit claims payable at end of year2016-02-29$40,314
Liabilities. Value of benefit claims payable at beginning of year2016-02-29$218,736
Did the plan have assets held for investment2016-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-02-29No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-02-29No
Opinion of an independent qualified public accountant for this plan2016-02-29Unqualified
Accountancy firm name2016-02-29BARNES, DENNIG & CO., LTD
Accountancy firm EIN2016-02-29311119890
2015 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-02-28$218,736
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-02-28$505,966
Total income from all sources (including contributions)2015-02-28$2,855,304
Total of all expenses incurred2015-02-28$2,482,080
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-02-28$2,338,659
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-02-28$2,855,304
Value of total assets at end of year2015-02-28$154,349
Value of total assets at beginning of year2015-02-28$68,355
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-02-28$143,421
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-02-28No
Administrative expenses professional fees incurred2015-02-28$3,586
Was this plan covered by a fidelity bond2015-02-28Yes
Value of fidelity bond cover2015-02-28$500,000
If this is an individual account plan, was there a blackout period2015-02-28No
Were there any nonexempt tranactions with any party-in-interest2015-02-28No
Contributions received from participants2015-02-28$641,740
Total non interest bearing cash at end of year2015-02-28$154,349
Total non interest bearing cash at beginning of year2015-02-28$68,355
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-02-28No
Value of net income/loss2015-02-28$373,224
Value of net assets at end of year (total assets less liabilities)2015-02-28$-64,387
Value of net assets at beginning of year (total assets less liabilities)2015-02-28$-437,611
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2015-02-28No
Were any leases to which the plan was party in default or uncollectible2015-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2015-02-28$200,659
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-02-28No
Was there a failure to transmit to the plan any participant contributions2015-02-28No
Has the plan failed to provide any benefit when due under the plan2015-02-28No
Contributions received in cash from employer2015-02-28$2,213,564
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-02-28$2,138,000
Contract administrator fees2015-02-28$139,835
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-02-28No
Liabilities. Value of benefit claims payable at end of year2015-02-28$218,736
Liabilities. Value of benefit claims payable at beginning of year2015-02-28$505,966
Did the plan have assets held for investment2015-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-02-28No
Opinion of an independent qualified public accountant for this plan2015-02-28Unqualified
Accountancy firm name2015-02-28FLAGEL HUBER FLAGEL
Accountancy firm EIN2015-02-28310796034
2014 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-02-28$505,966
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-02-28$135,105
Total income from all sources (including contributions)2014-02-28$3,161,802
Total of all expenses incurred2014-02-28$3,497,621
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-02-28$3,338,573
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-02-28$3,161,802
Value of total assets at end of year2014-02-28$68,355
Value of total assets at beginning of year2014-02-28$33,313
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-02-28$159,048
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-02-28No
Administrative expenses professional fees incurred2014-02-28$12,154
Was this plan covered by a fidelity bond2014-02-28Yes
Value of fidelity bond cover2014-02-28$500,000
If this is an individual account plan, was there a blackout period2014-02-28No
Were there any nonexempt tranactions with any party-in-interest2014-02-28No
Contributions received from participants2014-02-28$775,038
Total non interest bearing cash at end of year2014-02-28$68,355
Total non interest bearing cash at beginning of year2014-02-28$33,313
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-02-28No
Value of net income/loss2014-02-28$-335,819
Value of net assets at end of year (total assets less liabilities)2014-02-28$-437,611
Value of net assets at beginning of year (total assets less liabilities)2014-02-28$-101,792
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2014-02-28No
Were any leases to which the plan was party in default or uncollectible2014-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2014-02-28$240,384
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-02-28No
Was there a failure to transmit to the plan any participant contributions2014-02-28No
Has the plan failed to provide any benefit when due under the plan2014-02-28No
Contributions received in cash from employer2014-02-28$2,386,764
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-02-28$3,098,189
Contract administrator fees2014-02-28$146,894
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-02-28No
Liabilities. Value of benefit claims payable at end of year2014-02-28$505,966
Liabilities. Value of benefit claims payable at beginning of year2014-02-28$135,105
Did the plan have assets held for investment2014-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-02-28No
Opinion of an independent qualified public accountant for this plan2014-02-28Unqualified
Accountancy firm name2014-02-28FLAGEL HUBER FLAGEL
Accountancy firm EIN2014-02-28310796034
2013 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-02-28$135,105
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-02-28$139,778
Total income from all sources (including contributions)2013-02-28$2,672,757
Total of all expenses incurred2013-02-28$2,683,008
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-02-28$2,505,688
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-02-28$2,672,757
Value of total assets at end of year2013-02-28$33,313
Value of total assets at beginning of year2013-02-28$48,237
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-02-28$177,320
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-02-28No
Administrative expenses professional fees incurred2013-02-28$15,911
Was this plan covered by a fidelity bond2013-02-28Yes
Value of fidelity bond cover2013-02-28$500,000
If this is an individual account plan, was there a blackout period2013-02-28No
Were there any nonexempt tranactions with any party-in-interest2013-02-28No
Contributions received from participants2013-02-28$849,068
Total non interest bearing cash at end of year2013-02-28$33,313
Total non interest bearing cash at beginning of year2013-02-28$48,237
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-02-28No
Value of net income/loss2013-02-28$-10,251
Value of net assets at end of year (total assets less liabilities)2013-02-28$-101,792
Value of net assets at beginning of year (total assets less liabilities)2013-02-28$-91,541
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2013-02-28No
Were any leases to which the plan was party in default or uncollectible2013-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2013-02-28$227,966
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-02-28No
Was there a failure to transmit to the plan any participant contributions2013-02-28No
Has the plan failed to provide any benefit when due under the plan2013-02-28No
Contributions received in cash from employer2013-02-28$1,823,689
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-02-28$2,277,722
Contract administrator fees2013-02-28$161,409
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-02-28No
Liabilities. Value of benefit claims payable at end of year2013-02-28$135,105
Liabilities. Value of benefit claims payable at beginning of year2013-02-28$139,778
Did the plan have assets held for investment2013-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-02-28No
Opinion of an independent qualified public accountant for this plan2013-02-28Unqualified
Accountancy firm name2013-02-28FLAGEL HUBER FLAGEL
Accountancy firm EIN2013-02-28310796034
2012 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-02-29$139,778
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-02-29$138,313
Total income from all sources (including contributions)2012-02-29$2,877,594
Total of all expenses incurred2012-02-29$2,871,018
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-02-29$2,724,881
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-02-29$2,877,594
Value of total assets at end of year2012-02-29$48,237
Value of total assets at beginning of year2012-02-29$40,196
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-02-29$146,137
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-02-29No
Administrative expenses professional fees incurred2012-02-29$7,760
Was this plan covered by a fidelity bond2012-02-29Yes
Value of fidelity bond cover2012-02-29$500,000
If this is an individual account plan, was there a blackout period2012-02-29No
Were there any nonexempt tranactions with any party-in-interest2012-02-29No
Contributions received from participants2012-02-29$890,296
Liabilities. Value of operating payables at end of year2012-02-29$0
Liabilities. Value of operating payables at beginning of year2012-02-29$314
Total non interest bearing cash at end of year2012-02-29$48,237
Total non interest bearing cash at beginning of year2012-02-29$40,196
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-02-29No
Value of net income/loss2012-02-29$6,576
Value of net assets at end of year (total assets less liabilities)2012-02-29$-91,541
Value of net assets at beginning of year (total assets less liabilities)2012-02-29$-98,117
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2012-02-29No
Were any leases to which the plan was party in default or uncollectible2012-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2012-02-29$284,440
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-02-29No
Was there a failure to transmit to the plan any participant contributions2012-02-29No
Has the plan failed to provide any benefit when due under the plan2012-02-29No
Contributions received in cash from employer2012-02-29$1,987,298
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-02-29$2,440,441
Contract administrator fees2012-02-29$138,377
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-02-29No
Liabilities. Value of benefit claims payable at end of year2012-02-29$139,778
Liabilities. Value of benefit claims payable at beginning of year2012-02-29$137,999
Did the plan have assets held for investment2012-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-02-29No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-02-29No
Opinion of an independent qualified public accountant for this plan2012-02-29Unqualified
Accountancy firm name2012-02-29FLAGEL, HUBER, FLAGEL & CO.
Accountancy firm EIN2012-02-29310796034
2011 : LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-02-28$138,313
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-02-28$169,804
Total income from all sources (including contributions)2011-02-28$2,624,636
Total of all expenses incurred2011-02-28$2,590,111
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-02-28$2,392,094
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-02-28$2,624,636
Value of total assets at end of year2011-02-28$40,196
Value of total assets at beginning of year2011-02-28$37,162
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-02-28$198,017
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-02-28No
Administrative expenses professional fees incurred2011-02-28$3,809
Was this plan covered by a fidelity bond2011-02-28Yes
Value of fidelity bond cover2011-02-28$500,000
If this is an individual account plan, was there a blackout period2011-02-28No
Were there any nonexempt tranactions with any party-in-interest2011-02-28No
Contributions received from participants2011-02-28$899,747
Liabilities. Value of operating payables at end of year2011-02-28$314
Liabilities. Value of operating payables at beginning of year2011-02-28$421
Total non interest bearing cash at end of year2011-02-28$40,196
Total non interest bearing cash at beginning of year2011-02-28$37,162
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Value of net income/loss2011-02-28$34,525
Value of net assets at end of year (total assets less liabilities)2011-02-28$-98,117
Value of net assets at beginning of year (total assets less liabilities)2011-02-28$-132,642
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2011-02-28No
Were any leases to which the plan was party in default or uncollectible2011-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2011-02-28$290,089
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-02-28No
Was there a failure to transmit to the plan any participant contributions2011-02-28No
Has the plan failed to provide any benefit when due under the plan2011-02-28No
Contributions received in cash from employer2011-02-28$1,724,889
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-02-28$2,102,005
Contract administrator fees2011-02-28$194,208
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-02-28No
Liabilities. Value of benefit claims payable at end of year2011-02-28$137,999
Liabilities. Value of benefit claims payable at beginning of year2011-02-28$169,383
Did the plan have assets held for investment2011-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-02-28No
Opinion of an independent qualified public accountant for this plan2011-02-28Unqualified
Accountancy firm name2011-02-28FLAGEL, HUBER, FLAGEL & CO.
Accountancy firm EIN2011-02-28310796034

Form 5500 Responses for LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST

2020: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Plan funding arrangement – TrustYes
2020-03-01Plan benefit arrangement – InsuranceYes
2020-03-01Plan benefit arrangement - TrustYes
2019: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – TrustYes
2019-03-01Plan benefit arrangement – InsuranceYes
2019-03-01Plan benefit arrangement - TrustYes
2018: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – TrustYes
2018-03-01Plan benefit arrangement – InsuranceYes
2018-03-01Plan benefit arrangement - TrustYes
2017: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Plan funding arrangement – TrustYes
2017-03-01Plan benefit arrangement – InsuranceYes
2017-03-01Plan benefit arrangement - TrustYes
2016: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Plan funding arrangement – TrustYes
2016-03-01Plan benefit arrangement – InsuranceYes
2016-03-01Plan benefit arrangement - TrustYes
2015: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01Plan funding arrangement – TrustYes
2015-03-01Plan benefit arrangement – InsuranceYes
2015-03-01Plan benefit arrangement - TrustYes
2014: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Plan funding arrangement – TrustYes
2014-03-01Plan benefit arrangement – InsuranceYes
2014-03-01Plan benefit arrangement - TrustYes
2013: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01Plan funding arrangement – TrustYes
2013-03-01Plan benefit arrangement – InsuranceYes
2013-03-01Plan benefit arrangement - TrustYes
2012: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Plan funding arrangement – TrustYes
2012-03-01Plan benefit arrangement – InsuranceYes
2012-03-01Plan benefit arrangement - TrustYes
2011: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Plan funding arrangement – TrustYes
2011-03-01Plan benefit arrangement – InsuranceYes
2011-03-01Plan benefit arrangement - TrustYes
2009: LERNER, SAMPSON & ROTHFUSS EMPLOYEE BENEFIT TRUST 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01This submission is the final filingNo
2009-03-01Plan funding arrangement – TrustYes
2009-03-01Plan benefit arrangement – InsuranceYes
2009-03-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered97
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $150,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered144
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $183,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered159
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,462
Welfare Benefit Premiums Paid to CarrierUSD $178,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1462
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered185
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $194,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered219
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $189,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered268
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $211
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $200,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $200
Insurance broker organization code?3
Insurance broker nameHORAN ASSOC INC
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered376
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $37,368
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $240,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,052
Insurance broker organization code?3
Insurance broker nameUSI MIDWEST INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered440
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $47,325
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $227,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,325
Insurance broker organization code?3
Insurance broker nameHORAN ASSOC INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered506
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $68,673
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $284,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number602326
Policy instance 1
Insurance contract or identification number602326
Number of Individuals Covered553
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $45,677
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $290,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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