KISHA AND TABELLION CO LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CANTON REGIONAL CHAMBER HEALTH FUND
| Measure | Date | Value |
|---|
| 2020: CANTON REGIONAL CHAMBER HEALTH FUND 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 3 |
| Total participants | 2020-01-01 | 3 |
| 2019: CANTON REGIONAL CHAMBER HEALTH FUND 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 4 |
| Total participants | 2019-01-01 | 4 |
| Measure | Date | Value |
|---|
| 2020 : CANTON REGIONAL CHAMBER HEALTH FUND 2020 401k financial data |
|---|
| Transfers to/from the plan | 2020-12-31 | $3 |
| Total plan liabilities at end of year | 2020-12-31 | $2,352 |
| Total plan liabilities at beginning of year | 2020-12-31 | $1,883 |
| Total income from all sources | 2020-12-31 | $22,699 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $21,217 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $614 |
| Total plan assets at end of year | 2020-12-31 | $8,042 |
| Total plan assets at beginning of year | 2020-12-31 | $6,088 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $17 |
| Net income (gross income less expenses) | 2020-12-31 | $1,482 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $5,690 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $4,205 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $22,699 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $20,586 |
| 2019 : CANTON REGIONAL CHAMBER HEALTH FUND 2019 401k financial data |
|---|
| Transfers to/from the plan | 2019-12-31 | $-22 |
| Total plan liabilities at end of year | 2019-12-31 | $1,883 |
| Total plan liabilities at beginning of year | 2019-12-31 | $0 |
| Total income from all sources | 2019-12-31 | $20,076 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $15,849 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $1,672 |
| Total plan assets at end of year | 2019-12-31 | $6,088 |
| Total plan assets at beginning of year | 2019-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $1 |
| Net income (gross income less expenses) | 2019-12-31 | $4,227 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $4,205 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $20,076 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $14,176 |
| 2020: CANTON REGIONAL CHAMBER HEALTH FUND 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: CANTON REGIONAL CHAMBER HEALTH FUND 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | First time form 5500 has been submitted | Yes |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 ) |
| Policy contract number | HF915 |
| Policy instance | 1 |
| Insurance contract or identification number | HF915 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,100 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $22,699 | | Commission paid to Insurance Broker | USD $1,100 |
|
| MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 ) |
| Policy contract number | HF915 |
| Policy instance | 1 |
| Insurance contract or identification number | HF915 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $953 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $20,075 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $953 |
|
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