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FRANCISCAN UNIVERSITY OF STEUBENVILLE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameFRANCISCAN UNIVERSITY OF STEUBENVILLE WELFARE BENEFIT PLAN
Plan identification number 505

FRANCISCAN UNIVERSITY OF STEUBENVILLE WELFARE BENEFIT PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    FRANCISCAN UNIVERSITY OF STEUBENVILLE has sponsored the creation of one or more 401k plans.

    Company Name:FRANCISCAN UNIVERSITY OF STEUBENVILLE
    Employer identification number (EIN):340714818
    NAIC Classification:611000

    Additional information about FRANCISCAN UNIVERSITY OF STEUBENVILLE

    Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
    Incorporation Date: 1948-06-01
    Company Identification Number: 208392
    Legal Registered Office Address: 1235 UNIVERSITY BLVD
    -
    STEUBENVILLE
    United States of America (USA)
    43952

    More information about FRANCISCAN UNIVERSITY OF STEUBENVILLE

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan FRANCISCAN UNIVERSITY OF STEUBENVILLE WELFARE BENEFIT PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5052020-01-01
    5052019-01-01
    5052018-01-01
    5052017-01-01BRENAN PERGI BRENAN PERGI2018-10-12
    5052016-01-01BRENAN PERGI BRENAN PERGI2018-05-11
    5052016-01-01 BRENAN PERGI2018-05-09
    5052015-01-01DAVID M. SKIVIAT, SR. DAVID M. SKIVIAT, SR.2016-09-29
    5052014-01-01DAVID M. SKIVIAT, SR. DAVID M. SKIVIAT, SR.2015-06-15
    5052013-01-01DAVID M. SKIVIAT, SR. DAVID M. SKIVIAT, SR.2014-07-10
    5052012-01-01DAVID M. SKIVIAT, SR. DAVID M. SKIVIAT, SR.2013-07-30
    5052011-01-01DAVID M. SKIVIAT, SR. DAVID M. SKIVIAT, SR.2012-05-29
    5052009-01-01DAVID M. SKIVIAT, SR. DAVID M. SKIVIAT, SR.2010-07-29

    Plan Statistics for FRANCISCAN UNIVERSITY OF STEUBENVILLE WELFARE BENEFIT PLAN

    401k plan membership statisitcs for FRANCISCAN UNIVERSITY OF STEUBENVILLE WELFARE BENEFIT PLAN

    Measure Date Value
    2020
    Total participants, beginning-of-year2020-01-01367
    Total number of active participants reported on line 7a of the Form 55002020-01-01361
    Number of retired or separated participants receiving benefits2020-01-013
    Number of other retired or separated participants entitled to future benefits2020-01-010
    Total of all active and inactive participants2020-01-01364
    2019
    Total participants, beginning-of-year2019-01-01370
    Total number of active participants reported on line 7a of the Form 55002019-01-01365
    Number of retired or separated participants receiving benefits2019-01-012
    Number of other retired or separated participants entitled to future benefits2019-01-010
    Total of all active and inactive participants2019-01-01367
    2018
    Total participants, beginning-of-year2018-01-01344
    Total number of active participants reported on line 7a of the Form 55002018-01-01370
    Number of retired or separated participants receiving benefits2018-01-010
    Number of other retired or separated participants entitled to future benefits2018-01-010
    Total of all active and inactive participants2018-01-01370
    2017
    Total participants, beginning-of-year2017-01-01356
    Total number of active participants reported on line 7a of the Form 55002017-01-01340
    Number of retired or separated participants receiving benefits2017-01-014
    Number of other retired or separated participants entitled to future benefits2017-01-010
    Total of all active and inactive participants2017-01-01344
    2016
    Total participants, beginning-of-year2016-01-01354
    Total number of active participants reported on line 7a of the Form 55002016-01-01355
    Number of retired or separated participants receiving benefits2016-01-011
    Number of other retired or separated participants entitled to future benefits2016-01-010
    Total of all active and inactive participants2016-01-01356
    2015
    Total participants, beginning-of-year2015-01-01582
    Total number of active participants reported on line 7a of the Form 55002015-01-01352
    Number of retired or separated participants receiving benefits2015-01-012
    Number of other retired or separated participants entitled to future benefits2015-01-010
    Total of all active and inactive participants2015-01-01354
    2014
    Total participants, beginning-of-year2014-01-01323
    Total number of active participants reported on line 7a of the Form 55002014-01-01580
    Number of retired or separated participants receiving benefits2014-01-012
    Number of other retired or separated participants entitled to future benefits2014-01-010
    Total of all active and inactive participants2014-01-01582
    2013
    Total participants, beginning-of-year2013-01-01311
    Total number of active participants reported on line 7a of the Form 55002013-01-01323
    Number of retired or separated participants receiving benefits2013-01-010
    Number of other retired or separated participants entitled to future benefits2013-01-010
    Total of all active and inactive participants2013-01-01323
    2012
    Total participants, beginning-of-year2012-01-01313
    Total number of active participants reported on line 7a of the Form 55002012-01-01310
    Number of retired or separated participants receiving benefits2012-01-011
    Number of other retired or separated participants entitled to future benefits2012-01-010
    Total of all active and inactive participants2012-01-01311
    2011
    Total participants, beginning-of-year2011-01-01309
    Total number of active participants reported on line 7a of the Form 55002011-01-01309
    Number of retired or separated participants receiving benefits2011-01-014
    Number of other retired or separated participants entitled to future benefits2011-01-010
    Total of all active and inactive participants2011-01-01313
    2009
    Total participants, beginning-of-year2009-01-01313
    Total number of active participants reported on line 7a of the Form 55002009-01-01305
    Number of retired or separated participants receiving benefits2009-01-013
    Number of other retired or separated participants entitled to future benefits2009-01-010
    Total of all active and inactive participants2009-01-01308

    Financial Data on FRANCISCAN UNIVERSITY OF STEUBENVILLE WELFARE BENEFIT PLAN

    Measure Date Value
    2020
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$540,705
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$177,503
    Total income from all sources (including contributions)2020-12-31$6,704,363
    Total of all expenses incurred2020-12-31$6,583,929
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$6,490,763
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$6,704,363
    Value of total assets at end of year2020-12-31$872,148
    Value of total assets at beginning of year2020-12-31$388,512
    Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$93,166
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
    Administrative expenses professional fees incurred2020-12-31$57,500
    Was this plan covered by a fidelity bond2020-12-31Yes
    Value of fidelity bond cover2020-12-31$500,000
    Were there any nonexempt tranactions with any party-in-interest2020-12-31No
    Contributions received from participants2020-12-31$1,571,468
    Administrative expenses (other) incurred2020-12-31$23,042
    Liabilities. Value of operating payables at end of year2020-12-31$0
    Liabilities. Value of operating payables at beginning of year2020-12-31$57,747
    Total non interest bearing cash at end of year2020-12-31$872,148
    Total non interest bearing cash at beginning of year2020-12-31$388,512
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
    Value of net income/loss2020-12-31$120,434
    Value of net assets at end of year (total assets less liabilities)2020-12-31$331,443
    Value of net assets at beginning of year (total assets less liabilities)2020-12-31$211,009
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
    Were any leases to which the plan was party in default or uncollectible2020-12-31No
    Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,724,962
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
    Was there a failure to transmit to the plan any participant contributions2020-12-31No
    Has the plan failed to provide any benefit when due under the plan2020-12-31No
    Contributions received in cash from employer2020-12-31$5,132,895
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$4,765,801
    Contract administrator fees2020-12-31$12,624
    Liabilities. Value of benefit claims payable at end of year2020-12-31$540,705
    Liabilities. Value of benefit claims payable at beginning of year2020-12-31$119,756
    Did the plan have assets held for investment2020-12-31No
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
    Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
    Accountancy firm name2020-12-31SCHNEIDER DOWNS & CO., INC.
    Accountancy firm EIN2020-12-31251408703
    2019
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$177,503
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$177,503
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$176,617
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$176,617
    Total income from all sources (including contributions)2019-12-31$5,657,452
    Total income from all sources (including contributions)2019-12-31$5,657,452
    Total of all expenses incurred2019-12-31$6,014,825
    Total of all expenses incurred2019-12-31$6,014,825
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$5,936,309
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$5,936,309
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,657,452
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,657,452
    Value of total assets at end of year2019-12-31$388,512
    Value of total assets at end of year2019-12-31$388,512
    Value of total assets at beginning of year2019-12-31$744,999
    Value of total assets at beginning of year2019-12-31$744,999
    Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$78,516
    Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$78,516
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
    Administrative expenses professional fees incurred2019-12-31$38,450
    Administrative expenses professional fees incurred2019-12-31$38,450
    Was this plan covered by a fidelity bond2019-12-31Yes
    Was this plan covered by a fidelity bond2019-12-31Yes
    Value of fidelity bond cover2019-12-31$500,000
    Were there any nonexempt tranactions with any party-in-interest2019-12-31No
    Contributions received from participants2019-12-31$1,114,482
    Contributions received from participants2019-12-31$1,114,482
    Administrative expenses (other) incurred2019-12-31$40,066
    Administrative expenses (other) incurred2019-12-31$40,066
    Liabilities. Value of operating payables at end of year2019-12-31$57,747
    Liabilities. Value of operating payables at end of year2019-12-31$57,747
    Liabilities. Value of operating payables at beginning of year2019-12-31$61,982
    Liabilities. Value of operating payables at beginning of year2019-12-31$61,982
    Total non interest bearing cash at end of year2019-12-31$388,512
    Total non interest bearing cash at end of year2019-12-31$388,512
    Total non interest bearing cash at beginning of year2019-12-31$744,999
    Total non interest bearing cash at beginning of year2019-12-31$744,999
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
    Value of net income/loss2019-12-31$-357,373
    Value of net income/loss2019-12-31$-357,373
    Value of net assets at end of year (total assets less liabilities)2019-12-31$211,009
    Value of net assets at end of year (total assets less liabilities)2019-12-31$211,009
    Value of net assets at beginning of year (total assets less liabilities)2019-12-31$568,382
    Value of net assets at beginning of year (total assets less liabilities)2019-12-31$568,382
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
    Were any leases to which the plan was party in default or uncollectible2019-12-31No
    Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,187,339
    Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,187,339
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
    Was there a failure to transmit to the plan any participant contributions2019-12-31No
    Was there a failure to transmit to the plan any participant contributions2019-12-31No
    Has the plan failed to provide any benefit when due under the plan2019-12-31No
    Has the plan failed to provide any benefit when due under the plan2019-12-31No
    Contributions received in cash from employer2019-12-31$4,542,970
    Contributions received in cash from employer2019-12-31$4,542,970
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$4,748,970
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$4,748,970
    Liabilities. Value of benefit claims payable at end of year2019-12-31$119,756
    Liabilities. Value of benefit claims payable at end of year2019-12-31$119,756
    Liabilities. Value of benefit claims payable at beginning of year2019-12-31$114,635
    Liabilities. Value of benefit claims payable at beginning of year2019-12-31$114,635
    Did the plan have assets held for investment2019-12-31No
    Did the plan have assets held for investment2019-12-31No
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
    Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
    Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
    Accountancy firm name2019-12-31SCHNEIDER DOWNS & CO., INC.
    Accountancy firm name2019-12-31SCHNEIDER DOWNS & CO., INC.
    Accountancy firm EIN2019-12-31251408703
    Accountancy firm EIN2019-12-31251408703
    2018
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$176,617
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$582,250
    Total income from all sources (including contributions)2018-12-31$6,284,577
    Total of all expenses incurred2018-12-31$6,392,075
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$6,251,702
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$6,284,577
    Value of total assets at end of year2018-12-31$744,999
    Value of total assets at beginning of year2018-12-31$1,258,130
    Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$140,373
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
    Administrative expenses professional fees incurred2018-12-31$69,000
    Was this plan covered by a fidelity bond2018-12-31Yes
    Value of fidelity bond cover2018-12-31$500,000
    Were there any nonexempt tranactions with any party-in-interest2018-12-31No
    Contributions received from participants2018-12-31$1,124,064
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$527,756
    Administrative expenses (other) incurred2018-12-31$71,373
    Liabilities. Value of operating payables at end of year2018-12-31$61,982
    Liabilities. Value of operating payables at beginning of year2018-12-31$36,125
    Total non interest bearing cash at end of year2018-12-31$744,999
    Total non interest bearing cash at beginning of year2018-12-31$1,258,130
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
    Value of net income/loss2018-12-31$-107,498
    Value of net assets at end of year (total assets less liabilities)2018-12-31$568,382
    Value of net assets at beginning of year (total assets less liabilities)2018-12-31$675,880
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
    Were any leases to which the plan was party in default or uncollectible2018-12-31No
    Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$6,251,702
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
    Was there a failure to transmit to the plan any participant contributions2018-12-31No
    Has the plan failed to provide any benefit when due under the plan2018-12-31No
    Contributions received in cash from employer2018-12-31$5,160,513
    Liabilities. Value of benefit claims payable at end of year2018-12-31$114,635
    Liabilities. Value of benefit claims payable at beginning of year2018-12-31$18,369
    Did the plan have assets held for investment2018-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
    Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
    Accountancy firm name2018-12-31SCHNEIDER DOWNS & CO., INC.
    Accountancy firm EIN2018-12-31251408703
    2017
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$582,250
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$478,222
    Total income from all sources (including contributions)2017-12-31$5,978,620
    Total of all expenses incurred2017-12-31$5,302,740
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$5,190,064
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$5,978,620
    Value of total assets at end of year2017-12-31$1,258,130
    Value of total assets at beginning of year2017-12-31$478,222
    Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$112,676
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
    Administrative expenses professional fees incurred2017-12-31$69,000
    Was this plan covered by a fidelity bond2017-12-31Yes
    Value of fidelity bond cover2017-12-31$500,000
    Were there any nonexempt tranactions with any party-in-interest2017-12-31No
    Contributions received from participants2017-12-31$1,095,776
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$527,756
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$339,776
    Administrative expenses (other) incurred2017-12-31$43,676
    Liabilities. Value of operating payables at end of year2017-12-31$36,125
    Liabilities. Value of operating payables at beginning of year2017-12-31$43,680
    Total non interest bearing cash at end of year2017-12-31$1,258,130
    Total non interest bearing cash at beginning of year2017-12-31$0
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
    Value of net income/loss2017-12-31$675,880
    Value of net assets at end of year (total assets less liabilities)2017-12-31$675,880
    Value of net assets at beginning of year (total assets less liabilities)2017-12-31$0
    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
    Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
    Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$478,222
    Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$478,222
    Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$5,190,064
    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$4,882,844
    Liabilities. Value of benefit claims payable at end of year2017-12-31$18,369
    Liabilities. Value of benefit claims payable at beginning of year2017-12-31$94,766
    Did the plan have assets held for investment2017-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
    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 name2017-12-31SCHNEIDER DOWNS & CO., INC.
    Accountancy firm EIN2017-12-31251408703
    2016
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$478,222
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
    Total income from all sources (including contributions)2016-12-31$5,305,819
    Total of all expenses incurred2016-12-31$5,305,819
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$5,103,822
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$5,305,523
    Value of total assets at end of year2016-12-31$478,222
    Value of total assets at beginning of year2016-12-31$0
    Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$201,997
    Total interest from all sources2016-12-31$296
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
    Administrative expenses professional fees incurred2016-12-31$74,349
    Was this plan covered by a fidelity bond2016-12-31Yes
    Value of fidelity bond cover2016-12-31$500,000
    Were there any nonexempt tranactions with any party-in-interest2016-12-31No
    Contributions received from participants2016-12-31$948,395
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$339,776
    Administrative expenses (other) incurred2016-12-31$127,648
    Liabilities. Value of operating payables at end of year2016-12-31$43,680
    Liabilities. Value of operating payables at beginning of year2016-12-31$0
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
    Value of net income/loss2016-12-31$0
    Value of net assets at end of year (total assets less liabilities)2016-12-31$0
    Value of net assets at beginning of year (total assets less liabilities)2016-12-31$0
    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
    Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$478,222
    Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$0
    Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$0
    Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$296
    Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$5,103,822
    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$4,357,128
    Liabilities. Value of benefit claims payable at end of year2016-12-31$94,766
    Liabilities. Value of benefit claims payable at beginning of year2016-12-31$0
    Did the plan have assets held for investment2016-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
    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 name2016-12-31SCHNEIDER DOWNS & CO., INC.
    Accountancy firm EIN2016-12-31251408703

    Form 5500 Responses

    2020
    2020-01-01Type of plan entitySingle employer plan
    2020-01-01Plan funding arrangement – InsuranceYes
    2020-01-01Plan funding arrangement – TrustYes
    2020-01-01Plan benefit arrangement – InsuranceYes
    2020-01-01Plan benefit arrangement - TrustYes
    2019
    2019-01-01Type of plan entitySingle employer plan
    2019-01-01Plan funding arrangement – InsuranceYes
    2019-01-01Plan funding arrangement – TrustYes
    2019-01-01Plan benefit arrangement – InsuranceYes
    2019-01-01Plan benefit arrangement - TrustYes
    2018
    2018-01-01Type of plan entitySingle employer plan
    2018-01-01Plan funding arrangement – InsuranceYes
    2018-01-01Plan funding arrangement – TrustYes
    2018-01-01Plan benefit arrangement – InsuranceYes
    2018-01-01Plan benefit arrangement - TrustYes
    2017
    2017-01-01Type of plan entitySingle employer plan
    2017-01-01Plan funding arrangement – InsuranceYes
    2017-01-01Plan funding arrangement – TrustYes
    2017-01-01Plan benefit arrangement – InsuranceYes
    2017-01-01Plan benefit arrangement - TrustYes
    2016
    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
    2015-01-01Type of plan entitySingle employer plan
    2015-01-01Plan funding arrangement – InsuranceYes
    2015-01-01Plan funding arrangement – General assets of the sponsorYes
    2015-01-01Plan benefit arrangement – InsuranceYes
    2015-01-01Plan benefit arrangement – General assets of the sponsorYes
    2014
    2014-01-01Type of plan entitySingle employer plan
    2014-01-01Plan funding arrangement – InsuranceYes
    2014-01-01Plan funding arrangement – General assets of the sponsorYes
    2014-01-01Plan benefit arrangement – InsuranceYes
    2014-01-01Plan benefit arrangement – General assets of the sponsorYes
    2013
    2013-01-01Type of plan entitySingle employer plan
    2013-01-01Plan funding arrangement – InsuranceYes
    2013-01-01Plan funding arrangement – General assets of the sponsorYes
    2013-01-01Plan benefit arrangement – InsuranceYes
    2013-01-01Plan benefit arrangement – General assets of the sponsorYes
    2012
    2012-01-01Type of plan entitySingle employer plan
    2012-01-01Plan funding arrangement – InsuranceYes
    2012-01-01Plan funding arrangement – General assets of the sponsorYes
    2012-01-01Plan benefit arrangement – InsuranceYes
    2012-01-01Plan benefit arrangement – General assets of the sponsorYes
    2011
    2011-01-01Type of plan entitySingle employer plan
    2011-01-01Plan funding arrangement – InsuranceYes
    2011-01-01Plan funding arrangement – General assets of the sponsorYes
    2011-01-01Plan benefit arrangement – InsuranceYes
    2011-01-01Plan benefit arrangement – General assets of the sponsorYes
    2009
    2009-01-01Type of plan entitySingle employer plan
    2009-01-01This submission is the final filingNo
    2009-01-01Plan funding arrangement – InsuranceYes
    2009-01-01Plan funding arrangement – General assets of the sponsorYes
    2009-01-01Plan benefit arrangement – InsuranceYes
    2009-01-01Plan benefit arrangement – General assets of the sponsorYes

    Insurance Providers Used on plan

    SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
    Policy contract number16-014808-000
    Policy instance 5
    Insurance contract or identification number16-014808-000
    Number of Individuals Covered306
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $24,456
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees24456
    Additional information about fees paid to insurance brokerGROUP ADMINISTRATIVE SUPPORT FEE
    FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
    Policy contract number4EL-6820-19
    Policy instance 4
    Insurance contract or identification number4EL-6820-19
    Number of Individuals Covered1
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $149
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $3,720
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Amount paid for insurance broker fees149
    Insurance broker organization code?0
    VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
    Policy contract number4214
    Policy instance 3
    Insurance contract or identification number4214
    Number of Individuals Covered310
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number921202 AND SUBS
    Policy instance 2
    Insurance contract or identification number921202 AND SUBS
    Number of Individuals Covered687
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $136,985
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
    Policy contract numberAL00005358
    Policy instance 1
    Insurance contract or identification numberAL00005358
    Number of Individuals Covered364
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $15,610
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $151,062
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $15,610
    Insurance broker organization code?3
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number921202 AND SUBS
    Policy instance 2
    Insurance contract or identification number921202 AND SUBS
    Number of Individuals Covered619
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $124,914
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
    Policy contract number4214
    Policy instance 3
    Insurance contract or identification number4214
    Number of Individuals Covered305
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
    Policy contract number4EL-6820-19
    Policy instance 4
    Insurance contract or identification number4EL-6820-19
    Number of Individuals Covered2
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $149
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $3,720
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Amount paid for insurance broker fees149
    Additional information about fees paid to insurance brokerACCESS FEES
    Insurance broker organization code?0
    HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
    Policy contract number405779
    Policy instance 5
    Insurance contract or identification number405779
    Number of Individuals Covered302
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $861,181
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
    Policy contract numberAL00005358
    Policy instance 1
    Insurance contract or identification numberAL00005358
    Number of Individuals Covered357
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $17,863
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $153,834
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $17,863
    Insurance broker organization code?3
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number921202 AND SUBS
    Policy instance 2
    Insurance contract or identification number921202 AND SUBS
    Number of Individuals Covered617
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $122,968
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
    Policy contract numberAL00005358
    Policy instance 1
    Insurance contract or identification numberAL00005358
    Number of Individuals Covered354
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $14,561
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $148,896
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $14,561
    Insurance broker organization code?3
    VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
    Policy contract number4214
    Policy instance 3
    Insurance contract or identification number4214
    Number of Individuals Covered309
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
    Policy contract number4EL-6820-18
    Policy instance 4
    Insurance contract or identification number4EL-6820-18
    Number of Individuals Covered2
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $149
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $3,720
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Amount paid for insurance broker fees149
    Additional information about fees paid to insurance brokerACCESS FEE
    Insurance broker organization code?0
    ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
    Policy contract numberAL00005358
    Policy instance 1
    Insurance contract or identification numberAL00005358
    Number of Individuals Covered342
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $16,079
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $146,990
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $16,079
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AND FINANCIAL SERV
    VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
    Policy contract number4214
    Policy instance 3
    Insurance contract or identification number4214
    Number of Individuals Covered308
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    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 numberTM05912680
    Policy instance 2
    Insurance contract or identification numberTM05912680
    Number of Individuals Covered342
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $3,988
    Total amount of fees paid to insurance companyUSD $53
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $133,320
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,824
    Amount paid for insurance broker fees53
    Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameTRACY MCMANAMON
    FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
    Policy contract number4EL-7266-15
    Policy instance 4
    Insurance contract or identification number4EL-7266-15
    Number of Individuals Covered2
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $149
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $3,720
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Amount paid for insurance broker fees149
    Additional information about fees paid to insurance brokerACCESS FEE
    Insurance broker organization code?0
    Insurance broker nameHIGHMARK BLUE SHIELD
    FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
    Policy contract number4EL-7266-15
    Policy instance 4
    Insurance contract or identification number4EL-7266-15
    Number of Individuals Covered2
    Insurance policy start date2014-07-01
    Insurance policy end date2016-06-30
    Total amount of commissions paid to insurance brokerUSD $554
    Total amount of fees paid to insurance companyUSD $277
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $6,930
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $554
    Insurance broker organization code?3
    Amount paid for insurance broker fees277
    Additional information about fees paid to insurance brokerACCESS FEE
    Insurance broker nameHIGHMARK BLUE SHIELD
    METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
    Policy contract numberTM05912680
    Policy instance 2
    Insurance contract or identification numberTM05912680
    Number of Individuals Covered348
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $3,323
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $95,583
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,323
    Insurance broker organization code?3
    Insurance broker nameTRACY MCMANAMON
    ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
    Policy contract numberAL00005358
    Policy instance 1
    Insurance contract or identification numberAL00005358
    Number of Individuals Covered329
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $12,963
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $133,690
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $12,963
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AND FINANCIAL SERV
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number01031100
    Policy instance 3
    Insurance contract or identification number01031100
    Number of Individuals Covered898
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $54,532
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
    Policy contract number4EL-7266-13
    Policy instance 4
    Insurance contract or identification number4EL-7266-13
    Number of Individuals Covered3
    Insurance policy start date2013-07-01
    Insurance policy end date2014-06-30
    Total amount of commissions paid to insurance brokerUSD $1,795
    Total amount of fees paid to insurance companyUSD $897
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $22,435
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,795
    Insurance broker organization code?3
    Amount paid for insurance broker fees897
    Additional information about fees paid to insurance brokerACCESS FEE
    Insurance broker nameHIGHMARK BLUE SHIELD
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number01031100
    Policy instance 3
    Insurance contract or identification number01031100
    Number of Individuals Covered582
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    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
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $56,755
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number133497
    Policy instance 2
    Insurance contract or identification number133497
    Number of Individuals Covered147
    Insurance policy start date2013-11-01
    Insurance policy end date2014-10-31
    Total amount of commissions paid to insurance brokerUSD $5,564
    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
    Life Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $37,091
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,564
    Insurance broker organization code?3
    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
    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
    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
    Insurance broker nameMCBANE INSURANCE AND FINANCIAL
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number563429
    Policy instance 1
    Insurance contract or identification number563429
    Number of Individuals Covered328
    Insurance policy start date2013-12-01
    Insurance policy end date2014-11-30
    Total amount of commissions paid to insurance brokerUSD $10,755
    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
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $91,147
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,168
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AND FINANCIAL
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number563429
    Policy instance 1
    Insurance contract or identification number563429
    Number of Individuals Covered323
    Insurance policy start date2012-12-01
    Insurance policy end date2013-11-30
    Total amount of commissions paid to insurance brokerUSD $11,715
    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
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $81,308
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,959
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AND FINANCIAL
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number01031100
    Policy instance 3
    Insurance contract or identification number01031100
    Number of Individuals Covered283
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    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
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $52,066
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
    Policy contract number4EL-7266-13
    Policy instance 4
    Insurance contract or identification number4EL-7266-13
    Number of Individuals Covered1
    Insurance policy start date2012-07-01
    Insurance policy end date2013-06-30
    Total amount of commissions paid to insurance brokerUSD $529
    Total amount of fees paid to insurance companyUSD $265
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $6,612
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $529
    Insurance broker organization code?3
    Amount paid for insurance broker fees265
    Additional information about fees paid to insurance brokerACCESS FEES
    Insurance broker nameHIGHMARK
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number133497
    Policy instance 2
    Insurance contract or identification number133497
    Number of Individuals Covered136
    Insurance policy start date2012-11-01
    Insurance policy end date2013-10-31
    Total amount of commissions paid to insurance brokerUSD $6,162
    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
    Life Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $38,173
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $6,162
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AND FINANCIAL
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number01031010
    Policy instance 3
    Insurance contract or identification number01031010
    Number of Individuals Covered275
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    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
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $51,581
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number563429
    Policy instance 1
    Insurance contract or identification number563429
    Number of Individuals Covered310
    Insurance policy start date2011-12-01
    Insurance policy end date2012-11-30
    Total amount of commissions paid to insurance brokerUSD $9,592
    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
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $67,376
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $7,285
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AND FINANCIAL
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number133497
    Policy instance 2
    Insurance contract or identification number133497
    Number of Individuals Covered124
    Insurance policy start date2011-11-01
    Insurance policy end date2012-10-31
    Total amount of commissions paid to insurance brokerUSD $5,213
    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
    Life Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $37,663
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,213
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AND FINANCIAL
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number01031010
    Policy instance 3
    Insurance contract or identification number01031010
    Number of Individuals Covered272
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    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
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $56,207
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number563429
    Policy instance 1
    Insurance contract or identification number563429
    Number of Individuals Covered309
    Insurance policy start date2010-12-01
    Insurance policy end date2011-11-30
    Total amount of commissions paid to insurance brokerUSD $10,075
    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
    Life Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $69,215
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number133497
    Policy instance 2
    Insurance contract or identification number133497
    Number of Individuals Covered110
    Insurance policy start date2010-11-01
    Insurance policy end date2011-10-31
    Total amount of commissions paid to insurance brokerUSD $4,661
    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
    Life Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $31,074
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number563429
    Policy instance 1
    Insurance contract or identification number563429
    Number of Individuals Covered308
    Insurance policy start date2009-12-01
    Insurance policy end date2010-11-30
    Total amount of commissions paid to insurance brokerUSD $3,938
    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
    Long Term Disability Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $38,628
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,938
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AGENCY, INC.
    UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
    Policy contract number133497
    Policy instance 2
    Insurance contract or identification number133497
    Number of Individuals Covered104
    Insurance policy start date2009-11-01
    Insurance policy end date2010-10-31
    Total amount of commissions paid to insurance brokerUSD $3,936
    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
    Life Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $26,239
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,936
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AGENCY, INC.
    ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
    Policy contract numberAL00003480
    Policy instance 3
    Insurance contract or identification numberAL00003480
    Number of Individuals Covered306
    Insurance policy start date2009-11-01
    Insurance policy end date2010-10-31
    Total amount of commissions paid to insurance brokerUSD $2,272
    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
    Life Insurance Welfare BenefitYes
    Other welfare benefits providedAD&D
    Welfare Benefit Premiums Paid to CarrierUSD $27,340
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,272
    Insurance broker organization code?3
    Insurance broker nameMCBANE INSURANCE AGENCY, INC.
    HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
    Policy contract number01662048
    Policy instance 4
    Insurance contract or identification number01662048
    Number of Individuals Covered271
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    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
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $52,443
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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