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THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 401k Plan overview

Plan NameTHE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST
Plan identification number 501

THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

OHIO VALLEY FLOORING, INC. has sponsored the creation of one or more 401k plans.

Company Name:OHIO VALLEY FLOORING, INC.
Employer identification number (EIN):310937784
NAIC Classification:423990
NAIC Description:Other Miscellaneous Durable Goods Merchant Wholesalers

Additional information about OHIO VALLEY FLOORING, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1978-07-31
Company Identification Number: 520448
Legal Registered Office Address: 5555 MURRAY AVENUE
-
CINCINNATI
United States of America (USA)
45227

More information about OHIO VALLEY FLOORING, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01MATT FABIANI2023-10-12
5012021-01-01MATT FABIANI2022-10-06
5012020-01-01MATT FABIANI2021-10-05 ALVIN J. HURT, JR.2021-10-05
5012019-01-01MATT FABIANI2020-10-11 ALVIN J. HURT, JR.2020-10-11
5012018-01-01MATT FABIANI2019-10-10 ALVIN J. HURT, JR.2019-10-10
5012017-01-01JOY FRY ALVIN J. HURT, JR.2018-08-28
5012016-01-01STEPHEN W. STOUT ALVIN J. HURT, JR.2017-09-01
5012015-01-01STEPHEN W. STOUT ALVIN J. HURT, JR.2016-09-24
5012014-01-01STEPHEN W. STOUT ALVIN J. HURT, JR.2015-10-08
5012013-01-01STEPHEN W STOUT ALVIN J. HURT, JR.2014-07-25

Plan Statistics for THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST

401k plan membership statisitcs for THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST

Measure Date Value
2022: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-01182
Total number of active participants reported on line 7a of the Form 55002022-01-01189
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01191
2021: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-01116
Total number of active participants reported on line 7a of the Form 55002021-01-01182
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01182
2020: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-01183
Total number of active participants reported on line 7a of the Form 55002020-01-01112
Number of retired or separated participants receiving benefits2020-01-014
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01116
2019: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-01185
Total number of active participants reported on line 7a of the Form 55002019-01-01175
Number of retired or separated participants receiving benefits2019-01-018
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01183
2018: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-01423
Total number of active participants reported on line 7a of the Form 55002018-01-01165
Number of retired or separated participants receiving benefits2018-01-012
Total of all active and inactive participants2018-01-01167
2017: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-01477
Total number of active participants reported on line 7a of the Form 55002017-01-01421
Number of retired or separated participants receiving benefits2017-01-012
Total of all active and inactive participants2017-01-01423
2016: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-01461
Total number of active participants reported on line 7a of the Form 55002016-01-01474
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01477
2015: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-01277
Total number of active participants reported on line 7a of the Form 55002015-01-01458
Number of retired or separated participants receiving benefits2015-01-013
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01461
2014: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-01241
Total number of active participants reported on line 7a of the Form 55002014-01-01276
Number of retired or separated participants receiving benefits2014-01-011
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01277
2013: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-01232
Total number of active participants reported on line 7a of the Form 55002013-01-01241
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01241

Financial Data on THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST

Measure Date Value
2022 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$3,358
Total income from all sources (including contributions)2022-12-31$2,548,682
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,674,523
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,634,457
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,541,666
Value of total assets at end of year2022-12-31$927,943
Value of total assets at beginning of year2022-12-31$1,057,142
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$40,066
Total interest from all sources2022-12-31$7,016
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$363,115
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$42,000
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$426,187
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$3,358
Total non interest bearing cash at end of year2022-12-31$13,094
Total non interest bearing cash at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-125,841
Value of net assets at end of year (total assets less liabilities)2022-12-31$927,943
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,053,784
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$914,849
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$1,015,142
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$1,015,142
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$7,016
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$481,815
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,752,364
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,152,642
Contract administrator fees2022-12-31$40,066
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31CLARK SCHAEFER HACKETT & CO.
Accountancy firm EIN2022-12-31310800053
2021 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$3,358
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$2,269,744
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$2,205,653
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$2,135,479
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,269,383
Value of total assets at end of year2021-12-31$1,057,142
Value of total assets at beginning of year2021-12-31$989,693
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$70,174
Total interest from all sources2021-12-31$361
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$336,708
Assets. Other investments not covered elsewhere at end of year2021-12-31$42,000
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$323,708
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$3,358
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$4,607
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$64,091
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,053,784
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$989,693
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,015,142
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$985,086
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$985,086
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$361
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$415,859
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,608,967
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,719,620
Contract administrator fees2021-12-31$70,174
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31CLARK SCHAEFER HACKETT & CO.
Accountancy firm EIN2021-12-31310800053
2020 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$2,274,966
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$2,097,173
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,985,581
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,273,536
Value of total assets at end of year2020-12-31$989,693
Value of total assets at beginning of year2020-12-31$811,900
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$111,592
Total interest from all sources2020-12-31$1,430
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$392,308
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$127,215
Total non interest bearing cash at end of year2020-12-31$4,607
Total non interest bearing cash at beginning of year2020-12-31$3,619
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$177,793
Value of net assets at end of year (total assets less liabilities)2020-12-31$989,693
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$811,900
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$985,086
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$808,281
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$808,281
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$1,430
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$400,683
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,754,013
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,584,898
Contract administrator fees2020-12-31$111,592
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31CLARK SCHAEFER HACKETT & CO.
Accountancy firm EIN2020-12-31310800053
2019 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$2,721,062
Total income from all sources (including contributions)2019-12-31$2,721,062
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$2,709,688
Total of all expenses incurred2019-12-31$2,709,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,543,981
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,543,981
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,712,521
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,712,521
Value of total assets at end of year2019-12-31$811,900
Value of total assets at end of year2019-12-31$811,900
Value of total assets at beginning of year2019-12-31$800,526
Value of total assets at beginning of year2019-12-31$800,526
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$165,707
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$165,707
Total interest from all sources2019-12-31$8,541
Total interest from all sources2019-12-31$8,541
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$481,580
Contributions received from participants2019-12-31$481,580
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$101,399
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$101,399
Total non interest bearing cash at end of year2019-12-31$3,619
Total non interest bearing cash at end of year2019-12-31$3,619
Total non interest bearing cash at beginning of year2019-12-31$19,232
Total non interest bearing cash at beginning of year2019-12-31$19,232
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$11,374
Value of net income/loss2019-12-31$11,374
Value of net assets at end of year (total assets less liabilities)2019-12-31$811,900
Value of net assets at end of year (total assets less liabilities)2019-12-31$811,900
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$800,526
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$800,526
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$808,281
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$808,281
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$781,294
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$781,294
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$781,294
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$781,294
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$8,541
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$8,541
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$402,750
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$402,750
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$2,129,542
Contributions received in cash from employer2019-12-31$2,129,542
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,141,231
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,141,231
Contract administrator fees2019-12-31$165,707
Contract administrator fees2019-12-31$165,707
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31CLARK SCHAEFER HACKETT & CO.
Accountancy firm name2019-12-31CLARK SCHAEFER HACKETT & CO.
Accountancy firm EIN2019-12-31310800053
Accountancy firm EIN2019-12-31310800053
2018 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$2,529,106
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$2,232,067
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$2,096,707
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$2,523,713
Value of total assets at end of year2018-12-31$800,526
Value of total assets at beginning of year2018-12-31$503,487
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$135,360
Total interest from all sources2018-12-31$5,393
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$453,018
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$144,988
Total non interest bearing cash at end of year2018-12-31$19,232
Total non interest bearing cash at beginning of year2018-12-31$1,805
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$297,039
Value of net assets at end of year (total assets less liabilities)2018-12-31$800,526
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$503,487
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$781,294
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$501,682
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$501,682
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$5,393
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$366,832
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$1,925,707
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,729,875
Contract administrator fees2018-12-31$135,360
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31CLARK SCHAEFER HACKETT & CO.
Accountancy firm EIN2018-12-31310800053
2017 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$2,823,811
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$3,139,323
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$2,986,375
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,820,700
Value of total assets at end of year2017-12-31$503,487
Value of total assets at beginning of year2017-12-31$818,999
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$152,948
Total interest from all sources2017-12-31$3,111
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$500,028
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$417,508
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Total non interest bearing cash at end of year2017-12-31$1,805
Total non interest bearing cash at beginning of year2017-12-31$818,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-315,512
Value of net assets at end of year (total assets less liabilities)2017-12-31$503,487
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$818,999
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$501,682
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$150
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$150
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$3,111
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$325,717
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,903,164
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$2,660,658
Contract administrator fees2017-12-31$152,948
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31CLARK SCHAEFER HACKETT & CO.
Accountancy firm EIN2017-12-31310800053
2016 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$124,086
Total income from all sources (including contributions)2016-12-31$2,554,038
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$3,211,033
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,025,338
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,550,228
Value of total assets at end of year2016-12-31$818,999
Value of total assets at beginning of year2016-12-31$1,600,080
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$185,695
Total interest from all sources2016-12-31$3,810
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$505,708
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$265,916
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$124,086
Total non interest bearing cash at end of year2016-12-31$818,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-656,995
Value of net assets at end of year (total assets less liabilities)2016-12-31$818,999
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,475,994
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$7,744
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$150
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$1,600,080
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$1,600,080
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$3,810
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$320,427
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,778,604
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$2,704,911
Contract administrator fees2016-12-31$177,951
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31CLARK SCHAEFER HACKETT
Accountancy firm EIN2016-12-31310800053
2015 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$124,086
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$45,943
Total income from all sources (including contributions)2015-12-31$2,633,181
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$3,379,549
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,162,303
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$2,629,044
Value of total assets at end of year2015-12-31$1,600,080
Value of total assets at beginning of year2015-12-31$2,268,305
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$217,246
Total interest from all sources2015-12-31$4,137
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$517,334
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$305,184
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$124,086
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$45,943
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-746,368
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,475,994
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,222,362
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$28,237
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$1,600,080
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$2,268,305
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$2,268,305
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$4,137
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$475,950
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$1,806,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,686,353
Contract administrator fees2015-12-31$189,009
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31CLARK SCHAEFER HACKETT
Accountancy firm EIN2015-12-31310800053
2014 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$45,943
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$2,272,637
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$2,862,227
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$2,674,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$2,268,005
Value of total assets at end of year2014-12-31$2,268,305
Value of total assets at beginning of year2014-12-31$2,811,952
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$187,947
Total interest from all sources2014-12-31$4,632
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$470,521
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$153,808
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$233
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$45,943
Total non interest bearing cash at end of year2014-12-31$0
Total non interest bearing cash at beginning of year2014-12-31$26,198
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-589,590
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,222,362
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,811,952
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$24,265
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$2,268,305
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$2,785,521
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$2,785,521
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$4,632
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$382,778
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$1,643,676
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$2,291,502
Contract administrator fees2014-12-31$163,682
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31CLARK SCHAEFER HACKETT
Accountancy firm EIN2014-12-31310800053
2013 : THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$3,350,910
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$3,494,694
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$3,347,128
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$3,345,235
Value of total assets at end of year2013-12-31$2,811,952
Value of total assets at beginning of year2013-12-31$2,955,736
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$147,566
Total interest from all sources2013-12-31$5,675
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$460,826
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$1,023,862
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$233
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$557
Administrative expenses (other) incurred2013-12-31$6,188
Total non interest bearing cash at end of year2013-12-31$26,198
Total non interest bearing cash at beginning of year2013-12-31$37,952
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-143,784
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,811,952
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,955,736
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$2,785,521
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$2,917,227
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$2,917,227
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$5,675
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$357,393
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$1,860,547
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$2,989,735
Contract administrator fees2013-12-31$141,378
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31CLARK SCHAEFER HACKETT
Accountancy firm EIN2013-12-31310800053

Form 5500 Responses for THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST

2022: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: THE OHIO VALLEY FLOORING GROUP MEDICAL BENEFIT TRUST 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberW43060
Policy instance 4
Insurance contract or identification numberW43060
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare 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 $2,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9878851
Policy instance 3
Insurance contract or identification number9878851
Number of Individuals Covered215
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,834
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,834
Insurance broker organization code?3
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number0000182
Policy instance 2
Insurance contract or identification number0000182
Number of Individuals Covered389
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,981
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,981
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number925760
Policy instance 1
Insurance contract or identification number925760
Number of Individuals Covered357
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare 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 $459,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberW43060
Policy instance 1
Insurance contract or identification numberW43060
Number of Individuals Covered186
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare 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 $419,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number0000182
Policy instance 2
Insurance contract or identification number0000182
Number of Individuals Covered367
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,740
Total amount of fees paid to insurance companyUSD $127
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,921
Amount paid for insurance broker fees127
Additional information about fees paid to insurance brokerRETENTION BONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9878851
Policy instance 3
Insurance contract or identification number9878851
Number of Individuals Covered293
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,027
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,313
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9878851
Policy instance 3
Insurance contract or identification number9878851
Number of Individuals Covered270
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,733
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,733
Insurance broker organization code?3
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number0000182
Policy instance 2
Insurance contract or identification number0000182
Number of Individuals Covered364
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,237
Total amount of fees paid to insurance companyUSD $479
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,237
Amount paid for insurance broker fees479
Additional information about fees paid to insurance brokerNEW BUSINESS BONUS, RETENTION BONUS
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberW43060
Policy instance 1
Insurance contract or identification numberW43060
Number of Individuals Covered181
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare 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 $404,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9878851
Policy instance 3
Insurance contract or identification number9878851
Number of Individuals Covered307
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,955
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $19,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,955
Insurance broker organization code?3
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number0000182
Policy instance 2
Insurance contract or identification number0000182
Number of Individuals Covered394
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,269
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,269
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00252883
Policy instance 1
Insurance contract or identification number00252883
Number of Individuals Covered208
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare 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 $404,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00252883
Policy instance 1
Insurance contract or identification number00252883
Number of Individuals Covered216
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,000
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 $367,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3000
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number0000182
Policy instance 2
Insurance contract or identification number0000182
Number of Individuals Covered395
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,176
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,176
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9878851
Policy instance 3
Insurance contract or identification number9878851
Number of Individuals Covered306
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,834
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,834
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number674399
Policy instance 3
Insurance contract or identification number674399
Number of Individuals Covered218
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $38,793
Total amount of fees paid to insurance companyUSD $2,083
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,793
Amount paid for insurance broker fees2083
Additional information about fees paid to insurance brokerVOLUME-BASED BONUS
Insurance broker organization code?3
Insurance broker nameHORAN ASSOC. INC.
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9878851
Policy instance 2
Insurance contract or identification number9878851
Number of Individuals Covered303
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,828
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,828
Insurance broker organization code?3
Insurance broker nameHORAN ASSOCIATES & HORAN SECURITIES
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number0000182
Policy instance 1
Insurance contract or identification number0000182
Number of Individuals Covered407
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,708
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,708
Insurance broker organization code?3
Insurance broker nameHORAN ASSOCIATES INC.
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number0000182
Policy instance 1
Insurance contract or identification number0000182
Number of Individuals Covered443
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,297
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,297
Insurance broker organization code?3
Insurance broker nameHORAN ASSOCIATES INC.
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9878851
Policy instance 2
Insurance contract or identification number9878851
Number of Individuals Covered292
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,717
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,717
Insurance broker organization code?3
Insurance broker nameHORAN ASSOCIATES & HORAN SECURITIES
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number674399
Policy instance 3
Insurance contract or identification number674399
Number of Individuals Covered234
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $51,659
Total amount of fees paid to insurance companyUSD $1,447
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,659
Amount paid for insurance broker fees1447
Additional information about fees paid to insurance brokerVOLUME-BASED BONUS
Insurance broker organization code?3
Insurance broker nameHORAN ASSOC. INC.
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number0000185
Policy instance 3
Insurance contract or identification number0000185
Number of Individuals Covered455
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,009
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,009
Insurance broker organization code?3
Insurance broker nameHORAN ASSOCIATES INC.
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9878851
Policy instance 2
Insurance contract or identification number9878851
Number of Individuals Covered278
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,453
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $15,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,453
Insurance broker organization code?3
Insurance broker nameHORAN ASSOCIATES & HORAN SECURITIES
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number674399
Policy instance 1
Insurance contract or identification number674399
Number of Individuals Covered232
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $38,018
Total amount of fees paid to insurance companyUSD $3,806
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,018
Amount paid for insurance broker fees3806
Additional information about fees paid to insurance brokerVOLUME-BASED BONUS
Insurance broker organization code?3
Insurance broker nameHORAN ASSOC. INC.
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract numberN3167
Policy instance 2
Insurance contract or identification numberN3167
Number of Individuals Covered244
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $263
Total amount of fees paid to insurance companyUSD $2,022
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $6,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $263
Amount paid for insurance broker fees2022
Additional information about fees paid to insurance brokerVOLUME-BASED BONUS NON-MONETARY
Insurance broker organization code?3
Insurance broker nameHORAN ASSOCIATES INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number674399
Policy instance 1
Insurance contract or identification number674399
Number of Individuals Covered212
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $38,222
Total amount of fees paid to insurance companyUSD $1,768
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,222
Amount paid for insurance broker fees1768
Additional information about fees paid to insurance brokerVOLUME-BASED BONUS
Insurance broker organization code?3
Insurance broker nameHORAN ASSOCIATES INC

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