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OMNICARE, INC. WELFARE PLAN 401k Plan overview

Plan NameOMNICARE, INC. WELFARE PLAN
Plan identification number 510

OMNICARE, INC. WELFARE PLAN Benefits

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

401k Sponsoring company profile

OMNICARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:OMNICARE, INC.
Employer identification number (EIN):311001351
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Additional information about OMNICARE, INC.

Jurisdiction of Incorporation: Nevada Department of State
Incorporation Date: 1982-02-17
Company Identification Number: 19821000058
Legal Registered Office Address: 202 N. CARSON ST.

CARSON CITY
United States of America (USA)
89701-4201

More information about OMNICARE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OMNICARE, INC. WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5102014-01-01
5102013-01-01JON MAY
5102012-01-01DONNA LECKY
5102011-01-01BRUCE SMITH
5102010-01-01BRUCE SMITH THOMAS MARSH2011-10-17
5102009-01-01BRUCE R. SMITH THOMAS R. MARSH2010-10-12
5102009-01-01BRUCE SMITH THOMAS MARSH2010-12-20

Plan Statistics for OMNICARE, INC. WELFARE PLAN

401k plan membership statisitcs for OMNICARE, INC. WELFARE PLAN

Measure Date Value
2014: OMNICARE, INC. WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-019,619
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-010
2013: OMNICARE, INC. WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-019,803
Total number of active participants reported on line 7a of the Form 55002013-01-019,164
Number of retired or separated participants receiving benefits2013-01-01117
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-019,281
2012: OMNICARE, INC. WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-019,876
Total number of active participants reported on line 7a of the Form 55002012-01-019,541
Number of retired or separated participants receiving benefits2012-01-01262
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-019,803
2011: OMNICARE, INC. WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-016,566
Total number of active participants reported on line 7a of the Form 55002011-01-019,417
Number of retired or separated participants receiving benefits2011-01-01185
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-019,602
2010: OMNICARE, INC. WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-016,493
Total number of active participants reported on line 7a of the Form 55002010-01-016,374
Number of retired or separated participants receiving benefits2010-01-01192
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-016,566
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
2009: OMNICARE, INC. WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-016,820
Total number of active participants reported on line 7a of the Form 55002009-01-016,280
Number of retired or separated participants receiving benefits2009-01-01213
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-016,493

Financial Data on OMNICARE, INC. WELFARE PLAN

Measure Date Value
2013 : OMNICARE, INC. WELFARE PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$32,691,637
Total income from all sources (including contributions)2013-12-31$102,566,210
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$72,562,349
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$66,415,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$102,566,210
Value of total assets at end of year2013-12-31$0
Value of total assets at beginning of year2013-12-31$2,687,776
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$6,147,268
Total interest from all sources2013-12-31$0
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$2,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$25,824,827
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$2,159,807
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$527,969
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$30,003,861
Value of net assets at end of year (total assets less liabilities)2013-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-30,003,861
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
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$2,953,890
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
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$76,741,383
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$63,461,191
Contract administrator fees2013-12-31$6,147,268
Liabilities. Value of benefit claims payable at end of year2013-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$32,691,637
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31PLANTE MORAN, PLLC
Accountancy firm EIN2013-12-31381357951
2012 : OMNICARE, INC. WELFARE PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$32,691,637
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$10,860,507
Total income from all sources (including contributions)2012-12-31$92,093,654
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$113,547,804
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$106,050,947
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$92,093,654
Value of total assets at end of year2012-12-31$2,687,776
Value of total assets at beginning of year2012-12-31$2,310,796
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$7,496,857
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$15,151,149
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$2,159,807
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$1,050,759
Total non interest bearing cash at end of year2012-12-31$527,969
Total non interest bearing cash at beginning of year2012-12-31$431,371
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-21,454,150
Value of net assets at end of year (total assets less liabilities)2012-12-31$-30,003,861
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-8,549,711
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$226,518
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$828,666
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$828,666
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$76,942,505
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$106,050,947
Contract administrator fees2012-12-31$7,270,339
Liabilities. Value of benefit claims payable at end of year2012-12-31$32,691,637
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$10,860,507
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31PLANTE MORAN, PLLC
Accountancy firm EIN2012-12-31381357951
2011 : OMNICARE, INC. WELFARE PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$10,860,507
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$7,129,925
Total income from all sources (including contributions)2011-12-31$60,147,997
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$63,037,443
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$58,899,347
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$60,147,997
Value of total assets at end of year2011-12-31$2,310,796
Value of total assets at beginning of year2011-12-31$1,469,660
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$4,138,096
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$21,138,722
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$1,050,759
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$498,257
Total non interest bearing cash at end of year2011-12-31$431,371
Total non interest bearing cash at beginning of year2011-12-31$416,564
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-2,889,446
Value of net assets at end of year (total assets less liabilities)2011-12-31$-8,549,711
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-5,660,265
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$240,099
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$828,666
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$554,839
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$554,839
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$39,009,275
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$58,899,347
Contract administrator fees2011-12-31$3,897,997
Liabilities. Value of benefit claims payable at end of year2011-12-31$10,860,507
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$7,129,925
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31PLANTE MORAN, PLLC
Accountancy firm EIN2011-12-31381357951
2010 : OMNICARE, INC. WELFARE PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$6,500,000
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$7,129,925
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$5,477,433
Total income from all sources (including contributions)2010-12-31$42,733,962
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$55,944,440
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$49,841,254
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$42,733,956
Value of total assets at end of year2010-12-31$1,469,660
Value of total assets at beginning of year2010-12-31$6,527,646
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$6,103,186
Total interest from all sources2010-12-31$6
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$17,995,237
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$498,257
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$965,689
Total non interest bearing cash at end of year2010-12-31$416,564
Total non interest bearing cash at beginning of year2010-12-31$424,738
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-13,210,478
Value of net assets at end of year (total assets less liabilities)2010-12-31$-5,660,265
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,050,213
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$554,839
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$5,137,219
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$5,137,219
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$6
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$49,841,254
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$24,738,719
Contract administrator fees2010-12-31$6,103,186
Liabilities. Value of benefit claims payable at end of year2010-12-31$7,129,925
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$5,477,433
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2010-12-31381357951

Form 5500 Responses for OMNICARE, INC. WELFARE PLAN

2014: OMNICARE, INC. WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingYes
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 – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: OMNICARE, INC. WELFARE PLAN 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 funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: OMNICARE, INC. WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement - TrustYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: OMNICARE, INC. WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement - TrustYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: OMNICARE, INC. WELFARE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: OMNICARE, INC. WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number003320025
Policy instance 1
Insurance contract or identification number003320025
Number of Individuals Covered9281
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,953,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number2465598
Policy instance 1
Insurance contract or identification number2465598
Number of Individuals Covered3007
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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