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EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 401k Plan overview

Plan NameEMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS
Plan identification number 002

EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).
  • Life insurance

401k Sponsoring company profile

PREMIER HEALTH has sponsored the creation of one or more 401k plans.

Company Name:PREMIER HEALTH
Employer identification number (EIN):311446699
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about PREMIER HEALTH

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1995-07-14
Company Identification Number: 910665
Legal Registered Office Address: 110 N. MAIN ST.
STE 900
DAYTON
United States of America (USA)
45402

More information about PREMIER HEALTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01
0022017-01-01BARBARA JOHNSON
0022016-01-01BARBARA JOHNSON
0022015-01-01BARBARA JOHNSON
0022014-01-01BARBARA JOHNSON
0022013-01-01BARBARA JOHNSON

Plan Statistics for EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS

401k plan membership statisitcs for EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS

Measure Date Value
2022: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2022 401k membership
Total participants, beginning-of-year2022-01-0114,369
Total number of active participants reported on line 7a of the Form 55002022-01-0111,719
Number of retired or separated participants receiving benefits2022-01-0174
Number of other retired or separated participants entitled to future benefits2022-01-012,607
Total of all active and inactive participants2022-01-0114,400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-0127
Total participants2022-01-0114,427
Number of participants with account balances2022-01-0112,964
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2021 401k membership
Total participants, beginning-of-year2021-01-0114,226
Total number of active participants reported on line 7a of the Form 55002021-01-0111,790
Number of retired or separated participants receiving benefits2021-01-0176
Number of other retired or separated participants entitled to future benefits2021-01-012,473
Total of all active and inactive participants2021-01-0114,339
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-0130
Total participants2021-01-0114,369
Number of participants with account balances2021-01-0112,971
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2020 401k membership
Total participants, beginning-of-year2020-01-0112,237
Total number of active participants reported on line 7a of the Form 55002020-01-0112,383
Number of retired or separated participants receiving benefits2020-01-0146
Number of other retired or separated participants entitled to future benefits2020-01-011,774
Total of all active and inactive participants2020-01-0114,203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-0123
Total participants2020-01-0114,226
Number of participants with account balances2020-01-0111,487
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2019 401k membership
Total participants, beginning-of-year2019-01-0112,190
Total number of active participants reported on line 7a of the Form 55002019-01-0110,509
Number of retired or separated participants receiving benefits2019-01-0161
Number of other retired or separated participants entitled to future benefits2019-01-011,651
Total of all active and inactive participants2019-01-0112,221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-0116
Total participants2019-01-0112,237
Number of participants with account balances2019-01-0111,373
2018: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2018 401k membership
Total participants, beginning-of-year2018-01-0112,357
Total number of active participants reported on line 7a of the Form 55002018-01-019,926
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-012,264
Total of all active and inactive participants2018-01-0112,190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0112,190
Number of participants with account balances2018-01-0110,992
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2017 401k membership
Total participants, beginning-of-year2017-01-0112,081
Total number of active participants reported on line 7a of the Form 55002017-01-0110,410
Number of retired or separated participants receiving benefits2017-01-01118
Number of other retired or separated participants entitled to future benefits2017-01-011,549
Total of all active and inactive participants2017-01-0112,077
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0112,077
Number of participants with account balances2017-01-016,639
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2016 401k membership
Total participants, beginning-of-year2016-01-0112,770
Total number of active participants reported on line 7a of the Form 55002016-01-0110,704
Number of retired or separated participants receiving benefits2016-01-0186
Number of other retired or separated participants entitled to future benefits2016-01-011,258
Total of all active and inactive participants2016-01-0112,048
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0112,048
Number of participants with account balances2016-01-016,458
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2015 401k membership
Total participants, beginning-of-year2015-01-0112,168
Total number of active participants reported on line 7a of the Form 55002015-01-0111,059
Number of retired or separated participants receiving benefits2015-01-0185
Number of other retired or separated participants entitled to future benefits2015-01-011,626
Total of all active and inactive participants2015-01-0112,770
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0112,770
Number of participants with account balances2015-01-016,526
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2014 401k membership
Total participants, beginning-of-year2014-01-0112,240
Total number of active participants reported on line 7a of the Form 55002014-01-0110,605
Number of retired or separated participants receiving benefits2014-01-0182
Number of other retired or separated participants entitled to future benefits2014-01-011,481
Total of all active and inactive participants2014-01-0112,168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0112,168
Number of participants with account balances2014-01-016,216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2013 401k membership
Total participants, beginning-of-year2013-01-0112,428
Total number of active participants reported on line 7a of the Form 55002013-01-0110,807
Number of retired or separated participants receiving benefits2013-01-0163
Number of other retired or separated participants entitled to future benefits2013-01-011,282
Total of all active and inactive participants2013-01-0112,152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0112,152
Number of participants with account balances2013-01-016,114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010

Financial Data on EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS

Measure Date Value
2022 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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$0
Total income from all sources (including contributions)2022-12-31$-37,238,776
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$39,048,140
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$38,897,756
Expenses. Certain deemed distributions of participant loans2022-12-31$72,251
Value of total corrective distributions2022-12-31$1,354
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$46,488,750
Value of total assets at end of year2022-12-31$428,103,631
Value of total assets at beginning of year2022-12-31$504,390,547
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$76,779
Total interest from all sources2022-12-31$717,413
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$33,042,353
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$33,042,353
Administrative expenses professional fees incurred2022-12-31$9,209
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$43,835,656
Participant contributions at end of year2022-12-31$3,205,744
Participant contributions at beginning of year2022-12-31$3,204,651
Assets. Other investments not covered elsewhere at end of year2022-12-31$2,305,715
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$2,811,361
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$2,653,094
Administrative expenses (other) incurred2022-12-31$16,820
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-76,286,916
Value of net assets at end of year (total assets less liabilities)2022-12-31$428,103,631
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$504,390,547
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
Investment advisory and management fees2022-12-31$43,564
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$388,443,175
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$468,510,484
Value of interest in pooled separate accounts at end of year2022-12-31$4,286,792
Value of interest in pooled separate accounts at beginning of year2022-12-31$159,919
Interest on participant loans2022-12-31$177,831
Interest earned on other investments2022-12-31$523,672
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$15,910
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$29,862,205
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$29,704,132
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-117,389,920
Net investment gain/loss from pooled separate accounts2022-12-31$-97,372
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$38,897,756
Contract administrator fees2022-12-31$7,186
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31Yes
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 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$5,041,655
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
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$103,883,039
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$49,228,539
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$49,107,319
Expenses. Certain deemed distributions of participant loans2021-12-31$23,670
Value of total corrective distributions2021-12-31$865
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$44,136,486
Value of total assets at end of year2021-12-31$504,390,547
Value of total assets at beginning of year2021-12-31$444,694,392
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$96,685
Total interest from all sources2021-12-31$716,322
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$36,085,891
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$36,085,891
Administrative expenses professional fees incurred2021-12-31$21,954
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$41,689,382
Participant contributions at end of year2021-12-31$3,204,651
Participant contributions at beginning of year2021-12-31$3,255,821
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$78,470
Assets. Other investments not covered elsewhere at end of year2021-12-31$2,811,361
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$2,662,615
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$2,447,104
Administrative expenses (other) incurred2021-12-31$36,469
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$54,654,500
Value of net assets at end of year (total assets less liabilities)2021-12-31$504,390,547
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$444,694,392
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
Investment advisory and management fees2021-12-31$35,417
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$468,510,484
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$405,043,172
Value of interest in pooled separate accounts at end of year2021-12-31$159,919
Value of interest in pooled separate accounts at beginning of year2021-12-31$155,326
Interest on participant loans2021-12-31$186,453
Interest earned on other investments2021-12-31$529,655
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$214
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$29,704,132
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$33,498,988
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$22,929,398
Net investment gain/loss from pooled separate accounts2021-12-31$14,942
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$49,107,319
Contract administrator fees2021-12-31$2,845
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31Yes
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 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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$93,938,881
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$35,405,821
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$34,926,999
Expenses. Certain deemed distributions of participant loans2020-12-31$106,293
Value of total corrective distributions2020-12-31$1,500
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$33,347,830
Value of total assets at end of year2020-12-31$444,694,392
Value of total assets at beginning of year2020-12-31$386,161,332
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$371,029
Total interest from all sources2020-12-31$1,053,690
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$20,204,114
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$20,204,114
Administrative expenses professional fees incurred2020-12-31$8,051
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$32,370,818
Participant contributions at end of year2020-12-31$3,255,821
Participant contributions at beginning of year2020-12-31$3,690,839
Participant contributions at end of year2020-12-31$78,470
Participant contributions at beginning of year2020-12-31$0
Assets. Other investments not covered elsewhere at end of year2020-12-31$2,662,615
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$1,648,088
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$977,012
Administrative expenses (other) incurred2020-12-31$327,402
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$58,533,060
Value of net assets at end of year (total assets less liabilities)2020-12-31$444,694,392
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$386,161,332
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
Investment advisory and management fees2020-12-31$35,415
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$405,043,172
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$351,402,541
Value of interest in pooled separate accounts at end of year2020-12-31$155,326
Value of interest in pooled separate accounts at beginning of year2020-12-31$114,840
Interest on participant loans2020-12-31$212,401
Interest earned on other investments2020-12-31$839,258
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$2,031
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$33,498,988
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$29,305,024
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$38,508,294
Net investment gain/loss from pooled separate accounts2020-12-31$824,953
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$34,926,999
Contract administrator fees2020-12-31$161
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31Yes
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 plan2020-12-31Disclaimer
Accountancy firm name2020-12-31CLARK,SCHAEFER,HACKETT & CO.
Accountancy firm EIN2020-12-31310800053
2019 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2019 401k financial data
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 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$101,188,059
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$34,622,478
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$34,095,298
Expenses. Certain deemed distributions of participant loans2019-12-31$46,846
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$34,962,051
Value of total assets at end of year2019-12-31$386,161,332
Value of total assets at beginning of year2019-12-31$319,595,751
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$480,334
Total interest from all sources2019-12-31$1,013,064
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$13,352,740
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$13,352,740
Administrative expenses professional fees incurred2019-12-31$23,830
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$31,942,536
Participant contributions at end of year2019-12-31$3,690,839
Participant contributions at beginning of year2019-12-31$3,376,470
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$955,916
Assets. Other investments not covered elsewhere at end of year2019-12-31$1,648,088
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$7,188,246
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$3,019,515
Administrative expenses (other) incurred2019-12-31$431,533
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$306,322,236
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$66,565,581
Value of net assets at end of year (total assets less liabilities)2019-12-31$386,161,332
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$319,595,751
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 leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$24,791
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$351,402,541
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$114,840
Value of interest in pooled separate accounts at beginning of year2019-12-31$93,387
Interest on participant loans2019-12-31$208,910
Interest earned on other investments2019-12-31$794,392
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$9,762
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$29,305,024
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,659,496
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$51,833,313
Net investment gain/loss from pooled separate accounts2019-12-31$26,891
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
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$34,095,298
Contract administrator fees2019-12-31$180
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31Yes
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
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)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31CLARK,SCHAEFER,HACKETT & CO.
Accountancy firm EIN2019-12-31310800053
2018 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total transfer of assets to this plan2018-12-31$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
Expenses. Interest paid2018-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022018-12-31$0
Total income from all sources (including contributions)2018-12-31$14,142,710
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$40,322,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$39,153,327
Expenses. Certain deemed distributions of participant loans2018-12-31$-7,020
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$32,859,549
Value of total assets at end of year2018-12-31$319,595,751
Value of total assets at beginning of year2018-12-31$345,775,347
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,175,999
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$1,024,150
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$30,521,260
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$30,521,260
Assets. Real estate other than employer real property at end of year2018-12-31$0
Assets. Real estate other than employer real property at beginning of year2018-12-31$0
Administrative expenses professional fees incurred2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$30,802,529
Participant contributions at end of year2018-12-31$3,376,470
Participant contributions at beginning of year2018-12-31$3,548,514
Participant contributions at end of year2018-12-31$955,916
Participant contributions at beginning of year2018-12-31$730,010
Assets. Other investments not covered elsewhere at end of year2018-12-31$7,188,246
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$9,116,832
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$2,054,098
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Assets. Loans (other than to participants) at end of year2018-12-31$0
Assets. Loans (other than to participants) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$783,160
Administrative expenses (other) incurred2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$306,322,236
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$-26,179,596
Value of net assets at end of year (total assets less liabilities)2018-12-31$319,595,751
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$345,775,347
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
Assets. partnership/joint venture interests at end of year2018-12-31$0
Assets. partnership/joint venture interests at beginning of year2018-12-31$0
Investment advisory and management fees2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$300,810,818
Value of interest in pooled separate accounts at end of year2018-12-31$93,387
Value of interest in pooled separate accounts at beginning of year2018-12-31$237,145
Interest on participant loans2018-12-31$262,614
Income. Interest from loans (other than to participants)2018-12-31$0
Interest earned on other investments2018-12-31$761,536
Income. Interest from US Government securities2018-12-31$0
Income. Interest from corporate debt instruments2018-12-31$0
Value of interest in master investment trust accounts at end of year2018-12-31$0
Value of interest in master investment trust accounts at beginning of year2018-12-31$0
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2018-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,659,496
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$31,332,028
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Asset value of US Government securities at end of year2018-12-31$0
Asset value of US Government securities at beginning of year2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-51,041,073
Net investment gain/loss from pooled separate accounts2018-12-31$-4,336
Net investment gain or loss from common/collective trusts2018-12-31$0
Net gain/loss from 103.12 investment entities2018-12-31$0
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
Assets. Value of employer real property at end of year2018-12-31$0
Assets. Value of employer real property at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$2,922
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$0
Income. Dividends from preferred stock2018-12-31$0
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$39,153,327
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$0
Contract administrator fees2018-12-31$1,175,999
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31Yes
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$0
Liabilities. Value of benefit claims payable at end of year2018-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$0
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
Aggregate proceeds on sale of assets2018-12-31$0
Aggregate carrying amount (costs) on sale of assets2018-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2018-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2018-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31CLARK,SCHAEFER,HACKETT & CO.
Accountancy firm EIN2018-12-31310800053
2017 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets2017-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$0
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
Expenses. Interest paid2017-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022017-12-31$0
Total income from all sources (including contributions)2017-12-31$76,008,469
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$27,994,997
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$27,605,148
Expenses. Certain deemed distributions of participant loans2017-12-31$137,270
Value of total corrective distributions2017-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$24,780,265
Value of total assets at end of year2017-12-31$345,775,347
Value of total assets at beginning of year2017-12-31$297,761,875
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$252,579
Total income from rents2017-12-31$0
Total interest from all sources2017-12-31$1,010,876
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$13,385,682
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$13,385,682
Assets. Real estate other than employer real property at end of year2017-12-31$0
Assets. Real estate other than employer real property at beginning of year2017-12-31$0
Administrative expenses professional fees incurred2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2017-12-31$0
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$22,178,948
Participant contributions at end of year2017-12-31$3,548,514
Participant contributions at beginning of year2017-12-31$3,293,991
Participant contributions at end of year2017-12-31$730,010
Participant contributions at beginning of year2017-12-31$739,072
Assets. Other investments not covered elsewhere at end of year2017-12-31$9,116,832
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$8,617,796
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$2,601,317
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$0
Assets. Loans (other than to participants) at end of year2017-12-31$0
Assets. Loans (other than to participants) at beginning of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$2,242,514
Administrative expenses (other) incurred2017-12-31$0
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$48,013,472
Value of net assets at end of year (total assets less liabilities)2017-12-31$345,775,347
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$297,761,875
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
Assets. partnership/joint venture interests at end of year2017-12-31$0
Assets. partnership/joint venture interests at beginning of year2017-12-31$0
Investment advisory and management fees2017-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$300,810,818
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$251,282,147
Value of interest in pooled separate accounts at end of year2017-12-31$237,145
Value of interest in pooled separate accounts at beginning of year2017-12-31$227,772
Interest on participant loans2017-12-31$201,023
Income. Interest from loans (other than to participants)2017-12-31$0
Interest earned on other investments2017-12-31$809,853
Income. Interest from US Government securities2017-12-31$0
Income. Interest from corporate debt instruments2017-12-31$0
Value of interest in master investment trust accounts at end of year2017-12-31$0
Value of interest in master investment trust accounts at beginning of year2017-12-31$0
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest in common/collective trusts at beginning of year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2017-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$31,332,028
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$33,601,097
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Asset value of US Government securities at end of year2017-12-31$0
Asset value of US Government securities at beginning of year2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$34,548,010
Net investment gain/loss from pooled separate accounts2017-12-31$41,122
Net investment gain or loss from common/collective trusts2017-12-31$0
Net gain/loss from 103.12 investment entities2017-12-31$0
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 contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Assets. Invements in employer securities at end of year2017-12-31$0
Assets. Invements in employer securities at beginning of year2017-12-31$0
Assets. Value of employer real property at end of year2017-12-31$0
Assets. Value of employer real property at beginning of year2017-12-31$0
Contributions received in cash from employer2017-12-31$0
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$0
Income. Dividends from preferred stock2017-12-31$0
Income. Dividends from common stock2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$27,605,148
Asset. Corporate debt instrument preferred debt at end of year2017-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$0
Contract administrator fees2017-12-31$252,579
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$0
Liabilities. Value of benefit claims payable at end of year2017-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$0
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
Aggregate proceeds on sale of assets2017-12-31$0
Aggregate carrying amount (costs) on sale of assets2017-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2017-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2017-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31CLARK, SCHAEFER, HACKET &CO
Accountancy firm EIN2017-12-31310800053
2016 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets2016-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$0
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$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$0
Expenses. Interest paid2016-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022016-12-31$0
Total income from all sources (including contributions)2016-12-31$68,822,869
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$23,035,074
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$22,018,402
Expenses. Certain deemed distributions of participant loans2016-12-31$80,617
Value of total corrective distributions2016-12-31$5,816
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$45,965,699
Value of total assets at end of year2016-12-31$297,761,875
Value of total assets at beginning of year2016-12-31$251,974,080
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$930,239
Total income from rents2016-12-31$0
Total interest from all sources2016-12-31$1,087,975
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$7,553,643
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$7,553,643
Assets. Real estate other than employer real property at end of year2016-12-31$0
Assets. Real estate other than employer real property at beginning of year2016-12-31$0
Administrative expenses professional fees incurred2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2016-12-31$0
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$22,546,431
Participant contributions at end of year2016-12-31$3,293,991
Participant contributions at beginning of year2016-12-31$2,657,015
Participant contributions at end of year2016-12-31$739,072
Participant contributions at beginning of year2016-12-31$331,204
Assets. Other investments not covered elsewhere at end of year2016-12-31$8,617,796
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$8,170,814
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$23,419,268
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$0
Assets. Loans (other than to participants) at end of year2016-12-31$0
Assets. Loans (other than to participants) at beginning of year2016-12-31$0
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$0
Other income not declared elsewhere2016-12-31$1,377,035
Administrative expenses (other) incurred2016-12-31$0
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Income. Non cash contributions2016-12-31$0
Value of net income/loss2016-12-31$45,787,795
Value of net assets at end of year (total assets less liabilities)2016-12-31$297,761,875
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$251,974,080
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
Assets. partnership/joint venture interests at end of year2016-12-31$0
Assets. partnership/joint venture interests at beginning of year2016-12-31$0
Investment advisory and management fees2016-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$251,282,147
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$209,877,955
Value of interest in pooled separate accounts at end of year2016-12-31$227,772
Value of interest in pooled separate accounts at beginning of year2016-12-31$237,578
Interest on participant loans2016-12-31$236,912
Income. Interest from loans (other than to participants)2016-12-31$0
Interest earned on other investments2016-12-31$851,063
Income. Interest from US Government securities2016-12-31$0
Income. Interest from corporate debt instruments2016-12-31$0
Value of interest in master investment trust accounts at end of year2016-12-31$0
Value of interest in master investment trust accounts at beginning of year2016-12-31$0
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2016-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$33,601,097
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$30,699,514
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$0
Asset value of US Government securities at end of year2016-12-31$0
Asset value of US Government securities at beginning of year2016-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$12,827,370
Net investment gain/loss from pooled separate accounts2016-12-31$11,147
Net investment gain or loss from common/collective trusts2016-12-31$0
Net gain/loss from 103.12 investment entities2016-12-31$0
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 contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Assets. Invements in employer securities at end of year2016-12-31$0
Assets. Invements in employer securities at beginning of year2016-12-31$0
Assets. Value of employer real property at end of year2016-12-31$0
Assets. Value of employer real property at beginning of year2016-12-31$0
Contributions received in cash from employer2016-12-31$0
Employer contributions (assets) at end of year2016-12-31$0
Employer contributions (assets) at beginning of year2016-12-31$0
Income. Dividends from preferred stock2016-12-31$0
Income. Dividends from common stock2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$22,018,402
Asset. Corporate debt instrument preferred debt at end of year2016-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$0
Contract administrator fees2016-12-31$930,239
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$0
Liabilities. Value of benefit claims payable at end of year2016-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2016-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$0
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
Aggregate proceeds on sale of assets2016-12-31$0
Aggregate carrying amount (costs) on sale of assets2016-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2016-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2016-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31CLARK, SCHAEFER, HACKETT &CO
Accountancy firm EIN2016-12-31310800053
2015 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$24,725,476
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$23,175,927
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$22,518,203
Expenses. Certain deemed distributions of participant loans2015-12-31$124,184
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$23,847,327
Value of total assets at end of year2015-12-31$251,974,080
Value of total assets at beginning of year2015-12-31$250,424,531
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$533,540
Total interest from all sources2015-12-31$223,596
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$13,323,107
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$13,323,107
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$21,174,747
Participant contributions at end of year2015-12-31$2,657,015
Participant contributions at beginning of year2015-12-31$3,553,222
Participant contributions at end of year2015-12-31$331,204
Participant contributions at beginning of year2015-12-31$0
Assets. Other investments not covered elsewhere at end of year2015-12-31$8,170,814
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$9,202,200
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$2,672,580
Other income not declared elsewhere2015-12-31$53,117
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$1,549,549
Value of net assets at end of year (total assets less liabilities)2015-12-31$251,974,080
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$250,424,531
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$209,877,955
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$206,613,111
Value of interest in pooled separate accounts at end of year2015-12-31$237,578
Value of interest in pooled separate accounts at beginning of year2015-12-31$242,542
Interest on participant loans2015-12-31$151,818
Interest earned on other investments2015-12-31$71,778
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$30,699,514
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$30,813,456
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-12,721,624
Net investment gain/loss from pooled separate accounts2015-12-31$-47
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$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$22,518,203
Contract administrator fees2015-12-31$533,540
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31Yes
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)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31CLARK, SCHAEFER, HACKETT & CO
Accountancy firm EIN2015-12-31310800053
2014 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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$0
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$35,666,452
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$23,809,007
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$22,897,190
Expenses. Certain deemed distributions of participant loans2014-12-31$150,746
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$21,148,324
Value of total assets at end of year2014-12-31$250,424,531
Value of total assets at beginning of year2014-12-31$238,567,086
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$761,071
Total interest from all sources2014-12-31$1,009,869
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$10,043,500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$10,043,500
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$19,781,449
Participant contributions at end of year2014-12-31$3,553,222
Participant contributions at beginning of year2014-12-31$3,428,922
Assets. Other investments not covered elsewhere at end of year2014-12-31$9,202,200
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$10,688,824
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$1,366,875
Other income not declared elsewhere2014-12-31$1,279,939
Administrative expenses (other) incurred2014-12-31$17
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$11,857,445
Value of net assets at end of year (total assets less liabilities)2014-12-31$250,424,531
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$238,567,086
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$206,613,111
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$193,206,094
Value of interest in pooled separate accounts at end of year2014-12-31$242,542
Value of interest in pooled separate accounts at beginning of year2014-12-31$267,096
Interest on participant loans2014-12-31$151,626
Interest earned on other investments2014-12-31$858,243
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$30,813,456
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$30,976,150
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$1,789
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$2,164,139
Net investment gain/loss from pooled separate accounts2014-12-31$20,681
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$22,895,401
Contract administrator fees2014-12-31$761,054
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31Yes
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)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2014-12-31381357951
2013 : EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$0
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total transfer of assets to this plan2013-12-31$75,814,840
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
Expenses. Interest paid2013-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022013-12-31$0
Total income from all sources (including contributions)2013-12-31$52,844,817
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$21,256,172
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$20,637,133
Expenses. Certain deemed distributions of participant loans2013-12-31$157,060
Value of total corrective distributions2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$18,373,858
Value of total assets at end of year2013-12-31$238,567,086
Value of total assets at beginning of year2013-12-31$131,163,601
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$461,979
Total income from rents2013-12-31$0
Total interest from all sources2013-12-31$1,066,902
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$9,385,201
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$9,385,201
Assets. Real estate other than employer real property at end of year2013-12-31$0
Assets. Real estate other than employer real property at beginning of year2013-12-31$0
Administrative expenses professional fees incurred2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$16,498,068
Participant contributions at end of year2013-12-31$3,428,922
Participant contributions at beginning of year2013-12-31$1,844,058
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$0
Assets. Other investments not covered elsewhere at end of year2013-12-31$10,688,824
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$46,256,576
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$1,875,790
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$0
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$0
Assets. Loans (other than to participants) at end of year2013-12-31$0
Assets. Loans (other than to participants) at beginning of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$0
Other income not declared elsewhere2013-12-31$1,798,894
Administrative expenses (other) incurred2013-12-31$0
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Income. Non cash contributions2013-12-31$0
Value of net income/loss2013-12-31$31,588,645
Value of net assets at end of year (total assets less liabilities)2013-12-31$238,567,086
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$131,163,601
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
Assets. partnership/joint venture interests at end of year2013-12-31$0
Assets. partnership/joint venture interests at beginning of year2013-12-31$0
Investment advisory and management fees2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$193,206,094
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$62,379,534
Value of interest in pooled separate accounts at end of year2013-12-31$267,096
Value of interest in pooled separate accounts at beginning of year2013-12-31$0
Interest on participant loans2013-12-31$153,245
Income. Interest from loans (other than to participants)2013-12-31$0
Interest earned on other investments2013-12-31$913,657
Income. Interest from US Government securities2013-12-31$0
Income. Interest from corporate debt instruments2013-12-31$0
Value of interest in master investment trust accounts at end of year2013-12-31$0
Value of interest in master investment trust accounts at beginning of year2013-12-31$0
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest in common/collective trusts at beginning of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2013-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$30,976,150
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$20,683,433
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Asset value of US Government securities at end of year2013-12-31$0
Asset value of US Government securities at beginning of year2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$22,187,970
Net investment gain/loss from pooled separate accounts2013-12-31$31,992
Net investment gain or loss from common/collective trusts2013-12-31$0
Net gain/loss from 103.12 investment entities2013-12-31$0
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
Assets. Invements in employer securities at end of year2013-12-31$0
Assets. Invements in employer securities at beginning of year2013-12-31$0
Assets. Value of employer real property at end of year2013-12-31$0
Assets. Value of employer real property at beginning of year2013-12-31$0
Contributions received in cash from employer2013-12-31$0
Employer contributions (assets) at end of year2013-12-31$0
Employer contributions (assets) at beginning of year2013-12-31$0
Income. Dividends from preferred stock2013-12-31$0
Income. Dividends from common stock2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$20,637,133
Asset. Corporate debt instrument preferred debt at end of year2013-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2013-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$0
Contract administrator fees2013-12-31$461,979
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31Yes
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$0
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$0
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$0
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
Aggregate proceeds on sale of assets2013-12-31$0
Aggregate carrying amount (costs) on sale of assets2013-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2013-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2013-12-31381357951

Form 5500 Responses for EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS

2022: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 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: EMPLOYEE RETIREMENT SAVINGS PLAN - PREMIER HEALTH PARTNERS 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number746110-01
Policy instance 4
Insurance contract or identification number746110-01
Number of Individuals Covered8
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC5931
Policy instance 3
Insurance contract or identification numberVC5931
Number of Individuals Covered153
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,212
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,211
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCASH COMMISSIONS
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF3095
Policy instance 2
Insurance contract or identification numberVF3095
Number of Individuals Covered31
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $414
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $323
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCASH COMMISSIONS
Insurance broker organization code?3
LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )
Policy contract number895619-087
Policy instance 1
Insurance contract or identification number895619-087
Number of Individuals Covered688
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number666195
Policy instance 5
Insurance contract or identification number666195
Number of Individuals Covered24
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-082021
Policy instance 4
Insurance contract or identification numberGN-082021
Number of Individuals Covered10
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF3095
Policy instance 2
Insurance contract or identification numberVF3095
Number of Individuals Covered34
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $452
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $351
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCASH COMMISSIONS
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC5931
Policy instance 3
Insurance contract or identification numberVC5931
Number of Individuals Covered174
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,811
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,809
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCASH COMMISSIONS
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number666195
Policy instance 5
Insurance contract or identification number666195
Number of Individuals Covered40
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )
Policy contract number895619-087
Policy instance 1
Insurance contract or identification number895619-087
Number of Individuals Covered732
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-082021
Policy instance 4
Insurance contract or identification numberGN-082021
Number of Individuals Covered11
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )
Policy contract number895619-087
Policy instance 1
Insurance contract or identification number895619-087
Number of Individuals Covered716
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF3095
Policy instance 2
Insurance contract or identification numberVF3095
Number of Individuals Covered34
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 $378
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?Yes
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
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 fees303
Additional information about fees paid to insurance brokerCASH COMMISSIONS
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC5931
Policy instance 3
Insurance contract or identification numberVC5931
Number of Individuals Covered174
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 $5,909
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?Yes
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
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 fees5694
Additional information about fees paid to insurance brokerCASH COMMISSIONS
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF3095
Policy instance 2
Insurance contract or identification numberVF3095
Number of Individuals Covered34
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 $390
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees326
Additional information about fees paid to insurance brokerCASH COMMISSIONS
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-082021
Policy instance 4
Insurance contract or identification numberGN-082021
Number of Individuals Covered21
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )
Policy contract number895619-087
Policy instance 1
Insurance contract or identification number895619-087
Number of Individuals Covered776
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC5931
Policy instance 3
Insurance contract or identification numberVC5931
Number of Individuals Covered188
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 $6,289
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6065
Additional information about fees paid to insurance brokerCASH COMMISSIONS
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-082021
Policy instance 5
Insurance contract or identification numberGN-082021
Number of Individuals Covered21
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC3095
Policy instance 4
Insurance contract or identification numberVC3095
Number of Individuals Covered36
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $416
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $357
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number2467
Policy instance 2
Insurance contract or identification number2467
Number of Individuals Covered3
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $36
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36
Insurance broker organization code?3
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1013634-01
Policy instance 1
Insurance contract or identification number1013634-01
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF5931
Policy instance 3
Insurance contract or identification numberVF5931
Number of Individuals Covered202
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,033
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,802
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-082021
Policy instance 5
Insurance contract or identification numberGN-082021
Number of Individuals Covered21
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC3095
Policy instance 4
Insurance contract or identification numberVC3095
Number of Individuals Covered40
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $426
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $377
Insurance broker organization code?3
Insurance broker nameHOHL TINA
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF5931
Policy instance 3
Insurance contract or identification numberVF5931
Number of Individuals Covered236
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,740
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,555
Insurance broker organization code?3
Insurance broker nameBIRD ANGELENE
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number2467
Policy instance 2
Insurance contract or identification number2467
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $34
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34
Insurance broker organization code?3
Insurance broker nameLARRY KROPP
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1013634-01
Policy instance 1
Insurance contract or identification number1013634-01
Number of Individuals Covered795
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $795
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $505
Insurance broker organization code?3
Insurance broker nameMML INVESTORS SERVICES
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1013634-01
Policy instance 1
Insurance contract or identification number1013634-01
Number of Individuals Covered1093
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,059
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,059
Insurance broker organization code?3
Insurance broker nameMETLIFE SECURITIES INC.
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number2467
Policy instance 2
Insurance contract or identification number2467
Number of Individuals Covered3
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $33
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33
Insurance broker organization code?3
Insurance broker nameLARRY KROPP
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF5931
Policy instance 3
Insurance contract or identification numberVF5931
Number of Individuals Covered283
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $10,714
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,459
Insurance broker organization code?3
Insurance broker nameBIRD ANGELENE
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC3095
Policy instance 4
Insurance contract or identification numberVC3095
Number of Individuals Covered55
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $495
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $454
Insurance broker organization code?3
Insurance broker nameHOHL TINA
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-082021
Policy instance 5
Insurance contract or identification numberGN-082021
Number of Individuals Covered21
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1013634-01
Policy instance 1
Insurance contract or identification number1013634-01
Number of Individuals Covered1155
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,320
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,320
Insurance broker organization code?3
Insurance broker nameMETLIFE SECURITIES INC.
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number2467
Policy instance 2
Insurance contract or identification number2467
Number of Individuals Covered5
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $88
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,811
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51
Insurance broker organization code?3
Insurance broker nameCITISTREET ASSOCIATES, LLC
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF5931
Policy instance 3
Insurance contract or identification numberVF5931
Number of Individuals Covered359
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $12,273
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,876
Insurance broker organization code?3
Insurance broker nameBIRD ANGELENE
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC3095
Policy instance 4
Insurance contract or identification numberVC3095
Number of Individuals Covered55
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $595
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $553
Insurance broker organization code?3
Insurance broker nameLINK BRIAN
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-082021
Policy instance 5
Insurance contract or identification numberGN-082021
Number of Individuals Covered21
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-082021
Policy instance 5
Insurance contract or identification numberGN-082021
Number of Individuals Covered21
Insurance policy start date2013-06-01
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC3095
Policy instance 4
Insurance contract or identification numberVC3095
Number of Individuals Covered57
Insurance policy start date2013-06-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $332
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $312
Insurance broker organization code?3
Insurance broker nameLINK BRIAN
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVC5931
Policy instance 3
Insurance contract or identification numberVC5931
Number of Individuals Covered371
Insurance policy start date2013-06-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $7,236
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,019
Insurance broker organization code?3
Insurance broker nameBIRD ANGELENE
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number2467
Policy instance 2
Insurance contract or identification number2467
Number of Individuals Covered7
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $109
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $109
Insurance broker organization code?3
Insurance broker nameCITISTREET ASSOCIATES, LLC
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1013634-01
Policy instance 1
Insurance contract or identification number1013634-01
Number of Individuals Covered1247
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $7,678
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,678
Insurance broker organization code?3
Insurance broker nameMETLIFE SECURITIES INC.

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