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ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 401k Plan overview

Plan NameABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN
Plan identification number 501

ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN Benefits

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

401k Sponsoring company profile

ABBINGTON MANAGEMENT CORP. has sponsored the creation of one or more 401k plans.

Company Name:ABBINGTON MANAGEMENT CORP.
Employer identification number (EIN):311454490
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about ABBINGTON MANAGEMENT CORP.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1996-01-30
Company Identification Number: 930283
Legal Registered Office Address: 4248 TULLER RD
-
DUBLIN
United States of America (USA)
43017

More information about ABBINGTON MANAGEMENT CORP.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01J. MICHAEL HAEMMERLE
5012017-07-01J. MICHAEL HAEMMERLE

Plan Statistics for ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN

401k plan membership statisitcs for ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN

Measure Date Value
2022: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0141
Total number of active participants reported on line 7a of the Form 55002022-01-0141
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0141
2021: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0130
Total number of active participants reported on line 7a of the Form 55002021-01-0141
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0141
2020: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0138
Total number of active participants reported on line 7a of the Form 55002020-01-0129
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0130
2019: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0137
Total number of active participants reported on line 7a of the Form 55002019-01-0138
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0138
2018: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0144
Total number of active participants reported on line 7a of the Form 55002018-01-0137
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0137
2017: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-0149
Total number of active participants reported on line 7a of the Form 55002017-07-0144
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-0144

Financial Data on ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN

Measure Date Value
2022 : ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$39,012
Total plan liabilities at beginning of year2022-12-31$55,758
Total income from all sources2022-12-31$664,449
Expenses. Total of all expenses incurred2022-12-31$679,129
Benefits paid (including direct rollovers)2022-12-31$334,598
Total plan assets at end of year2022-12-31$26,863
Total plan assets at beginning of year2022-12-31$58,289
Value of fidelity bond covering the plan2022-12-31$265,000
Total contributions received or receivable from participants2022-12-31$55,358
Expenses. Other expenses not covered elsewhere2022-12-31$256,316
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$118
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-14,680
Net plan assets at end of year (total assets less liabilities)2022-12-31$-12,149
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$2,531
Total contributions received or receivable from employer(s)2022-12-31$608,973
Value of corrective distributions2022-12-31$62,750
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$25,465
2021 : ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$55,758
Total plan liabilities at beginning of year2021-12-31$24,653
Total income from all sources2021-12-31$613,102
Expenses. Total of all expenses incurred2021-12-31$768,286
Benefits paid (including direct rollovers)2021-12-31$437,851
Total plan assets at end of year2021-12-31$58,289
Total plan assets at beginning of year2021-12-31$182,368
Value of fidelity bond covering the plan2021-12-31$265,000
Total contributions received or receivable from participants2021-12-31$53,708
Expenses. Other expenses not covered elsewhere2021-12-31$225,816
Contributions received from other sources (not participants or employers)2021-12-31$7,029
Other income received2021-12-31$418
Net income (gross income less expenses)2021-12-31$-155,184
Net plan assets at end of year (total assets less liabilities)2021-12-31$2,531
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$157,715
Total contributions received or receivable from employer(s)2021-12-31$551,947
Value of corrective distributions2021-12-31$81,000
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$23,619
2020 : ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$24,653
Total plan liabilities at beginning of year2020-12-31$30,793
Total income from all sources2020-12-31$623,861
Expenses. Total of all expenses incurred2020-12-31$533,485
Benefits paid (including direct rollovers)2020-12-31$256,053
Total plan assets at end of year2020-12-31$182,368
Total plan assets at beginning of year2020-12-31$98,132
Value of fidelity bond covering the plan2020-12-31$265,000
Total contributions received or receivable from participants2020-12-31$56,310
Expenses. Other expenses not covered elsewhere2020-12-31$218,907
Contributions received from other sources (not participants or employers)2020-12-31$3,285
Other income received2020-12-31$408
Net income (gross income less expenses)2020-12-31$90,376
Net plan assets at end of year (total assets less liabilities)2020-12-31$157,715
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$67,339
Total contributions received or receivable from employer(s)2020-12-31$563,858
Value of corrective distributions2020-12-31$35,000
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$23,525
2019 : ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$30,793
Total plan liabilities at beginning of year2019-12-31$42,716
Total income from all sources2019-12-31$618,408
Expenses. Total of all expenses incurred2019-12-31$578,861
Benefits paid (including direct rollovers)2019-12-31$315,507
Total plan assets at end of year2019-12-31$98,132
Total plan assets at beginning of year2019-12-31$70,508
Value of fidelity bond covering the plan2019-12-31$265,000
Total contributions received or receivable from participants2019-12-31$58,328
Expenses. Other expenses not covered elsewhere2019-12-31$204,099
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$229
Net income (gross income less expenses)2019-12-31$39,547
Net plan assets at end of year (total assets less liabilities)2019-12-31$67,339
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$27,792
Total contributions received or receivable from employer(s)2019-12-31$559,851
Value of corrective distributions2019-12-31$35,000
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$24,255
2018 : ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$42,716
Total plan liabilities at beginning of year2018-12-31$2,163
Total income from all sources2018-12-31$523,467
Expenses. Total of all expenses incurred2018-12-31$535,447
Benefits paid (including direct rollovers)2018-12-31$336,030
Total plan assets at end of year2018-12-31$70,508
Total plan assets at beginning of year2018-12-31$41,935
Value of fidelity bond covering the plan2018-12-31$265,000
Total contributions received or receivable from participants2018-12-31$57,298
Expenses. Other expenses not covered elsewhere2018-12-31$176,052
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$163
Net income (gross income less expenses)2018-12-31$-11,980
Net plan assets at end of year (total assets less liabilities)2018-12-31$27,792
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$39,772
Total contributions received or receivable from employer(s)2018-12-31$466,006
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$23,365
2017 : ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$2,163
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$288,943
Expenses. Total of all expenses incurred2017-12-31$249,171
Benefits paid (including direct rollovers)2017-12-31$139,035
Total plan assets at end of year2017-12-31$41,935
Total plan assets at beginning of year2017-12-31$0
Value of fidelity bond covering the plan2017-12-31$265,000
Total contributions received or receivable from participants2017-12-31$34,235
Expenses. Other expenses not covered elsewhere2017-12-31$97,472
Other income received2017-12-31$18
Net income (gross income less expenses)2017-12-31$39,772
Net plan assets at end of year (total assets less liabilities)2017-12-31$39,772
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$0
Total contributions received or receivable from employer(s)2017-12-31$254,690
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$12,664

Form 5500 Responses for ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN

2022: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 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: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 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: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 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: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 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: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 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: ABBINGTON MANAGEMENT CORP. GROUP MEDICAL PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01First time form 5500 has been submittedYes
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500283
Policy instance 1
Insurance contract or identification number30500283
Number of Individuals Covered41
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract number287250
Policy instance 2
Insurance contract or identification number287250
Number of Individuals Covered41
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $226,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500283
Policy instance 1
Insurance contract or identification number30500283
Number of Individuals Covered41
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
Welfare Benefit Premiums Paid to CarrierUSD $197,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500283
Policy instance 1
Insurance contract or identification number30500283
Number of Individuals Covered30
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $190,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered38
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $173,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered37
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $150,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered44
Insurance policy start date2017-07-01
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $82,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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