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THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 401k Plan overview

Plan NameTHE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN
Plan identification number 501

THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

DIX 1898, INC. has sponsored the creation of one or more 401k plans.

Company Name:DIX 1898, INC.
Employer identification number (EIN):340628530
NAIC Classification:511110
NAIC Description:Newspaper Publishers

Additional information about DIX 1898, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1890-12-19
Company Identification Number: 8441
Legal Registered Office Address: 212 EAST LIBERTY STREET
-
WOOSTER
United States of America (USA)
44691

More information about DIX 1898, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT 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
5012018-01-01
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01DALE E GERBER
5012012-01-01DALE E GERBER
5012011-01-01DALE E GERBER
5012009-01-01DALE E GERBER DALE E GERBER2010-07-13
5012009-01-01DALE E GERBER DALE E GERBER2010-07-13

Plan Statistics for THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN

401k plan membership statisitcs for THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN

Measure Date Value
2017: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01395
Total number of active participants reported on line 7a of the Form 55002017-01-0166
Number of retired or separated participants receiving benefits2017-01-011
Total of all active and inactive participants2017-01-0167
2016: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01575
Total number of active participants reported on line 7a of the Form 55002016-01-01394
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-01395
2015: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01580
Total number of active participants reported on line 7a of the Form 55002015-01-01572
Number of retired or separated participants receiving benefits2015-01-013
Total of all active and inactive participants2015-01-01575
2014: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01396
Total number of active participants reported on line 7a of the Form 55002014-01-01572
Number of retired or separated participants receiving benefits2014-01-018
Total of all active and inactive participants2014-01-01580
2013: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01416
Total number of active participants reported on line 7a of the Form 55002013-01-01396
Total of all active and inactive participants2013-01-01396
Total participants2013-01-01396
2012: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01420
Total number of active participants reported on line 7a of the Form 55002012-01-01416
Total of all active and inactive participants2012-01-01416
Total participants2012-01-01416
2011: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01438
Total number of active participants reported on line 7a of the Form 55002011-01-01420
Total of all active and inactive participants2011-01-01420
Total participants2011-01-01420
2009: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01482
Total number of active participants reported on line 7a of the Form 55002009-01-01442
Total of all active and inactive participants2009-01-01442
Total participants2009-01-01442

Financial Data on THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN

Measure Date Value
2017 : THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$980,848
Total of all expenses incurred2017-12-31$1,330,740
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,237,237
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$980,848
Value of total assets at end of year2017-12-31$27,005
Value of total assets at beginning of year2017-12-31$376,897
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$93,503
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$125,792
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$191,940
Total non interest bearing cash at end of year2017-12-31$27,005
Total non interest bearing cash at beginning of year2017-12-31$376,897
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-349,892
Value of net assets at end of year (total assets less liabilities)2017-12-31$27,005
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$376,897
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
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$125,993
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$663,116
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,111,244
Contract administrator fees2017-12-31$93,503
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31MEADEN & MOORE, LTD.
Accountancy firm EIN2017-12-31341818258
2016 : THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$2,685,660
Total of all expenses incurred2016-12-31$2,955,491
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$2,823,848
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,685,660
Value of total assets at end of year2016-12-31$376,897
Value of total assets at beginning of year2016-12-31$646,728
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$131,643
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$652,386
Total non interest bearing cash at end of year2016-12-31$376,897
Total non interest bearing cash at beginning of year2016-12-31$646,728
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-269,831
Value of net assets at end of year (total assets less liabilities)2016-12-31$376,897
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$646,728
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
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$306,038
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$2,033,274
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$2,517,810
Contract administrator fees2016-12-31$131,643
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31MEADEN & MOORE LTD.
Accountancy firm EIN2016-12-31341818258
2015 : THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$3,046,830
Total of all expenses incurred2015-12-31$3,101,589
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,942,013
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$3,046,830
Value of total assets at end of year2015-12-31$646,728
Value of total assets at beginning of year2015-12-31$701,487
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$159,576
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$803,465
Total non interest bearing cash at end of year2015-12-31$646,728
Total non interest bearing cash at beginning of year2015-12-31$701,487
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-54,759
Value of net assets at end of year (total assets less liabilities)2015-12-31$646,728
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$701,487
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
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$344,504
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$2,243,365
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,597,509
Contract administrator fees2015-12-31$159,576
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31MEADEN & MOORE LTD
Accountancy firm EIN2015-12-31341818258
2014 : THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$2,994,574
Total of all expenses incurred2014-12-31$3,296,223
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$3,124,034
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$2,994,574
Value of total assets at end of year2014-12-31$701,487
Value of total assets at beginning of year2014-12-31$1,003,136
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$172,189
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$782,719
Total non interest bearing cash at end of year2014-12-31$701,487
Total non interest bearing cash at beginning of year2014-12-31$1,003,136
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-301,649
Value of net assets at end of year (total assets less liabilities)2014-12-31$701,487
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,003,136
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
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$286,580
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$2,211,855
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$2,837,454
Contract administrator fees2014-12-31$172,189
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31MEADEN & MOORE, LTD
Accountancy firm EIN2014-12-31341818258
2013 : THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$3,392,390
Total of all expenses incurred2013-12-31$2,654,808
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$2,425,572
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$3,392,390
Value of total assets at end of year2013-12-31$1,003,136
Value of total assets at beginning of year2013-12-31$265,554
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$229,236
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,027,250
Total non interest bearing cash at end of year2013-12-31$1,003,136
Total non interest bearing cash at beginning of year2013-12-31$265,554
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$737,582
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,003,136
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$265,554
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$265,917
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$2,365,140
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$2,159,655
Contract administrator fees2013-12-31$229,236
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31MEADEN & MOORE, LTD.
Accountancy firm EIN2013-12-31341818258
2012 : THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$4,071,679
Total of all expenses incurred2012-12-31$4,083,610
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,821,803
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$4,071,679
Value of total assets at end of year2012-12-31$265,554
Value of total assets at beginning of year2012-12-31$277,485
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$261,807
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$977,902
Total non interest bearing cash at end of year2012-12-31$265,554
Total non interest bearing cash at beginning of year2012-12-31$277,485
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-11,931
Value of net assets at end of year (total assets less liabilities)2012-12-31$265,554
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$277,485
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$306,521
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$3,093,777
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$3,515,282
Contract administrator fees2012-12-31$261,807
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31MEADEN & MOORE, LTD.
Accountancy firm EIN2012-12-31341818258
2011 : THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$3,299,279
Total of all expenses incurred2011-12-31$3,346,960
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$3,148,503
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$3,299,279
Value of total assets at end of year2011-12-31$277,485
Value of total assets at beginning of year2011-12-31$325,166
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$198,457
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$827,036
Total non interest bearing cash at end of year2011-12-31$277,485
Total non interest bearing cash at beginning of year2011-12-31$325,166
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-47,681
Value of net assets at end of year (total assets less liabilities)2011-12-31$277,485
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$325,166
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$239,751
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$2,472,243
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$2,908,752
Contract administrator fees2011-12-31$198,457
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31MEADEN & MOORE, LTD.
Accountancy firm EIN2011-12-31341818258
2010 : THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$3,167,273
Total of all expenses incurred2010-12-31$2,963,857
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,644,985
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$3,167,273
Value of total assets at end of year2010-12-31$325,166
Value of total assets at beginning of year2010-12-31$121,750
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$318,872
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$808,019
Total non interest bearing cash at end of year2010-12-31$325,166
Total non interest bearing cash at beginning of year2010-12-31$121,750
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$203,416
Value of net assets at end of year (total assets less liabilities)2010-12-31$325,166
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$121,750
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$231,802
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$2,359,254
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,413,183
Contract administrator fees2010-12-31$318,872
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31MEADEN & MOORE, LTD.
Accountancy firm EIN2010-12-31341818258

Form 5500 Responses for THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN

2017: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: THE WOOSTER REPUBLICAN PRINTING COMPANY AND SUBSIDIARIES AND AFFILIATES SICK ACCIDENT AND LIFE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AH4T
Policy instance 5
Insurance contract or identification numberGUPR0AH4T
Number of Individuals Covered19
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,226
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,226
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SVCS OF OHIO
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AH4T
Policy instance 4
Insurance contract or identification numberGLUG0AH4T
Number of Individuals Covered48
Insurance policy start date2016-10-01
Insurance policy end date2017-10-01
Total amount of commissions paid to insurance brokerUSD $733
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $7,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $733
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SVCS OF OHIO
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number10410
Policy instance 3
Insurance contract or identification number10410
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $930
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedORGAN TRANSPLANT RIDER
Welfare Benefit Premiums Paid to CarrierUSD $9,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $930
Insurance broker organization code?5
Insurance broker nameMEDICAL BENEFITS ADMINISTRATORS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AH4T
Policy instance 2
Insurance contract or identification numberGVTL0AH4T
Number of Individuals Covered14
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $2,706
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,706
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SVCS OF OHIO
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10410
Policy instance 1
Insurance contract or identification number10410
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $14,089
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $79,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,089
Insurance broker organization code?5
Insurance broker nameMEDICAL BENEFITS ADMINISTRATORS
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-0104; 1047
Policy instance 3
Insurance contract or identification number947-0104; 1047
Number of Individuals Covered298
Insurance policy start date2014-08-01
Insurance policy end date2015-08-01
Total amount of commissions paid to insurance brokerUSD $4,847
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedORGAN TRANSPLANT RIDER
Welfare Benefit Premiums Paid to CarrierUSD $48,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,847
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SVCS OF OHIO
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AH4T
Policy instance 2
Insurance contract or identification numberG000AH4T
Number of Individuals Covered366
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $8,202
Total amount of fees paid to insurance companyUSD $2,524
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCID DEATH AND DISMEM BENEFIT
Welfare Benefit Premiums Paid to CarrierUSD $61,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,202
Amount paid for insurance broker fees2524
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SVCS OF OHIO
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10410
Policy instance 1
Insurance contract or identification number10410
Number of Individuals Covered249
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $41,348
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $234,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,348
Insurance broker organization code?5
Insurance broker nameMEDICAL BENEFITS ADMINISTRATORS
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10410
Policy instance 1
Insurance contract or identification number10410
Number of Individuals Covered299
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $32,782
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $185,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,782
Insurance broker organization code?5
Insurance broker nameMEDICAL BENEFITS ADMINISTRATORS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AH4T
Policy instance 2
Insurance contract or identification numberG000AH4T
Number of Individuals Covered410
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $2,200
Total amount of fees paid to insurance companyUSD $1,100
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,200
Amount paid for insurance broker fees1100
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERV OF OHIO
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number10410
Policy instance 3
Insurance contract or identification number10410
Number of Individuals Covered299
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,753
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedORGAN TRANSPLANT RIDER
Welfare Benefit Premiums Paid to CarrierUSD $42,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,753
Insurance broker organization code?5
Insurance broker nameMEDICAL BENEFITS ADMINISTRATORS
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10410
Policy instance 2
Insurance contract or identification number10410
Number of Individuals Covered302
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $29,044
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $164,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,044
Insurance broker organization code?5
Insurance broker nameMEDICAL BENEFITS ADMINISTRATORS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AH4T
Policy instance 3
Insurance contract or identification numberG000AH4T
Number of Individuals Covered406
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $2,235
Total amount of fees paid to insurance companyUSD $1,132
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,235
Amount paid for insurance broker fees1132
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERV OF OHIO
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number10410
Policy instance 4
Insurance contract or identification number10410
Number of Individuals Covered302
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,859
Other welfare benefits providedORGAN TRANSPLANT RIDER
Welfare Benefit Premiums Paid to CarrierUSD $43,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,859
Insurance broker organization code?5
Insurance broker nameMEDICAL BENEFITS ADMINISTRATORS
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number179838
Policy instance 1
Insurance contract or identification number179838
Number of Individuals Covered0
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $1,769
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,769
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERV OF OH
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL16670
Policy instance 2
Insurance contract or identification numberHCL16670
Number of Individuals Covered329
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $34,987
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $233,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,987
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERV OF OH
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number949-0568
Policy instance 4
Insurance contract or identification number949-0568
Number of Individuals Covered343
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $5,298
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,298
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERV OF OH
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AH4T
Policy instance 3
Insurance contract or identification numberG000AH4T
Number of Individuals Covered406
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $3,035
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,035
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERV OF OHIO
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number179838
Policy instance 1
Insurance contract or identification number179838
Number of Individuals Covered25
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $4,361
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,361
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERV OF OH
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number179838
Policy instance 2
Insurance contract or identification number179838
Number of Individuals Covered26
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL16670
Policy instance 3
Insurance contract or identification numberHCL16670
Number of Individuals Covered350
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $31,485
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AH4T
Policy instance 4
Insurance contract or identification numberG000AH4T
Number of Individuals Covered417
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $2,981
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0105923
Policy instance 1
Insurance contract or identification number0105923
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $98
Total amount of fees paid to insurance companyUSD $72
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL16670
Policy instance 3
Insurance contract or identification numberHCL16670
Number of Individuals Covered358
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $29,455
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Commission paid to Insurance BrokerUSD $29,455
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INS SERVICES USA INC
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number179838
Policy instance 2
Insurance contract or identification number179838
Number of Individuals Covered358
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0105923
Policy instance 1
Insurance contract or identification number0105923
Number of Individuals Covered431
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $2,382
Total amount of fees paid to insurance companyUSD $639
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Commission paid to Insurance BrokerUSD $1,667
Amount paid for insurance broker fees239
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INS SERVICES USA INC

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