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HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan NameHIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN
Plan identification number 501

HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:HIRSCHVOGEL, INC.
Employer identification number (EIN):311239333
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-04-01MICHELLE ROBISON2024-07-09
5012022-04-01
5012022-04-01MICHELLE ROBISON
5012021-04-01
5012021-04-01WOJCIECH PRYSZCZEWSKI
5012020-04-01
5012019-04-01WOJCIECH PRYSZCZEWSKI2020-08-29
5012018-04-01WOJCIECH PRYSZCZEWSKI2020-01-13
5012017-04-01WOJCIECH PRYSZCZEWSKI2019-12-29
5012016-04-01JAMES SCHEIN
5012015-04-01JAMES SCHEIN
5012014-04-01JAMES SCHEIN
5012013-04-01JAMES SCHEIN
5012013-01-01JAMES SCHEIN
5012012-01-01ROBERT M. HARTWELL
5012011-01-01ROBERT M. HARTWELL
5012009-01-01 CHARLES R. BENTZ2010-10-15
5012009-01-01CHARLES R. BENTZ

Financial Data on HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2018 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-03-31$39,194
Total income from all sources (including contributions)2018-03-31$3,167,905
Total loss/gain on sale of assets2018-03-31$0
Total of all expenses incurred2018-03-31$3,248,583
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-03-31$3,116,979
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-03-31$3,167,905
Value of total assets at end of year2018-03-31$0
Value of total assets at beginning of year2018-03-31$119,872
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-03-31$131,604
Total interest from all sources2018-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-03-31No
Administrative expenses professional fees incurred2018-03-31$131,604
Was this plan covered by a fidelity bond2018-03-31Yes
Value of fidelity bond cover2018-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-03-31No
Contributions received from participants2018-03-31$784,191
Total non interest bearing cash at end of year2018-03-31$0
Total non interest bearing cash at beginning of year2018-03-31$64,638
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Income. Non cash contributions2018-03-31$22,398
Value of net income/loss2018-03-31$-80,678
Value of net assets at end of year (total assets less liabilities)2018-03-31$0
Value of net assets at beginning of year (total assets less liabilities)2018-03-31$80,678
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-03-31No
Were any leases to which the plan was party in default or uncollectible2018-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-03-31$787,572
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-03-31No
Was there a failure to transmit to the plan any participant contributions2018-03-31No
Has the plan failed to provide any benefit when due under the plan2018-03-31No
Contributions received in cash from employer2018-03-31$2,361,316
Employer contributions (assets) at end of year2018-03-31$0
Employer contributions (assets) at beginning of year2018-03-31$55,234
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-03-31$2,329,407
Liabilities. Value of benefit claims payable at beginning of year2018-03-31$39,194
Did the plan have assets held for investment2018-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-03-31No
Opinion of an independent qualified public accountant for this plan2018-03-31Unqualified
Accountancy firm name2018-03-31CLARK, SCHAEFER, HACKETT & CO.
Accountancy firm EIN2018-03-31310800053
2017 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-03-31$39,194
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-03-31$150,722
Total income from all sources (including contributions)2017-03-31$2,926,725
Total loss/gain on sale of assets2017-03-31$0
Total of all expenses incurred2017-03-31$3,188,352
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-03-31$2,998,821
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-03-31$2,926,725
Value of total assets at end of year2017-03-31$119,872
Value of total assets at beginning of year2017-03-31$493,027
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-03-31$189,531
Total interest from all sources2017-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-03-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2017-03-31$0
Was this plan covered by a fidelity bond2017-03-31Yes
Value of fidelity bond cover2017-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-03-31No
Contributions received from participants2017-03-31$572,056
Total non interest bearing cash at end of year2017-03-31$64,638
Total non interest bearing cash at beginning of year2017-03-31$168,217
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Value of net income/loss2017-03-31$-261,627
Value of net assets at end of year (total assets less liabilities)2017-03-31$80,678
Value of net assets at beginning of year (total assets less liabilities)2017-03-31$342,305
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-03-31No
Were any leases to which the plan was party in default or uncollectible2017-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-03-31$623,845
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-03-31No
Was there a failure to transmit to the plan any participant contributions2017-03-31No
Has the plan failed to provide any benefit when due under the plan2017-03-31No
Contributions received in cash from employer2017-03-31$2,354,669
Employer contributions (assets) at end of year2017-03-31$55,234
Employer contributions (assets) at beginning of year2017-03-31$324,810
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-03-31$2,374,976
Contract administrator fees2017-03-31$189,531
Liabilities. Value of benefit claims payable at end of year2017-03-31$39,194
Liabilities. Value of benefit claims payable at beginning of year2017-03-31$150,722
Did the plan have assets held for investment2017-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-03-31No
Opinion of an independent qualified public accountant for this plan2017-03-31Unqualified
Accountancy firm name2017-03-31M.K. JEFFERS & COMPANY
Accountancy firm EIN2017-03-31311239333
2016 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-31$150,722
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-31$246,170
Total income from all sources (including contributions)2016-03-31$4,288,333
Total loss/gain on sale of assets2016-03-31$0
Total of all expenses incurred2016-03-31$3,944,815
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-03-31$3,749,521
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-03-31$4,288,333
Value of total assets at end of year2016-03-31$493,027
Value of total assets at beginning of year2016-03-31$244,957
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-03-31$195,294
Total interest from all sources2016-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-03-31No
Was this plan covered by a fidelity bond2016-03-31Yes
Value of fidelity bond cover2016-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-03-31No
Contributions received from participants2016-03-31$547,628
Total non interest bearing cash at end of year2016-03-31$168,217
Total non interest bearing cash at beginning of year2016-03-31$125,130
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Value of net income/loss2016-03-31$343,518
Value of net assets at end of year (total assets less liabilities)2016-03-31$342,305
Value of net assets at beginning of year (total assets less liabilities)2016-03-31$-1,213
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-03-31No
Were any leases to which the plan was party in default or uncollectible2016-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-03-31$459,197
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-03-31No
Was there a failure to transmit to the plan any participant contributions2016-03-31No
Has the plan failed to provide any benefit when due under the plan2016-03-31No
Contributions received in cash from employer2016-03-31$3,740,705
Employer contributions (assets) at end of year2016-03-31$324,810
Employer contributions (assets) at beginning of year2016-03-31$119,827
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-03-31$3,290,324
Contract administrator fees2016-03-31$195,294
Liabilities. Value of benefit claims payable at end of year2016-03-31$150,722
Liabilities. Value of benefit claims payable at beginning of year2016-03-31$246,170
Did the plan have assets held for investment2016-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-03-31No
Opinion of an independent qualified public accountant for this plan2016-03-31Unqualified
Accountancy firm name2016-03-31M.K. JEFFERS & COMPANY
Accountancy firm EIN2016-03-31311239333
2015 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-03-31$246,170
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-03-31$280,093
Total income from all sources (including contributions)2015-03-31$2,176,926
Total loss/gain on sale of assets2015-03-31$0
Total of all expenses incurred2015-03-31$2,201,233
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-03-31$1,997,645
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-03-31$2,176,926
Value of total assets at end of year2015-03-31$244,957
Value of total assets at beginning of year2015-03-31$303,187
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-03-31$203,588
Total interest from all sources2015-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-03-31No
Was this plan covered by a fidelity bond2015-03-31Yes
Value of fidelity bond cover2015-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-03-31No
Contributions received from participants2015-03-31$522,678
Administrative expenses (other) incurred2015-03-31$32
Total non interest bearing cash at end of year2015-03-31$125,130
Total non interest bearing cash at beginning of year2015-03-31$45,233
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Value of net income/loss2015-03-31$-24,307
Value of net assets at end of year (total assets less liabilities)2015-03-31$-1,213
Value of net assets at beginning of year (total assets less liabilities)2015-03-31$23,094
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-03-31No
Were any leases to which the plan was party in default or uncollectible2015-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-03-31$436,039
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-03-31No
Was there a failure to transmit to the plan any participant contributions2015-03-31No
Has the plan failed to provide any benefit when due under the plan2015-03-31No
Contributions received in cash from employer2015-03-31$1,654,248
Employer contributions (assets) at end of year2015-03-31$119,827
Employer contributions (assets) at beginning of year2015-03-31$257,954
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-03-31$1,561,606
Contract administrator fees2015-03-31$203,556
Liabilities. Value of benefit claims payable at end of year2015-03-31$246,170
Liabilities. Value of benefit claims payable at beginning of year2015-03-31$280,093
Did the plan have assets held for investment2015-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-03-31No
Opinion of an independent qualified public accountant for this plan2015-03-31Unqualified
Accountancy firm name2015-03-31M.K. JEFFERS & COMPANY
Accountancy firm EIN2015-03-31311239333
2014 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-03-31$280,093
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-03-31$140,757
Total income from all sources (including contributions)2014-03-31$2,563,783
Total loss/gain on sale of assets2014-03-31$0
Total of all expenses incurred2014-03-31$2,562,224
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-03-31$2,393,616
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-03-31$2,563,783
Value of total assets at end of year2014-03-31$303,187
Value of total assets at beginning of year2014-03-31$162,292
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-03-31$168,608
Total interest from all sources2014-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-03-31No
Was this plan covered by a fidelity bond2014-03-31Yes
Value of fidelity bond cover2014-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2014-03-31No
Contributions received from participants2014-03-31$461,040
Total non interest bearing cash at end of year2014-03-31$45,233
Total non interest bearing cash at beginning of year2014-03-31$38,828
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Value of net income/loss2014-03-31$1,559
Value of net assets at end of year (total assets less liabilities)2014-03-31$23,094
Value of net assets at beginning of year (total assets less liabilities)2014-03-31$21,535
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-03-31No
Were any leases to which the plan was party in default or uncollectible2014-03-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-03-31$381,604
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-03-31No
Was there a failure to transmit to the plan any participant contributions2014-03-31No
Has the plan failed to provide any benefit when due under the plan2014-03-31No
Contributions received in cash from employer2014-03-31$2,102,743
Employer contributions (assets) at end of year2014-03-31$257,954
Employer contributions (assets) at beginning of year2014-03-31$123,464
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-03-31$2,012,012
Contract administrator fees2014-03-31$168,608
Liabilities. Value of benefit claims payable at end of year2014-03-31$280,093
Liabilities. Value of benefit claims payable at beginning of year2014-03-31$140,757
Did the plan have assets held for investment2014-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-03-31No
Opinion of an independent qualified public accountant for this plan2014-03-31Unqualified
Accountancy firm name2014-03-31M.K. JEFFERS & COMPANY
Accountancy firm EIN2014-03-31311239333
2013 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-03-31$140,757
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-03-31$184,769
Total income from all sources (including contributions)2013-03-31$486,198
Total loss/gain on sale of assets2013-03-31$0
Total of all expenses incurred2013-03-31$494,161
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-03-31$455,700
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-03-31$486,198
Value of total assets at end of year2013-03-31$162,292
Value of total assets at beginning of year2013-03-31$214,267
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-03-31$38,461
Total interest from all sources2013-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-03-31No
Was this plan covered by a fidelity bond2013-03-31Yes
Value of fidelity bond cover2013-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2013-03-31No
Contributions received from participants2013-03-31$97,608
Total non interest bearing cash at end of year2013-03-31$38,828
Total non interest bearing cash at beginning of year2013-03-31$27,454
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Value of net income/loss2013-03-31$-7,963
Value of net assets at end of year (total assets less liabilities)2013-03-31$21,535
Value of net assets at beginning of year (total assets less liabilities)2013-03-31$29,498
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-03-31No
Were any leases to which the plan was party in default or uncollectible2013-03-31No
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-03-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-03-31$75,974
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-03-31No
Was there a failure to transmit to the plan any participant contributions2013-03-31No
Has the plan failed to provide any benefit when due under the plan2013-03-31No
Contributions received in cash from employer2013-03-31$388,590
Employer contributions (assets) at end of year2013-03-31$123,464
Employer contributions (assets) at beginning of year2013-03-31$186,813
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-03-31$379,726
Contract administrator fees2013-03-31$38,461
Liabilities. Value of benefit claims payable at end of year2013-03-31$140,757
Liabilities. Value of benefit claims payable at beginning of year2013-03-31$184,769
Did the plan have assets held for investment2013-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-03-31No
Opinion of an independent qualified public accountant for this plan2013-03-31Unqualified
Accountancy firm name2013-03-31M.K. JEFFERS & COMPANY
Accountancy firm EIN2013-03-31311239333
2012 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT 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$184,769
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$253,378
Total income from all sources (including contributions)2012-12-31$1,971,076
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,972,978
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,835,526
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,971,076
Value of total assets at end of year2012-12-31$214,267
Value of total assets at beginning of year2012-12-31$284,778
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$137,452
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$500,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$411,982
Total non interest bearing cash at end of year2012-12-31$27,454
Total non interest bearing cash at beginning of year2012-12-31$25,671
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-1,902
Value of net assets at end of year (total assets less liabilities)2012-12-31$29,498
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$31,400
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
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$267,507
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
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$1,559,094
Employer contributions (assets) at end of year2012-12-31$186,813
Employer contributions (assets) at beginning of year2012-12-31$259,107
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,568,019
Contract administrator fees2012-12-31$137,452
Liabilities. Value of benefit claims payable at end of year2012-12-31$184,769
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$253,378
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)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31M.K. JEFFERS & COMPANY
Accountancy firm EIN2012-12-31311239333
2011 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT 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$253,378
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$162,384
Total income from all sources (including contributions)2011-12-31$2,240,305
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$2,209,192
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,088,901
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,240,305
Value of total assets at end of year2011-12-31$284,778
Value of total assets at beginning of year2011-12-31$162,671
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$120,291
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$500,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$355,773
Total non interest bearing cash at end of year2011-12-31$25,671
Total non interest bearing cash at beginning of year2011-12-31$60,631
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$31,113
Value of net assets at end of year (total assets less liabilities)2011-12-31$31,400
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$287
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
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$208,070
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
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$1,884,532
Employer contributions (assets) at end of year2011-12-31$259,107
Employer contributions (assets) at beginning of year2011-12-31$102,040
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,880,831
Contract administrator fees2011-12-31$120,291
Liabilities. Value of benefit claims payable at end of year2011-12-31$253,378
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$162,384
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31M.K. JEFFERS & COMPANY
Accountancy firm EIN2011-12-31311239333
2010 : HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$162,384
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$155,923
Total income from all sources (including contributions)2010-12-31$1,272,519
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,297,006
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,196,894
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,272,519
Value of total assets at end of year2010-12-31$162,671
Value of total assets at beginning of year2010-12-31$180,697
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$100,112
Total interest from all sources2010-12-31$0
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$230,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$315,286
Total non interest bearing cash at end of year2010-12-31$60,631
Total non interest bearing cash at beginning of year2010-12-31$24,774
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-24,487
Value of net assets at end of year (total assets less liabilities)2010-12-31$287
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$24,774
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 funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$163,514
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
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$957,233
Employer contributions (assets) at end of year2010-12-31$102,040
Employer contributions (assets) at beginning of year2010-12-31$155,923
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,033,380
Contract administrator fees2010-12-31$100,112
Liabilities. Value of benefit claims payable at end of year2010-12-31$162,384
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$155,923
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31M.K. JEFFERS & COMPANY
Accountancy firm EIN2010-12-31311239333

Form 5500 Responses for HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN

2023: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan funding arrangement – General assets of the sponsorYes
2023-04-01Plan benefit arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – General assets of the sponsorYes
2022: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Submission has been amendedNo
2022-04-01This submission is the final filingNo
2022-04-01This return/report is a short plan year return/report (less than 12 months)No
2022-04-01Plan is a collectively bargained planNo
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – General assets of the sponsorYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – General assets of the sponsorYes
2021: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – General assets of the sponsorYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – General assets of the sponsorYes
2020: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – General assets of the sponsorYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – General assets of the sponsorYes
2019: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – General assets of the sponsorYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – General assets of the sponsorYes
2018: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – General assets of the sponsorYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – General assets of the sponsorYes
2017: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – TrustYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement - TrustYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – TrustYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement - TrustYes
2015: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – TrustYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement - TrustYes
2014: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – TrustYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement - TrustYes
2013: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan funding arrangement – TrustYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement - TrustYes
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)Yes
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
2012: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT 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 – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT 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 – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: HIRSCHVOGEL INCORPORATED EMPLOYEE HEALTH & WELFARE BENEFIT 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 – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number34670
Policy instance 3
Insurance contract or identification number34670
Number of Individuals Covered278
Insurance policy start date2023-04-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $17,576
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $120,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30075070
Policy instance 2
Insurance contract or identification number30075070
Number of Individuals Covered216
Insurance policy start date2023-04-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,376
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,331
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 number1647
Policy instance 1
Insurance contract or identification number1647
Number of Individuals Covered452
Insurance policy start date2023-04-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,057
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIDECAR HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 17104 )
Policy contract numberOH015021
Policy instance 4
Insurance contract or identification numberOH015021
Number of Individuals Covered424
Insurance policy start date2023-04-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $83,666
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,995,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30075070
Policy instance 2
Insurance contract or identification number30075070
Number of Individuals Covered226
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $1,295
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 $28,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00034670
Policy instance 3
Insurance contract or identification number00034670
Number of Individuals Covered285
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $51,476
Total amount of fees paid to insurance companyUSD $4,860
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, AD&D, OPTIONAL LIFE, OPTIONAL AD&D, VOL CI, VOL HI
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 $183,643
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 number1647
Policy instance 1
Insurance contract or identification number1647
Number of Individuals Covered460
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $4,019
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
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number1647
Policy instance 2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number27476
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30075070
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AZTQ
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AZTQ
Policy instance 5
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AZTQ
Policy instance 6
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberOH2400
Policy instance 1
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number1647
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30075070
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AZTQ
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AZTQ
Policy instance 3
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number1647
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30075070
Policy instance 4
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberOH2400
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number417002412821
Policy instance 2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AZTQ
Policy instance 3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number417003412821
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30075070
Policy instance 5
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number1647
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AZTQ
Policy instance 3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberG537127
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number417003412821
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54380 )
Policy contract number30075070
Policy instance 5
DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )
Policy contract number1647
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK821035
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number345288
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1000512
Policy instance 4
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200024
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK821035
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number345288
Policy instance 2
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200024
Policy instance 3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1000512
Policy instance 4
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number345288
Policy instance 2
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200024
Policy instance 3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1000512
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK821035
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK821035
Policy instance 1
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200024
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number345288
Policy instance 2
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number345288
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK821035
Policy instance 1
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200024
Policy instance 3
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200024
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number345288
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK821035
Policy instance 1
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200024
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number345288
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK821035
Policy instance 1

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