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KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan NameKIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN
Plan identification number 501

KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

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

Company Name:KIFFER INDUSTRIES, INC.
Employer identification number (EIN):340676800
NAIC Classification:332900

Additional information about KIFFER INDUSTRIES, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1947-09-27
Company Identification Number: 204192
Legal Registered Office Address: 6055 ROCKSIDE WOODS BLVD
SUITE 200
CLEVELAND
United States of America (USA)
44131

More information about KIFFER INDUSTRIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01
5012020-10-01
5012019-10-01
5012018-10-01
5012017-10-01
5012016-10-01THOMAS S. PETRELLA
5012015-10-01THOMAS S. PETRELLA
5012014-10-01THOMAS S. PETRELLA
5012013-10-01THOMAS S. PETRELLA
5012012-10-01THOMAS PETRELLA
5012011-10-01THOMAS PETRELLA
5012010-10-01THOMAS PETRELLA
5012009-10-01THOMAS PETRELLA
5012008-10-01THOMAS PETRELLA
5012007-10-01THOMAS PETRELLA
5012006-10-01THOMAS PETRELLA
5012005-10-01THOMAS PETRELLA
5012004-10-01THOMAS PETRELLA
5012003-10-01THOMAS PETRELLA
5012002-10-01THOMAS PETRELLA
5012001-10-01THOMAS PETRELLA
5012000-10-01THOMAS PETRELLA
5011999-10-01THOMAS PETRELLA

Plan Statistics for KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2021: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-0144
Total number of active participants reported on line 7a of the Form 55002021-10-0142
Total of all active and inactive participants2021-10-0142
2020: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-0144
Total number of active participants reported on line 7a of the Form 55002020-10-0147
Total of all active and inactive participants2020-10-0147
2019: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-0146
Total number of active participants reported on line 7a of the Form 55002019-10-0143
Total of all active and inactive participants2019-10-0143
2018: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-0147
Total number of active participants reported on line 7a of the Form 55002018-10-0146
Total of all active and inactive participants2018-10-0146
2017: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-0142
Total number of active participants reported on line 7a of the Form 55002017-10-0146
Total of all active and inactive participants2017-10-0146
2016: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-0144
Total number of active participants reported on line 7a of the Form 55002016-10-0144
Total of all active and inactive participants2016-10-0144
2015: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-0148
Total number of active participants reported on line 7a of the Form 55002015-10-0145
Total of all active and inactive participants2015-10-0145
2014: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-0145
Total number of active participants reported on line 7a of the Form 55002014-10-0148
Total of all active and inactive participants2014-10-0148
2013: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-0148
Total number of active participants reported on line 7a of the Form 55002013-10-0145
Total of all active and inactive participants2013-10-0145
2012: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-010
Total number of active participants reported on line 7a of the Form 55002012-10-0148
Total of all active and inactive participants2012-10-0148
Total participants2012-10-0148
2011: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-010
Total number of active participants reported on line 7a of the Form 55002011-10-0140
Total of all active and inactive participants2011-10-0140
Total participants2011-10-0140
2010: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-010
Total number of active participants reported on line 7a of the Form 55002010-10-0138
Total of all active and inactive participants2010-10-0138
Total participants2010-10-0138
2009: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-010
Total number of active participants reported on line 7a of the Form 55002009-10-0143
Total of all active and inactive participants2009-10-0143
Total participants2009-10-0143
2008: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-10-010
Total number of active participants reported on line 7a of the Form 55002008-10-0149
Total of all active and inactive participants2008-10-0149
Total participants2008-10-0149
2007: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-10-010
Total number of active participants reported on line 7a of the Form 55002007-10-0152
Total of all active and inactive participants2007-10-0152
Total participants2007-10-0152
2006: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-10-010
Total number of active participants reported on line 7a of the Form 55002006-10-0153
Total of all active and inactive participants2006-10-0153
Total participants2006-10-0153
2005: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-10-010
Total number of active participants reported on line 7a of the Form 55002005-10-0151
Total of all active and inactive participants2005-10-0151
Total participants2005-10-0151
2004: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-10-010
Total number of active participants reported on line 7a of the Form 55002004-10-0152
Total of all active and inactive participants2004-10-0152
Total participants2004-10-0152
2003: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2003 401k membership
Total participants, beginning-of-year2003-10-010
Total number of active participants reported on line 7a of the Form 55002003-10-0150
Total of all active and inactive participants2003-10-0150
Total participants2003-10-0150
2002: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2002 401k membership
Total participants, beginning-of-year2002-10-010
Total number of active participants reported on line 7a of the Form 55002002-10-0150
Total of all active and inactive participants2002-10-0150
Total participants2002-10-0150
2001: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2001 401k membership
Total participants, beginning-of-year2001-10-010
Total number of active participants reported on line 7a of the Form 55002001-10-0150
Total of all active and inactive participants2001-10-0150
Total participants2001-10-0150
2000: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2000 401k membership
Total participants, beginning-of-year2000-10-010
Total number of active participants reported on line 7a of the Form 55002000-10-0150
Total of all active and inactive participants2000-10-0150
Total participants2000-10-0150
1999: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 1999 401k membership
Total participants, beginning-of-year1999-10-010
Total number of active participants reported on line 7a of the Form 55001999-10-0150
Total of all active and inactive participants1999-10-0150
Total participants1999-10-0150

Financial Data on KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2022 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2022 401k financial data
Total plan liabilities at end of year2022-09-30$14,271
Total plan liabilities at beginning of year2022-09-30$8,427
Total income from all sources2022-09-30$778,258
Expenses. Total of all expenses incurred2022-09-30$778,583
Benefits paid (including direct rollovers)2022-09-30$733,822
Total plan assets at end of year2022-09-30$31,453
Total plan assets at beginning of year2022-09-30$25,934
Total contributions received or receivable from participants2022-09-30$43,801
Net income (gross income less expenses)2022-09-30$-325
Net plan assets at end of year (total assets less liabilities)2022-09-30$17,182
Net plan assets at beginning of year (total assets less liabilities)2022-09-30$17,507
Total contributions received or receivable from employer(s)2022-09-30$734,457
Expenses. Administrative service providers (salaries,fees and commissions)2022-09-30$44,761
2021 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2021 401k financial data
Total plan liabilities at end of year2021-09-30$8,427
Total plan liabilities at beginning of year2021-09-30$17,223
Total income from all sources2021-09-30$650,583
Expenses. Total of all expenses incurred2021-09-30$650,227
Benefits paid (including direct rollovers)2021-09-30$606,067
Total plan assets at end of year2021-09-30$25,934
Total plan assets at beginning of year2021-09-30$34,374
Total contributions received or receivable from participants2021-09-30$47,432
Net income (gross income less expenses)2021-09-30$356
Net plan assets at end of year (total assets less liabilities)2021-09-30$17,507
Net plan assets at beginning of year (total assets less liabilities)2021-09-30$17,151
Total contributions received or receivable from employer(s)2021-09-30$603,151
Expenses. Administrative service providers (salaries,fees and commissions)2021-09-30$44,160
2020 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2020 401k financial data
Total plan liabilities at end of year2020-09-30$17,223
Total plan liabilities at beginning of year2020-09-30$6,850
Total income from all sources2020-09-30$541,932
Expenses. Total of all expenses incurred2020-09-30$536,235
Benefits paid (including direct rollovers)2020-09-30$495,575
Total plan assets at end of year2020-09-30$34,374
Total plan assets at beginning of year2020-09-30$18,304
Total contributions received or receivable from participants2020-09-30$45,910
Net income (gross income less expenses)2020-09-30$5,697
Net plan assets at end of year (total assets less liabilities)2020-09-30$17,151
Net plan assets at beginning of year (total assets less liabilities)2020-09-30$11,454
Total contributions received or receivable from employer(s)2020-09-30$496,022
Expenses. Administrative service providers (salaries,fees and commissions)2020-09-30$40,660
2019 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2019 401k financial data
Total plan liabilities at end of year2019-09-30$6,850
Total plan liabilities at beginning of year2019-09-30$16,247
Total income from all sources2019-09-30$647,439
Expenses. Total of all expenses incurred2019-09-30$661,491
Benefits paid (including direct rollovers)2019-09-30$619,482
Total plan assets at end of year2019-09-30$18,304
Total plan assets at beginning of year2019-09-30$41,753
Total contributions received or receivable from participants2019-09-30$44,907
Expenses. Other expenses not covered elsewhere2019-09-30$14
Net income (gross income less expenses)2019-09-30$-14,052
Net plan assets at end of year (total assets less liabilities)2019-09-30$11,454
Net plan assets at beginning of year (total assets less liabilities)2019-09-30$25,506
Total contributions received or receivable from employer(s)2019-09-30$602,532
Expenses. Administrative service providers (salaries,fees and commissions)2019-09-30$41,995
2017 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2017 401k financial data
Total plan liabilities at end of year2017-09-30$7,596
Total plan liabilities at beginning of year2017-09-30$12,134
Total income from all sources2017-09-30$600,327
Expenses. Total of all expenses incurred2017-09-30$601,242
Benefits paid (including direct rollovers)2017-09-30$560,093
Total plan assets at end of year2017-09-30$20,344
Total plan assets at beginning of year2017-09-30$25,797
Total contributions received or receivable from participants2017-09-30$6,511
Net income (gross income less expenses)2017-09-30$-915
Net plan assets at end of year (total assets less liabilities)2017-09-30$12,748
Net plan assets at beginning of year (total assets less liabilities)2017-09-30$13,663
Total contributions received or receivable from employer(s)2017-09-30$593,816
Expenses. Administrative service providers (salaries,fees and commissions)2017-09-30$41,149
2016 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2016 401k financial data
Total plan liabilities at end of year2016-09-30$12,134
Total plan liabilities at beginning of year2016-09-30$7,446
Total income from all sources2016-09-30$646,657
Expenses. Total of all expenses incurred2016-09-30$641,811
Benefits paid (including direct rollovers)2016-09-30$597,703
Total plan assets at end of year2016-09-30$25,797
Total plan assets at beginning of year2016-09-30$16,263
Total contributions received or receivable from participants2016-09-30$4,180
Net income (gross income less expenses)2016-09-30$4,846
Net plan assets at end of year (total assets less liabilities)2016-09-30$13,663
Net plan assets at beginning of year (total assets less liabilities)2016-09-30$8,817
Total contributions received or receivable from employer(s)2016-09-30$642,477
Expenses. Administrative service providers (salaries,fees and commissions)2016-09-30$44,108
2015 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2015 401k financial data
Total plan liabilities at end of year2015-09-30$7,446
Total plan liabilities at beginning of year2015-09-30$6,108
Total income from all sources2015-09-30$542,494
Expenses. Total of all expenses incurred2015-09-30$545,161
Benefits paid (including direct rollovers)2015-09-30$499,555
Total plan assets at end of year2015-09-30$16,263
Total plan assets at beginning of year2015-09-30$17,592
Total contributions received or receivable from participants2015-09-30$3,820
Expenses. Other expenses not covered elsewhere2015-09-30$11
Net income (gross income less expenses)2015-09-30$-2,667
Net plan assets at end of year (total assets less liabilities)2015-09-30$8,817
Net plan assets at beginning of year (total assets less liabilities)2015-09-30$11,484
Total contributions received or receivable from employer(s)2015-09-30$538,674
Expenses. Administrative service providers (salaries,fees and commissions)2015-09-30$45,595
2014 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2014 401k financial data
Total plan liabilities at end of year2014-09-30$6,108
Total plan liabilities at beginning of year2014-09-30$13,602
Total income from all sources2014-09-30$514,568
Expenses. Total of all expenses incurred2014-09-30$513,151
Benefits paid (including direct rollovers)2014-09-30$473,796
Total plan assets at end of year2014-09-30$17,592
Total plan assets at beginning of year2014-09-30$23,669
Total contributions received or receivable from participants2014-09-30$3,935
Net income (gross income less expenses)2014-09-30$1,417
Net plan assets at end of year (total assets less liabilities)2014-09-30$11,484
Net plan assets at beginning of year (total assets less liabilities)2014-09-30$10,067
Total contributions received or receivable from employer(s)2014-09-30$510,633
Expenses. Administrative service providers (salaries,fees and commissions)2014-09-30$39,355
2013 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2013 401k financial data
Total plan liabilities at end of year2013-09-30$13,602
Total income from all sources2013-09-30$686,002
Expenses. Total of all expenses incurred2013-09-30$686,823
Benefits paid (including direct rollovers)2013-09-30$644,766
Total plan assets at end of year2013-09-30$23,669
Total plan assets at beginning of year2013-09-30$10,888
Total contributions received or receivable from participants2013-09-30$3,875
Net income (gross income less expenses)2013-09-30$-821
Net plan assets at end of year (total assets less liabilities)2013-09-30$10,067
Net plan assets at beginning of year (total assets less liabilities)2013-09-30$10,888
Total contributions received or receivable from employer(s)2013-09-30$682,127
Expenses. Administrative service providers (salaries,fees and commissions)2013-09-30$42,057
2012 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2012 401k financial data
Total income from all sources2012-09-30$493,106
Expenses. Total of all expenses incurred2012-09-30$493,106
Benefits paid (including direct rollovers)2012-09-30$463,879
Total plan assets at end of year2012-09-30$10,888
Total plan assets at beginning of year2012-09-30$10,888
Total contributions received or receivable from participants2012-09-30$3,150
Net income (gross income less expenses)2012-09-30$0
Net plan assets at end of year (total assets less liabilities)2012-09-30$10,888
Net plan assets at beginning of year (total assets less liabilities)2012-09-30$10,888
Total contributions received or receivable from employer(s)2012-09-30$489,956
Expenses. Administrative service providers (salaries,fees and commissions)2012-09-30$29,227
2011 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2011 401k financial data
Total income from all sources2011-09-30$498,082
Expenses. Total of all expenses incurred2011-09-30$498,082
Benefits paid (including direct rollovers)2011-09-30$468,843
Total plan assets at end of year2011-09-30$10,888
Total plan assets at beginning of year2011-09-30$10,888
Total contributions received or receivable from participants2011-09-30$3,175
Net income (gross income less expenses)2011-09-30$0
Net plan assets at end of year (total assets less liabilities)2011-09-30$10,888
Net plan assets at beginning of year (total assets less liabilities)2011-09-30$10,888
Total contributions received or receivable from employer(s)2011-09-30$494,907
Expenses. Administrative service providers (salaries,fees and commissions)2011-09-30$29,239
2010 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2010 401k financial data
Total income from all sources2010-09-30$358,814
Expenses. Total of all expenses incurred2010-09-30$358,814
Benefits paid (including direct rollovers)2010-09-30$328,612
Total plan assets at end of year2010-09-30$10,888
Total plan assets at beginning of year2010-09-30$10,088
Total contributions received or receivable from participants2010-09-30$3,150
Net income (gross income less expenses)2010-09-30$0
Net plan assets at end of year (total assets less liabilities)2010-09-30$10,888
Net plan assets at beginning of year (total assets less liabilities)2010-09-30$10,088
Total contributions received or receivable from employer(s)2010-09-30$355,664
Expenses. Administrative service providers (salaries,fees and commissions)2010-09-30$30,202
2009 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2009 401k financial data
Total income from all sources2009-09-30$413,862
Expenses. Total of all expenses incurred2009-09-30$413,862
Benefits paid (including direct rollovers)2009-09-30$376,170
Total plan assets at end of year2009-09-30$10,888
Total plan assets at beginning of year2009-09-30$10,088
Total contributions received or receivable from participants2009-09-30$3,150
Net income (gross income less expenses)2009-09-30$0
Net plan assets at end of year (total assets less liabilities)2009-09-30$10,888
Net plan assets at beginning of year (total assets less liabilities)2009-09-30$10,088
Total contributions received or receivable from employer(s)2009-09-30$410,712
Expenses. Administrative service providers (salaries,fees and commissions)2009-09-30$37,692
2008 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2008 401k financial data
Total income from all sources2008-09-30$413,862
Expenses. Total of all expenses incurred2008-09-30$413,862
Benefits paid (including direct rollovers)2008-09-30$376,170
Total plan assets at end of year2008-09-30$10,888
Total plan assets at beginning of year2008-09-30$10,088
Total contributions received or receivable from participants2008-09-30$3,150
Net income (gross income less expenses)2008-09-30$0
Net plan assets at end of year (total assets less liabilities)2008-09-30$10,888
Net plan assets at beginning of year (total assets less liabilities)2008-09-30$10,088
Total contributions received or receivable from employer(s)2008-09-30$410,712
Expenses. Administrative service providers (salaries,fees and commissions)2008-09-30$37,692
2007 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2007 401k financial data
Total income from all sources2007-09-30$565,256
Expenses. Total of all expenses incurred2007-09-30$558,262
Benefits paid (including direct rollovers)2007-09-30$521,062
Total plan assets at end of year2007-09-30$10,888
Total plan assets at beginning of year2007-09-30$3,894
Total contributions received or receivable from participants2007-09-30$3,150
Net income (gross income less expenses)2007-09-30$6,994
Net plan assets at end of year (total assets less liabilities)2007-09-30$10,888
Net plan assets at beginning of year (total assets less liabilities)2007-09-30$3,894
Total contributions received or receivable from employer(s)2007-09-30$562,106
Expenses. Administrative service providers (salaries,fees and commissions)2007-09-30$37,200
2006 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2006 401k financial data
Total income from all sources2006-09-30$601,197
Expenses. Total of all expenses incurred2006-09-30$632,707
Benefits paid (including direct rollovers)2006-09-30$607,512
Total plan assets at end of year2006-09-30$3,894
Total plan assets at beginning of year2006-09-30$35,404
Total contributions received or receivable from participants2006-09-30$5,452
Net income (gross income less expenses)2006-09-30$-31,510
Net plan assets at end of year (total assets less liabilities)2006-09-30$3,894
Net plan assets at beginning of year (total assets less liabilities)2006-09-30$35,404
Total contributions received or receivable from employer(s)2006-09-30$595,745
Expenses. Administrative service providers (salaries,fees and commissions)2006-09-30$25,195
2005 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2005 401k financial data
Total plan liabilities at beginning of year2005-09-30$2,917
Total income from all sources2005-09-30$448,968
Expenses. Total of all expenses incurred2005-09-30$410,863
Benefits paid (including direct rollovers)2005-09-30$385,088
Total plan assets at end of year2005-09-30$35,404
Total plan assets at beginning of year2005-09-30$0
Total contributions received or receivable from participants2005-09-30$2,941
Net income (gross income less expenses)2005-09-30$38,105
Net plan assets at end of year (total assets less liabilities)2005-09-30$35,404
Net plan assets at beginning of year (total assets less liabilities)2005-09-30$-2,917
Total contributions received or receivable from employer(s)2005-09-30$446,027
Expenses. Administrative service providers (salaries,fees and commissions)2005-09-30$25,775
2004 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2004 401k financial data
Total plan liabilities at end of year2004-09-30$2,917
Total income from all sources2004-09-30$449,000
Expenses. Total of all expenses incurred2004-09-30$451,917
Benefits paid (including direct rollovers)2004-09-30$426,917
Total plan assets at end of year2004-09-30$0
Total plan assets at beginning of year2004-09-30$0
Total contributions received or receivable from participants2004-09-30$3,000
Net income (gross income less expenses)2004-09-30$-2,917
Net plan assets at end of year (total assets less liabilities)2004-09-30$-2,917
Net plan assets at beginning of year (total assets less liabilities)2004-09-30$0
Total contributions received or receivable from employer(s)2004-09-30$446,000
Expenses. Administrative service providers (salaries,fees and commissions)2004-09-30$25,000
2003 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2003 401k financial data
Total income from all sources2003-09-30$449,000
Expenses. Total of all expenses incurred2003-09-30$449,000
Benefits paid (including direct rollovers)2003-09-30$424,000
Total plan assets at end of year2003-09-30$0
Total plan assets at beginning of year2003-09-30$0
Total contributions received or receivable from participants2003-09-30$3,000
Net income (gross income less expenses)2003-09-30$0
Net plan assets at end of year (total assets less liabilities)2003-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2003-09-30$0
Total contributions received or receivable from employer(s)2003-09-30$446,000
Expenses. Administrative service providers (salaries,fees and commissions)2003-09-30$25,000
2002 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2002 401k financial data
Total income from all sources2002-09-30$449,000
Expenses. Total of all expenses incurred2002-09-30$449,000
Benefits paid (including direct rollovers)2002-09-30$424,000
Total plan assets at end of year2002-09-30$0
Total plan assets at beginning of year2002-09-30$0
Total contributions received or receivable from participants2002-09-30$3,000
Net income (gross income less expenses)2002-09-30$0
Net plan assets at end of year (total assets less liabilities)2002-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2002-09-30$0
Total contributions received or receivable from employer(s)2002-09-30$446,000
Expenses. Administrative service providers (salaries,fees and commissions)2002-09-30$25,000
2001 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2001 401k financial data
Total income from all sources2001-09-30$449,000
Expenses. Total of all expenses incurred2001-09-30$449,000
Benefits paid (including direct rollovers)2001-09-30$424,000
Total plan assets at end of year2001-09-30$0
Total plan assets at beginning of year2001-09-30$0
Total contributions received or receivable from participants2001-09-30$3,000
Net income (gross income less expenses)2001-09-30$0
Net plan assets at end of year (total assets less liabilities)2001-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2001-09-30$0
Total contributions received or receivable from employer(s)2001-09-30$446,000
Expenses. Administrative service providers (salaries,fees and commissions)2001-09-30$25,000
2000 : KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2000 401k financial data
Total income from all sources2000-09-30$449,000
Expenses. Total of all expenses incurred2000-09-30$449,000
Benefits paid (including direct rollovers)2000-09-30$424,000
Total plan assets at end of year2000-09-30$0
Total plan assets at beginning of year2000-09-30$0
Total contributions received or receivable from participants2000-09-30$3,000
Net income (gross income less expenses)2000-09-30$0
Net plan assets at end of year (total assets less liabilities)2000-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2000-09-30$0
Total contributions received or receivable from employer(s)2000-09-30$446,000
Expenses. Administrative service providers (salaries,fees and commissions)2000-09-30$25,000

Form 5500 Responses for KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN

2021: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes
2020: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Submission has been amendedNo
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planNo
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – TrustYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement - TrustYes
2019: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement - TrustYes
2018: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – TrustYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement - TrustYes
2017: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2016: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2015: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2014: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2013: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2012: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes
2011: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – TrustYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement - TrustYes
2010: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan funding arrangement – TrustYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement - TrustYes
2009: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – TrustYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement - TrustYes
2008: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedNo
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo
2008-10-01Plan funding arrangement – InsuranceYes
2008-10-01Plan funding arrangement – TrustYes
2008-10-01Plan benefit arrangement – InsuranceYes
2008-10-01Plan benefit arrangement - TrustYes
2007: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2007 form 5500 responses
2007-10-01Type of plan entitySingle employer plan
2007-10-01Submission has been amendedNo
2007-10-01This submission is the final filingNo
2007-10-01This return/report is a short plan year return/report (less than 12 months)No
2007-10-01Plan is a collectively bargained planNo
2007-10-01Plan funding arrangement – InsuranceYes
2007-10-01Plan funding arrangement – TrustYes
2007-10-01Plan benefit arrangement – InsuranceYes
2007-10-01Plan benefit arrangement - TrustYes
2006: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2006 form 5500 responses
2006-10-01Type of plan entitySingle employer plan
2006-10-01Submission has been amendedNo
2006-10-01This submission is the final filingNo
2006-10-01This return/report is a short plan year return/report (less than 12 months)No
2006-10-01Plan is a collectively bargained planNo
2006-10-01Plan funding arrangement – InsuranceYes
2006-10-01Plan funding arrangement – TrustYes
2006-10-01Plan benefit arrangement – InsuranceYes
2006-10-01Plan benefit arrangement - TrustYes
2005: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2005 form 5500 responses
2005-10-01Type of plan entitySingle employer plan
2005-10-01Submission has been amendedNo
2005-10-01This submission is the final filingNo
2005-10-01This return/report is a short plan year return/report (less than 12 months)No
2005-10-01Plan is a collectively bargained planNo
2005-10-01Plan funding arrangement – InsuranceYes
2005-10-01Plan funding arrangement – TrustYes
2005-10-01Plan benefit arrangement – InsuranceYes
2005-10-01Plan benefit arrangement - TrustYes
2004: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2004 form 5500 responses
2004-10-01Type of plan entitySingle employer plan
2004-10-01Submission has been amendedNo
2004-10-01This submission is the final filingNo
2004-10-01This return/report is a short plan year return/report (less than 12 months)No
2004-10-01Plan is a collectively bargained planNo
2004-10-01Plan funding arrangement – InsuranceYes
2004-10-01Plan funding arrangement – TrustYes
2004-10-01Plan benefit arrangement – InsuranceYes
2004-10-01Plan benefit arrangement - TrustYes
2003: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2003 form 5500 responses
2003-10-01Type of plan entitySingle employer plan
2003-10-01Submission has been amendedNo
2003-10-01This submission is the final filingNo
2003-10-01This return/report is a short plan year return/report (less than 12 months)No
2003-10-01Plan is a collectively bargained planNo
2003-10-01Plan funding arrangement – InsuranceYes
2003-10-01Plan funding arrangement – TrustYes
2003-10-01Plan benefit arrangement – InsuranceYes
2003-10-01Plan benefit arrangement - TrustYes
2002: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2002 form 5500 responses
2002-10-01Type of plan entitySingle employer plan
2002-10-01Submission has been amendedNo
2002-10-01This submission is the final filingNo
2002-10-01This return/report is a short plan year return/report (less than 12 months)No
2002-10-01Plan is a collectively bargained planNo
2002-10-01Plan funding arrangement – InsuranceYes
2002-10-01Plan funding arrangement – TrustYes
2002-10-01Plan benefit arrangement – InsuranceYes
2002-10-01Plan benefit arrangement - TrustYes
2001: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2001 form 5500 responses
2001-10-01Type of plan entitySingle employer plan
2001-10-01Submission has been amendedNo
2001-10-01This submission is the final filingNo
2001-10-01This return/report is a short plan year return/report (less than 12 months)No
2001-10-01Plan is a collectively bargained planNo
2001-10-01Plan funding arrangement – InsuranceYes
2001-10-01Plan funding arrangement – TrustYes
2001-10-01Plan benefit arrangement – InsuranceYes
2001-10-01Plan benefit arrangement - TrustYes
2000: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2000 form 5500 responses
2000-10-01Type of plan entitySingle employer plan
2000-10-01Submission has been amendedNo
2000-10-01This submission is the final filingNo
2000-10-01This return/report is a short plan year return/report (less than 12 months)No
2000-10-01Plan is a collectively bargained planNo
2000-10-01Plan funding arrangement – InsuranceYes
2000-10-01Plan funding arrangement – TrustYes
2000-10-01Plan benefit arrangement – InsuranceYes
2000-10-01Plan benefit arrangement - TrustYes
1999: KIFFER INDUSTRIES, INC. EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 1999 form 5500 responses
1999-10-01Type of plan entitySingle employer plan
1999-10-01Submission has been amendedNo
1999-10-01This submission is the final filingNo
1999-10-01This return/report is a short plan year return/report (less than 12 months)No
1999-10-01Plan is a collectively bargained planNo
1999-10-01Plan funding arrangement – InsuranceYes
1999-10-01Plan funding arrangement – TrustYes
1999-10-01Plan benefit arrangement – InsuranceYes
1999-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001217
Policy instance 2
Insurance contract or identification number1001217
Number of Individuals Covered42
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $572
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMANAGED TRANSPLANT
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 $5,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $572
Insurance broker organization code?5
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered42
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 BenefitYes
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 $250,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001217
Policy instance 2
Insurance contract or identification number1001217
Number of Individuals Covered47
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $569
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMANAGED TRANSPLANT
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 $5,701
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $569
Insurance broker organization code?5
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered47
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 BenefitYes
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 $239,516
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 numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered43
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 BenefitYes
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 $227,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001217
Policy instance 2
Insurance contract or identification number1001217
Number of Individuals Covered43
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $556
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMANAGED TRANSPLANT
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 $5,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $556
Insurance broker organization code?5
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001217
Policy instance 2
Insurance contract or identification number1001217
Number of Individuals Covered46
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $549
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMANAGED TRANSPLANT
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 $5,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $549
Insurance broker organization code?5
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered46
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 BenefitYes
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 $205,386
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 numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered46
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 BenefitYes
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 $168,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001217
Policy instance 2
Insurance contract or identification number1001217
Number of Individuals Covered46
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $505
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMANAGED TRANSPLANT
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 $5,054
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 numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered45
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $158,474
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 numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered48
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $136,807
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 numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered45
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $126,772
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 numberUNI-201608
Policy instance 1
Insurance contract or identification numberUNI-201608
Number of Individuals Covered48
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $110,327
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI-70189
Policy instance 1
Insurance contract or identification numberCLI-70189
Number of Individuals Covered40
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $90,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 70189
Policy instance 1
Insurance contract or identification numberCLI 70189
Number of Individuals Covered38
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $75,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-8820
Policy instance 2
Insurance contract or identification number280-8820
Number of Individuals Covered38
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $579
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $5,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 70189
Policy instance 1
Insurance contract or identification numberCLI 70189
Number of Individuals Covered41
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
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $71,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-7890
Policy instance 2
Insurance contract or identification number280-7890
Number of Individuals Covered44
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $595
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $5,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $595
Insurance broker nameSELF FUNDED PLANS
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-7135
Policy instance 1
Insurance contract or identification number280-7135
Number of Individuals Covered48
Insurance policy start date2008-10-01
Insurance policy end date2009-09-30
Total amount of commissions paid to insurance brokerUSD $661
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $6,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $661
Insurance broker nameSELF FUNDED PLANS
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 70189
Policy instance 2
Insurance contract or identification numberCLI 70189
Number of Individuals Covered49
Insurance policy start date2008-10-01
Insurance policy end date2009-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $81,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-6376
Policy instance 1
Insurance contract or identification number280-6376
Number of Individuals Covered51
Insurance policy start date2007-10-01
Insurance policy end date2008-09-30
Total amount of commissions paid to insurance brokerUSD $603
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $6,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $603
Insurance broker nameSELF FUNDED PLANS
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 70189
Policy instance 2
Insurance contract or identification numberCLI 70189
Number of Individuals Covered53
Insurance policy start date2007-10-01
Insurance policy end date2008-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $81,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-5722
Policy instance 2
Insurance contract or identification number280-5722
Number of Individuals Covered53
Insurance policy start date2006-10-01
Insurance policy end date2007-09-30
Total amount of commissions paid to insurance brokerUSD $533
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $5,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $533
Insurance broker nameSELF FUNDED PLANS
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 70189
Policy instance 1
Insurance contract or identification numberCLI 70189
Number of Individuals Covered52
Insurance policy start date2006-10-01
Insurance policy end date2007-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $68,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200073
Policy instance 1
Insurance contract or identification numberUNI-200073
Number of Individuals Covered51
Insurance policy start date2005-10-01
Insurance policy end date2006-09-30
Total amount of commissions paid to insurance brokerUSD $20,183
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $134,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,728
Insurance broker organization code?5
Insurance broker nameWILLIAM MORRIS
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-200073
Policy instance 1
Insurance contract or identification numberUNI-200073
Number of Individuals Covered52
Insurance policy start date2004-10-01
Insurance policy end date2005-09-30
Total amount of commissions paid to insurance brokerUSD $22,042
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $146,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,347
Insurance broker organization code?5
Insurance broker nameWILLIAM MORRIS

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