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TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan NameTEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN
Plan identification number 501

TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BOARD OF TRUSTEES OF TEAMSTERS LOCAL 1164 WELFARE FUND has sponsored the creation of one or more 401k plans.

Company Name:BOARD OF TRUSTEES OF TEAMSTERS LOCAL 1164 WELFARE FUND
Employer identification number (EIN):346529411
NAIC Classification:312110
NAIC Description: Soft Drink and Ice Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01MICHAEL BOLYARD2023-10-13
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01ROBERTO PARO MICHAEL D'AMICO2018-10-04
5012016-01-01ROBERTO PARO MICHAEL D'AMICO2017-10-05
5012015-01-01ROBERTO PARO JAMES STIEGEL2016-08-24
5012014-01-01ROBERTO PARO JAMES STIEGEL2015-10-12
5012013-01-01ROBERTO PARO JAMES STIEGEL2014-09-02
5012012-01-01ROBERTO PARO JAMES STIEGEL2013-09-11
5012011-01-01ROBERTO PARO JAMES STIEGEL2012-09-24
5012009-01-01ROBERTO PARO JAMES STIEGEL2010-10-13

Plan Statistics for TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2022: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01298
Total number of active participants reported on line 7a of the Form 55002022-01-01325
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01325
Number of employers contributing to the scheme2022-01-016
2021: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01296
Total number of active participants reported on line 7a of the Form 55002021-01-01298
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01298
Number of employers contributing to the scheme2021-01-016
2020: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01285
Total number of active participants reported on line 7a of the Form 55002020-01-01296
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01296
Number of employers contributing to the scheme2020-01-016
2019: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01291
Total number of active participants reported on line 7a of the Form 55002019-01-01285
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01285
Number of employers contributing to the scheme2019-01-016
2018: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01287
Total number of active participants reported on line 7a of the Form 55002018-01-01291
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 participants2018-01-01291
2017: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01280
Total number of active participants reported on line 7a of the Form 55002017-01-01287
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01287
2016: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01281
Total number of active participants reported on line 7a of the Form 55002016-01-01280
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01280
Number of employers contributing to the scheme2016-01-016
2015: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01294
Total number of active participants reported on line 7a of the Form 55002015-01-01281
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01281
Number of employers contributing to the scheme2015-01-016
2014: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01299
Total number of active participants reported on line 7a of the Form 55002014-01-01294
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01294
Number of employers contributing to the scheme2014-01-019
2013: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01291
Total number of active participants reported on line 7a of the Form 55002013-01-01299
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 participants2013-01-01299
Number of employers contributing to the scheme2013-01-019
2012: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01287
Total number of active participants reported on line 7a of the Form 55002012-01-01291
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01291
Number of employers contributing to the scheme2012-01-019
2011: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01309
Total number of active participants reported on line 7a of the Form 55002011-01-01287
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01287
Number of employers contributing to the scheme2011-01-0110
2009: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01320
Total number of active participants reported on line 7a of the Form 55002009-01-01304
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01304
Number of employers contributing to the scheme2009-01-0111

Financial Data on TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2022 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-352,639
Total unrealized appreciation/depreciation of assets2022-12-31$-352,639
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$362,537
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$500,371
Total income from all sources (including contributions)2022-12-31$4,275,888
Total loss/gain on sale of assets2022-12-31$-104,981
Total of all expenses incurred2022-12-31$4,475,360
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$4,161,970
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$4,628,335
Value of total assets at end of year2022-12-31$5,330,048
Value of total assets at beginning of year2022-12-31$5,667,354
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$313,390
Total interest from all sources2022-12-31$105,173
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$23,912
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$367,998
Participant contributions at end of year2022-12-31$10,796
Participant contributions at beginning of year2022-12-31$8,360
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$27,803
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$42,432
Administrative expenses (other) incurred2022-12-31$96,223
Liabilities. Value of operating payables at end of year2022-12-31$8,037
Liabilities. Value of operating payables at beginning of year2022-12-31$6,371
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-199,472
Value of net assets at end of year (total assets less liabilities)2022-12-31$4,967,511
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$5,166,983
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$12,378
Income. Interest from US Government securities2022-12-31$32,950
Income. Interest from corporate debt instruments2022-12-31$71,155
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$1,125,916
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$1,125,028
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$1,125,028
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$1,068
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$128,774
Asset value of US Government securities at end of year2022-12-31$2,065,237
Asset value of US Government securities at beginning of year2022-12-31$1,540,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$4,260,337
Employer contributions (assets) at end of year2022-12-31$109,246
Employer contributions (assets) at beginning of year2022-12-31$80,289
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$4,033,196
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$1,985,033
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$2,866,671
Contract administrator fees2022-12-31$180,877
Liabilities. Value of benefit claims payable at end of year2022-12-31$354,500
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$494,000
Assets. Value of buildings and other operty used in plan operation at end of year2022-12-31$6,017
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-12-31$4,184
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$3,418,902
Aggregate carrying amount (costs) on sale of assets2022-12-31$3,523,883
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31J SCHAEFER & COMPANY LLC
Accountancy firm EIN2022-12-31823706925
2021 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$-175,689
Total unrealized appreciation/depreciation of assets2021-12-31$-175,689
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$500,371
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$343,773
Total income from all sources (including contributions)2021-12-31$4,288,077
Total loss/gain on sale of assets2021-12-31$16,726
Total of all expenses incurred2021-12-31$4,021,608
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$3,702,980
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$4,343,912
Value of total assets at end of year2021-12-31$5,667,354
Value of total assets at beginning of year2021-12-31$5,244,287
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$318,628
Total interest from all sources2021-12-31$103,128
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$23,024
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$342,832
Participant contributions at end of year2021-12-31$8,360
Participant contributions at beginning of year2021-12-31$10,570
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$42,432
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$26,085
Administrative expenses (other) incurred2021-12-31$94,668
Liabilities. Value of operating payables at end of year2021-12-31$6,371
Liabilities. Value of operating payables at beginning of year2021-12-31$4,773
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$266,469
Value of net assets at end of year (total assets less liabilities)2021-12-31$5,166,983
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$4,900,514
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$12,498
Income. Interest from US Government securities2021-12-31$26,822
Income. Interest from corporate debt instruments2021-12-31$76,189
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,125,028
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$637,656
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$637,656
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$117
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$115,601
Asset value of US Government securities at end of year2021-12-31$1,540,390
Asset value of US Government securities at beginning of year2021-12-31$1,918,893
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$4,001,080
Employer contributions (assets) at end of year2021-12-31$80,289
Employer contributions (assets) at beginning of year2021-12-31$78,060
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$3,587,379
Asset. Corporate debt instrument debt (other) at end of year2021-12-31$2,866,671
Asset. Corporate debt instrument debt (other) at beginning of year2021-12-31$2,566,675
Contract administrator fees2021-12-31$188,438
Liabilities. Value of benefit claims payable at end of year2021-12-31$494,000
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$339,000
Assets. Value of buildings and other operty used in plan operation at end of year2021-12-31$4,184
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-12-31$6,348
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$3,817,570
Aggregate carrying amount (costs) on sale of assets2021-12-31$3,800,844
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31J SCHAEFER & COMPANY LLC
Accountancy firm EIN2021-12-31823706925
2020 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$68,102
Total unrealized appreciation/depreciation of assets2020-12-31$68,102
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$343,773
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$408,829
Total income from all sources (including contributions)2020-12-31$4,366,856
Total loss/gain on sale of assets2020-12-31$131,227
Total of all expenses incurred2020-12-31$3,854,785
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$3,581,999
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$4,051,916
Value of total assets at end of year2020-12-31$5,244,287
Value of total assets at beginning of year2020-12-31$4,797,272
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$272,786
Total interest from all sources2020-12-31$115,611
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
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$24,656
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$315,197
Participant contributions at end of year2020-12-31$10,570
Participant contributions at beginning of year2020-12-31$6,680
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$26,085
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$28,473
Administrative expenses (other) incurred2020-12-31$89,551
Liabilities. Value of operating payables at end of year2020-12-31$4,773
Liabilities. Value of operating payables at beginning of year2020-12-31$3,829
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$512,071
Value of net assets at end of year (total assets less liabilities)2020-12-31$4,900,514
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,388,443
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
Investment advisory and management fees2020-12-31$12,227
Income. Interest from US Government securities2020-12-31$33,408
Income. Interest from corporate debt instruments2020-12-31$81,834
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$637,656
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$509,119
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$509,119
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$369
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$105,753
Asset value of US Government securities at end of year2020-12-31$1,918,893
Asset value of US Government securities at beginning of year2020-12-31$1,578,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
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$3,736,719
Employer contributions (assets) at end of year2020-12-31$78,060
Employer contributions (assets) at beginning of year2020-12-31$76,647
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$3,476,246
Asset. Corporate debt instrument debt (other) at end of year2020-12-31$2,566,675
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$2,592,447
Contract administrator fees2020-12-31$146,352
Liabilities. Value of benefit claims payable at end of year2020-12-31$339,000
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$405,000
Assets. Value of buildings and other operty used in plan operation at end of year2020-12-31$6,348
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-12-31$5,531
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
Aggregate proceeds on sale of assets2020-12-31$5,590,807
Aggregate carrying amount (costs) on sale of assets2020-12-31$5,459,580
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31J SCHAEFER & COMPANY LLC
Accountancy firm EIN2020-12-31823706925
2019 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$174,088
Total unrealized appreciation/depreciation of assets2019-12-31$174,088
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$408,829
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$441,357
Total income from all sources (including contributions)2019-12-31$4,279,528
Total loss/gain on sale of assets2019-12-31$118
Total of all expenses incurred2019-12-31$3,858,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,589,546
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,982,331
Value of total assets at end of year2019-12-31$4,797,272
Value of total assets at beginning of year2019-12-31$4,409,010
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$269,192
Total interest from all sources2019-12-31$122,991
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
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$29,621
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$324,290
Participant contributions at end of year2019-12-31$6,680
Participant contributions at beginning of year2019-12-31$7,000
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$28,473
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$25,605
Administrative expenses (other) incurred2019-12-31$84,757
Liabilities. Value of operating payables at end of year2019-12-31$3,829
Liabilities. Value of operating payables at beginning of year2019-12-31$5,357
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$420,790
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,388,443
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,967,653
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 leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$11,459
Income. Interest from US Government securities2019-12-31$30,488
Income. Interest from corporate debt instruments2019-12-31$90,706
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$509,119
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$431,460
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$431,460
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$1,797
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$99,170
Asset value of US Government securities at end of year2019-12-31$1,578,375
Asset value of US Government securities at beginning of year2019-12-31$1,096,308
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
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
Contributions received in cash from employer2019-12-31$3,658,041
Employer contributions (assets) at end of year2019-12-31$76,647
Employer contributions (assets) at beginning of year2019-12-31$69,777
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$3,490,376
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$2,592,447
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$2,771,656
Contract administrator fees2019-12-31$143,355
Liabilities. Value of benefit claims payable at end of year2019-12-31$405,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$436,000
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$5,531
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$7,204
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
Aggregate proceeds on sale of assets2019-12-31$4,820,718
Aggregate carrying amount (costs) on sale of assets2019-12-31$4,820,600
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31J SCHAEFER & COMPANY LLC
Accountancy firm EIN2019-12-31823706925
2018 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-27,716
Total unrealized appreciation/depreciation of assets2018-12-31$-27,716
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$441,357
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$393,655
Total income from all sources (including contributions)2018-12-31$3,879,143
Total loss/gain on sale of assets2018-12-31$-52,171
Total of all expenses incurred2018-12-31$3,471,961
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$3,215,452
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$3,848,948
Value of total assets at end of year2018-12-31$4,409,010
Value of total assets at beginning of year2018-12-31$3,954,126
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$256,509
Total interest from all sources2018-12-31$110,082
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Assets. Real estate other than employer real property at end of year2018-12-31$0
Assets. Real estate other than employer real property at beginning of year2018-12-31$0
Administrative expenses professional fees incurred2018-12-31$30,007
Assets. Corporate prefeered stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$322,382
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Participant contributions at end of year2018-12-31$7,000
Participant contributions at beginning of year2018-12-31$7,740
Assets. Other investments not covered elsewhere at end of year2018-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$25,605
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$26,088
Assets. Loans (other than to participants) at end of year2018-12-31$0
Assets. Loans (other than to participants) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Administrative expenses (other) incurred2018-12-31$83,184
Liabilities. Value of operating payables at end of year2018-12-31$5,357
Liabilities. Value of operating payables at beginning of year2018-12-31$4,555
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$407,182
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,967,653
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,560,471
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
Assets. partnership/joint venture interests at end of year2018-12-31$0
Assets. partnership/joint venture interests at beginning of year2018-12-31$0
Investment advisory and management fees2018-12-31$10,213
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$0
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
Interest earned on other investments2018-12-31$11,352
Income. Interest from US Government securities2018-12-31$20,541
Income. Interest from corporate debt instruments2018-12-31$77,237
Value of interest in master investment trust accounts at end of year2018-12-31$0
Value of interest in master investment trust accounts at beginning of year2018-12-31$0
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$431,460
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$600,669
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$600,669
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$952
Assets. Value of investments in 103.12 investment entities at end of year2018-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$59,691
Asset value of US Government securities at end of year2018-12-31$1,096,308
Asset value of US Government securities at beginning of year2018-12-31$1,234,085
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
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
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$0
Assets. Value of employer real property at end of year2018-12-31$0
Assets. Value of employer real property at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$3,526,566
Employer contributions (assets) at end of year2018-12-31$69,777
Employer contributions (assets) at beginning of year2018-12-31$79,201
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$3,155,761
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$2,771,656
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$1,999,071
Contract administrator fees2018-12-31$133,105
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$0
Liabilities. Value of benefit claims payable at end of year2018-12-31$436,000
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$389,100
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$7,204
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$7,272
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
Aggregate proceeds on sale of assets2018-12-31$3,900,988
Aggregate carrying amount (costs) on sale of assets2018-12-31$3,953,159
Liabilities. Value of acquisition indebtedness at end of year2018-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2018-12-31$0
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 name2018-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2018-12-31340677006
2017 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$51,629
Total unrealized appreciation/depreciation of assets2017-12-31$51,629
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$393,655
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$310,386
Total income from all sources (including contributions)2017-12-31$3,723,723
Total loss/gain on sale of assets2017-12-31$-56,784
Total of all expenses incurred2017-12-31$3,560,966
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$3,329,418
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,626,145
Value of total assets at end of year2017-12-31$3,954,126
Value of total assets at beginning of year2017-12-31$3,708,100
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$231,548
Total interest from all sources2017-12-31$102,733
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Assets. Real estate other than employer real property at end of year2017-12-31$0
Assets. Real estate other than employer real property at beginning of year2017-12-31$0
Administrative expenses professional fees incurred2017-12-31$28,920
Assets. Corporate prefeered stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2017-12-31$0
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$333,677
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$0
Participant contributions at end of year2017-12-31$7,740
Participant contributions at beginning of year2017-12-31$8,252
Assets. Other investments not covered elsewhere at end of year2017-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$26,088
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$26,644
Assets. Loans (other than to participants) at end of year2017-12-31$0
Assets. Loans (other than to participants) at beginning of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Administrative expenses (other) incurred2017-12-31$82,662
Liabilities. Value of operating payables at end of year2017-12-31$4,555
Liabilities. Value of operating payables at beginning of year2017-12-31$8,986
Total non interest bearing cash at end of year2017-12-31$0
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$162,757
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,560,471
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,397,714
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
Assets. partnership/joint venture interests at end of year2017-12-31$0
Assets. partnership/joint venture interests at beginning of year2017-12-31$0
Investment advisory and management fees2017-12-31$9,372
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$0
Value of interest in pooled separate accounts at end of year2017-12-31$0
Value of interest in pooled separate accounts at beginning of year2017-12-31$0
Interest earned on other investments2017-12-31$5,888
Income. Interest from US Government securities2017-12-31$19,877
Income. Interest from corporate debt instruments2017-12-31$76,491
Value of interest in master investment trust accounts at end of year2017-12-31$0
Value of interest in master investment trust accounts at beginning of year2017-12-31$0
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest in common/collective trusts at beginning of year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$600,669
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$411,424
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$411,424
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$477
Assets. Value of investments in 103.12 investment entities at end of year2017-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$60,221
Asset value of US Government securities at end of year2017-12-31$1,234,085
Asset value of US Government securities at beginning of year2017-12-31$1,061,009
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
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
Assets. Invements in employer securities at end of year2017-12-31$0
Assets. Invements in employer securities at beginning of year2017-12-31$0
Assets. Value of employer real property at end of year2017-12-31$0
Assets. Value of employer real property at beginning of year2017-12-31$0
Contributions received in cash from employer2017-12-31$3,292,468
Employer contributions (assets) at end of year2017-12-31$79,201
Employer contributions (assets) at beginning of year2017-12-31$79,706
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$3,269,197
Asset. Corporate debt instrument preferred debt at end of year2017-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$1,999,071
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$2,100,364
Contract administrator fees2017-12-31$110,594
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$0
Liabilities. Value of benefit claims payable at end of year2017-12-31$389,100
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$301,400
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$7,272
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$20,701
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
Aggregate proceeds on sale of assets2017-12-31$4,934,374
Aggregate carrying amount (costs) on sale of assets2017-12-31$4,991,158
Liabilities. Value of acquisition indebtedness at end of year2017-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2017-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2017-12-31340677006
2016 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$-19,917
Total unrealized appreciation/depreciation of assets2016-12-31$-19,917
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$310,386
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$333,750
Total income from all sources (including contributions)2016-12-31$3,364,801
Total loss/gain on sale of assets2016-12-31$-17,046
Total of all expenses incurred2016-12-31$3,422,924
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,178,275
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$3,292,764
Value of total assets at end of year2016-12-31$3,708,100
Value of total assets at beginning of year2016-12-31$3,789,587
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$244,649
Total interest from all sources2016-12-31$109,000
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Assets. Real estate other than employer real property at end of year2016-12-31$0
Assets. Real estate other than employer real property at beginning of year2016-12-31$0
Administrative expenses professional fees incurred2016-12-31$32,670
Assets. Corporate prefeered stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2016-12-31$0
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$242,860
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$0
Participant contributions at end of year2016-12-31$8,252
Participant contributions at beginning of year2016-12-31$0
Assets. Other investments not covered elsewhere at end of year2016-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$26,644
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$27,636
Assets. Loans (other than to participants) at end of year2016-12-31$0
Assets. Loans (other than to participants) at beginning of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Administrative expenses (other) incurred2016-12-31$90,347
Liabilities. Value of operating payables at end of year2016-12-31$8,986
Liabilities. Value of operating payables at beginning of year2016-12-31$38,250
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-58,123
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,397,714
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,455,837
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
Assets. partnership/joint venture interests at end of year2016-12-31$0
Assets. partnership/joint venture interests at beginning of year2016-12-31$0
Investment advisory and management fees2016-12-31$9,948
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$0
Value of interest in pooled separate accounts at end of year2016-12-31$0
Value of interest in pooled separate accounts at beginning of year2016-12-31$0
Income. Interest from US Government securities2016-12-31$26,063
Income. Interest from corporate debt instruments2016-12-31$82,595
Value of interest in master investment trust accounts at end of year2016-12-31$0
Value of interest in master investment trust accounts at beginning of year2016-12-31$0
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$411,424
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$18,572
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$18,572
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$342
Assets. Value of investments in 103.12 investment entities at end of year2016-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$48,635
Asset value of US Government securities at end of year2016-12-31$1,061,009
Asset value of US Government securities at beginning of year2016-12-31$1,339,454
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
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
Assets. Invements in employer securities at end of year2016-12-31$0
Assets. Invements in employer securities at beginning of year2016-12-31$0
Assets. Value of employer real property at end of year2016-12-31$0
Assets. Value of employer real property at beginning of year2016-12-31$0
Contributions received in cash from employer2016-12-31$3,049,904
Employer contributions (assets) at end of year2016-12-31$79,706
Employer contributions (assets) at beginning of year2016-12-31$59,293
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$3,129,640
Asset. Corporate debt instrument preferred debt at end of year2016-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$2,100,364
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$2,331,615
Contract administrator fees2016-12-31$111,684
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$0
Liabilities. Value of benefit claims payable at end of year2016-12-31$301,400
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$295,500
Assets. Value of buildings and other operty used in plan operation at end of year2016-12-31$20,701
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$13,017
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
Aggregate proceeds on sale of assets2016-12-31$4,776,202
Aggregate carrying amount (costs) on sale of assets2016-12-31$4,793,248
Liabilities. Value of acquisition indebtedness at end of year2016-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2016-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2016-12-31340677006
2015 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-36,199
Total unrealized appreciation/depreciation of assets2015-12-31$-36,199
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$333,750
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$412,356
Total income from all sources (including contributions)2015-12-31$3,063,851
Total loss/gain on sale of assets2015-12-31$-33,935
Total of all expenses incurred2015-12-31$3,561,233
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,325,596
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$3,009,132
Value of total assets at end of year2015-12-31$3,789,587
Value of total assets at beginning of year2015-12-31$4,365,575
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$235,637
Total interest from all sources2015-12-31$124,853
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Assets. Real estate other than employer real property at end of year2015-12-31$0
Assets. Real estate other than employer real property at beginning of year2015-12-31$0
Administrative expenses professional fees incurred2015-12-31$11,455
Assets. Corporate prefeered stocks other than exployer securities at end of year2015-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2015-12-31$0
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$33,835
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$0
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$0
Assets. Other investments not covered elsewhere at end of year2015-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$27,636
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$32,742
Assets. Loans (other than to participants) at end of year2015-12-31$0
Assets. Loans (other than to participants) at beginning of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$0
Administrative expenses (other) incurred2015-12-31$100,454
Liabilities. Value of operating payables at end of year2015-12-31$38,250
Liabilities. Value of operating payables at beginning of year2015-12-31$25,356
Total non interest bearing cash at end of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-497,382
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,455,837
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,953,219
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Assets. partnership/joint venture interests at end of year2015-12-31$0
Assets. partnership/joint venture interests at beginning of year2015-12-31$0
Investment advisory and management fees2015-12-31$9,178
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$0
Value of interest in pooled separate accounts at end of year2015-12-31$0
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Income. Interest from US Government securities2015-12-31$97,603
Income. Interest from corporate debt instruments2015-12-31$27,107
Value of interest in master investment trust accounts at end of year2015-12-31$0
Value of interest in master investment trust accounts at beginning of year2015-12-31$0
Value of interest in common/collective trusts at end of year2015-12-31$0
Value of interest in common/collective trusts at beginning of year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$18,572
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$121,018
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$121,018
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$143
Assets. Value of investments in 103.12 investment entities at end of year2015-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$43,297
Asset value of US Government securities at end of year2015-12-31$1,339,454
Asset value of US Government securities at beginning of year2015-12-31$1,742,646
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Assets. Invements in employer securities at end of year2015-12-31$0
Assets. Invements in employer securities at beginning of year2015-12-31$0
Assets. Value of employer real property at end of year2015-12-31$0
Assets. Value of employer real property at beginning of year2015-12-31$0
Contributions received in cash from employer2015-12-31$2,975,297
Employer contributions (assets) at end of year2015-12-31$59,293
Employer contributions (assets) at beginning of year2015-12-31$100,179
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$3,282,299
Asset. Corporate debt instrument preferred debt at end of year2015-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2015-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$2,331,615
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$2,366,703
Contract administrator fees2015-12-31$114,550
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$0
Liabilities. Value of benefit claims payable at end of year2015-12-31$295,500
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$387,000
Assets. Value of buildings and other operty used in plan operation at end of year2015-12-31$13,017
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-12-31$2,287
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$3,642,431
Aggregate carrying amount (costs) on sale of assets2015-12-31$3,676,366
Liabilities. Value of acquisition indebtedness at end of year2015-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2015-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2015-12-31340677006
2014 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$26,634
Total unrealized appreciation/depreciation of assets2014-12-31$26,634
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$412,356
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$312,472
Total income from all sources (including contributions)2014-12-31$3,120,378
Total loss/gain on sale of assets2014-12-31$-15,194
Total of all expenses incurred2014-12-31$3,628,419
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$3,366,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$2,963,498
Value of total assets at end of year2014-12-31$4,365,575
Value of total assets at beginning of year2014-12-31$4,773,732
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$262,178
Total interest from all sources2014-12-31$145,440
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Assets. Real estate other than employer real property at end of year2014-12-31$0
Assets. Real estate other than employer real property at beginning of year2014-12-31$0
Administrative expenses professional fees incurred2014-12-31$30,990
Assets. Corporate prefeered stocks other than exployer securities at end of year2014-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2014-12-31$0
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$20,994
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$0
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$0
Assets. Other investments not covered elsewhere at end of year2014-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$158,347
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$32,742
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$54,711
Assets. Loans (other than to participants) at end of year2014-12-31$0
Assets. Loans (other than to participants) at beginning of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$0
Administrative expenses (other) incurred2014-12-31$70,105
Liabilities. Value of operating payables at end of year2014-12-31$25,356
Liabilities. Value of operating payables at beginning of year2014-12-31$39,472
Total non interest bearing cash at end of year2014-12-31$0
Total non interest bearing cash at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-508,041
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,953,219
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$4,461,260
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Assets. partnership/joint venture interests at end of year2014-12-31$0
Assets. partnership/joint venture interests at beginning of year2014-12-31$0
Investment advisory and management fees2014-12-31$14,976
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$0
Value of interest in pooled separate accounts at end of year2014-12-31$0
Value of interest in pooled separate accounts at beginning of year2014-12-31$0
Interest earned on other investments2014-12-31$164
Income. Interest from US Government securities2014-12-31$39,395
Income. Interest from corporate debt instruments2014-12-31$105,858
Value of interest in master investment trust accounts at end of year2014-12-31$0
Value of interest in master investment trust accounts at beginning of year2014-12-31$0
Value of interest in common/collective trusts at end of year2014-12-31$0
Value of interest in common/collective trusts at beginning of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$121,018
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$270,226
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$270,226
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$23
Assets. Value of investments in 103.12 investment entities at end of year2014-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$37,631
Asset value of US Government securities at end of year2014-12-31$1,742,646
Asset value of US Government securities at beginning of year2014-12-31$1,915,103
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Assets. Invements in employer securities at end of year2014-12-31$0
Assets. Invements in employer securities at beginning of year2014-12-31$0
Assets. Value of employer real property at end of year2014-12-31$0
Assets. Value of employer real property at beginning of year2014-12-31$0
Contributions received in cash from employer2014-12-31$2,942,504
Employer contributions (assets) at end of year2014-12-31$100,179
Employer contributions (assets) at beginning of year2014-12-31$79,275
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$3,328,610
Asset. Corporate debt instrument preferred debt at end of year2014-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2014-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$2,366,703
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$2,293,366
Contract administrator fees2014-12-31$146,107
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$0
Liabilities. Value of benefit claims payable at end of year2014-12-31$387,000
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$273,000
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$2,287
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$2,704
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$6,129,166
Aggregate carrying amount (costs) on sale of assets2014-12-31$6,144,360
Liabilities. Value of acquisition indebtedness at end of year2014-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2014-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2014-12-31340677006
2013 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$-125,627
Total unrealized appreciation/depreciation of assets2013-12-31$-125,627
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$312,472
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$382,682
Total income from all sources (including contributions)2013-12-31$2,883,270
Total loss/gain on sale of assets2013-12-31$-38,047
Total of all expenses incurred2013-12-31$3,826,402
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$3,595,260
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$2,886,065
Value of total assets at end of year2013-12-31$4,773,732
Value of total assets at beginning of year2013-12-31$5,787,074
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$231,142
Total interest from all sources2013-12-31$160,879
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Assets. Real estate other than employer real property at end of year2013-12-31$0
Assets. Real estate other than employer real property at beginning of year2013-12-31$0
Administrative expenses professional fees incurred2013-12-31$34,847
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$20,143
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$0
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$0
Assets. Other investments not covered elsewhere at end of year2013-12-31$158,347
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$124,312
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$54,711
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$38,786
Assets. Loans (other than to participants) at end of year2013-12-31$0
Assets. Loans (other than to participants) at beginning of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$0
Administrative expenses (other) incurred2013-12-31$68,270
Liabilities. Value of operating payables at end of year2013-12-31$39,472
Liabilities. Value of operating payables at beginning of year2013-12-31$13,682
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-943,132
Value of net assets at end of year (total assets less liabilities)2013-12-31$4,461,260
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$5,404,392
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Assets. partnership/joint venture interests at end of year2013-12-31$0
Assets. partnership/joint venture interests at beginning of year2013-12-31$0
Investment advisory and management fees2013-12-31$13,924
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$0
Value of interest in pooled separate accounts at end of year2013-12-31$0
Value of interest in pooled separate accounts at beginning of year2013-12-31$0
Interest earned on other investments2013-12-31$309
Income. Interest from US Government securities2013-12-31$34,860
Income. Interest from corporate debt instruments2013-12-31$114,590
Value of interest in master investment trust accounts at end of year2013-12-31$0
Value of interest in master investment trust accounts at beginning of year2013-12-31$0
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest in common/collective trusts at beginning of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$270,226
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$367,301
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$367,301
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$11,120
Assets. Value of investments in 103.12 investment entities at end of year2013-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$28,132
Asset value of US Government securities at end of year2013-12-31$1,915,103
Asset value of US Government securities at beginning of year2013-12-31$2,256,245
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Assets. Invements in employer securities at end of year2013-12-31$0
Assets. Invements in employer securities at beginning of year2013-12-31$0
Assets. Value of employer real property at end of year2013-12-31$0
Assets. Value of employer real property at beginning of year2013-12-31$0
Contributions received in cash from employer2013-12-31$2,865,922
Employer contributions (assets) at end of year2013-12-31$79,275
Employer contributions (assets) at beginning of year2013-12-31$76,187
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$3,567,128
Asset. Corporate debt instrument preferred debt at end of year2013-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2013-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$2,293,366
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$2,922,710
Contract administrator fees2013-12-31$114,101
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$0
Liabilities. Value of benefit claims payable at end of year2013-12-31$273,000
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$369,000
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$2,704
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$1,533
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$5,852,705
Aggregate carrying amount (costs) on sale of assets2013-12-31$5,890,752
Liabilities. Value of acquisition indebtedness at end of year2013-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2013-12-31340677006
2012 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$-63,232
Total unrealized appreciation/depreciation of assets2012-12-31$-63,232
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$382,682
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$451,982
Total income from all sources (including contributions)2012-12-31$2,867,244
Total loss/gain on sale of assets2012-12-31$97,295
Total of all expenses incurred2012-12-31$3,397,253
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,179,833
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$2,664,103
Value of total assets at end of year2012-12-31$5,787,074
Value of total assets at beginning of year2012-12-31$6,386,383
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$217,420
Total interest from all sources2012-12-31$169,078
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$0
Assets. Real estate other than employer real property at end of year2012-12-31$0
Assets. Real estate other than employer real property at beginning of year2012-12-31$0
Administrative expenses professional fees incurred2012-12-31$29,237
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$2,123
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$0
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$0
Assets. Other investments not covered elsewhere at end of year2012-12-31$124,312
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$317,601
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$38,786
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$319,001
Assets. Loans (other than to participants) at end of year2012-12-31$0
Assets. Loans (other than to participants) at beginning of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$226,194
Administrative expenses (other) incurred2012-12-31$68,454
Liabilities. Value of operating payables at end of year2012-12-31$13,682
Liabilities. Value of operating payables at beginning of year2012-12-31$10,788
Total non interest bearing cash at end of year2012-12-31$0
Total non interest bearing cash at beginning of year2012-12-31$3,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-530,009
Value of net assets at end of year (total assets less liabilities)2012-12-31$5,404,392
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$5,934,401
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Assets. partnership/joint venture interests at end of year2012-12-31$0
Assets. partnership/joint venture interests at beginning of year2012-12-31$0
Investment advisory and management fees2012-12-31$13,687
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$0
Value of interest in pooled separate accounts at end of year2012-12-31$0
Value of interest in pooled separate accounts at beginning of year2012-12-31$0
Interest earned on other investments2012-12-31$379
Income. Interest from US Government securities2012-12-31$49,427
Income. Interest from corporate debt instruments2012-12-31$105,635
Value of interest in master investment trust accounts at end of year2012-12-31$0
Value of interest in master investment trust accounts at beginning of year2012-12-31$0
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$367,301
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$907,942
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$907,942
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$13,637
Assets. Value of investments in 103.12 investment entities at end of year2012-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$22,253
Asset value of US Government securities at end of year2012-12-31$2,256,245
Asset value of US Government securities at beginning of year2012-12-31$3,861,216
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Assets. Invements in employer securities at end of year2012-12-31$0
Assets. Invements in employer securities at beginning of year2012-12-31$0
Assets. Value of employer real property at end of year2012-12-31$0
Assets. Value of employer real property at beginning of year2012-12-31$0
Contributions received in cash from employer2012-12-31$2,661,980
Employer contributions (assets) at end of year2012-12-31$76,187
Employer contributions (assets) at beginning of year2012-12-31$74,911
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$3,157,580
Asset. Corporate debt instrument preferred debt at end of year2012-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$2,922,710
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$900,201
Contract administrator fees2012-12-31$106,042
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$0
Liabilities. Value of benefit claims payable at end of year2012-12-31$369,000
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$215,000
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$1,533
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$2,511
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$9,473,810
Aggregate carrying amount (costs) on sale of assets2012-12-31$9,376,515
Liabilities. Value of acquisition indebtedness at end of year2012-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2012-12-31340677006
2011 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$117,078
Total unrealized appreciation/depreciation of assets2011-12-31$117,078
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$451,982
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,922,959
Total income from all sources (including contributions)2011-12-31$2,852,129
Total loss/gain on sale of assets2011-12-31$24,431
Total of all expenses incurred2011-12-31$2,438,317
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,228,630
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,552,947
Value of total assets at end of year2011-12-31$6,386,383
Value of total assets at beginning of year2011-12-31$8,443,548
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$209,687
Total interest from all sources2011-12-31$157,364
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$0
Assets. Real estate other than employer real property at end of year2011-12-31$0
Assets. Real estate other than employer real property at beginning of year2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$29,601
Assets. Corporate prefeered stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$3,229
Participant contributions at end of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$0
Participant contributions at end of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$0
Assets. Other investments not covered elsewhere at end of year2011-12-31$317,601
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$254,943
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$319,001
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$2,390,216
Assets. Loans (other than to participants) at end of year2011-12-31$0
Assets. Loans (other than to participants) at beginning of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$226,194
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$2,360,355
Other income not declared elsewhere2011-12-31$309
Administrative expenses (other) incurred2011-12-31$68,978
Liabilities. Value of operating payables at end of year2011-12-31$10,788
Liabilities. Value of operating payables at beginning of year2011-12-31$202,604
Total non interest bearing cash at end of year2011-12-31$3,000
Total non interest bearing cash at beginning of year2011-12-31$3,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$413,812
Value of net assets at end of year (total assets less liabilities)2011-12-31$5,934,401
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$5,520,589
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Assets. partnership/joint venture interests at end of year2011-12-31$0
Assets. partnership/joint venture interests at beginning of year2011-12-31$0
Investment advisory and management fees2011-12-31$6,264
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$0
Value of interest in pooled separate accounts at end of year2011-12-31$0
Value of interest in pooled separate accounts at beginning of year2011-12-31$0
Income. Interest from US Government securities2011-12-31$80,933
Income. Interest from corporate debt instruments2011-12-31$52,766
Value of interest in master investment trust accounts at end of year2011-12-31$0
Value of interest in master investment trust accounts at beginning of year2011-12-31$0
Value of interest in common/collective trusts at end of year2011-12-31$0
Value of interest in common/collective trusts at beginning of year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$907,942
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$960,848
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$960,848
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$23,665
Assets. Value of investments in 103.12 investment entities at end of year2011-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$71,130
Asset value of US Government securities at end of year2011-12-31$3,861,216
Asset value of US Government securities at beginning of year2011-12-31$3,864,139
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Assets. Invements in employer securities at end of year2011-12-31$0
Assets. Invements in employer securities at beginning of year2011-12-31$0
Assets. Value of employer real property at end of year2011-12-31$0
Assets. Value of employer real property at beginning of year2011-12-31$0
Contributions received in cash from employer2011-12-31$2,549,718
Employer contributions (assets) at end of year2011-12-31$74,911
Employer contributions (assets) at beginning of year2011-12-31$223,786
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$2,157,500
Asset. Corporate debt instrument preferred debt at end of year2011-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2011-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$900,201
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$744,520
Contract administrator fees2011-12-31$104,844
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$0
Liabilities. Value of benefit claims payable at end of year2011-12-31$215,000
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$360,000
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$2,511
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$2,096
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$7,194,255
Aggregate carrying amount (costs) on sale of assets2011-12-31$7,169,824
Liabilities. Value of acquisition indebtedness at end of year2011-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2011-12-31340677006
2010 : TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$16,570
Total unrealized appreciation/depreciation of assets2010-12-31$16,570
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$2,922,959
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$309,954
Total income from all sources (including contributions)2010-12-31$2,813,559
Total loss/gain on sale of assets2010-12-31$40,950
Total of all expenses incurred2010-12-31$3,111,034
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,641,698
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$2,569,610
Value of total assets at end of year2010-12-31$8,443,548
Value of total assets at beginning of year2010-12-31$6,128,018
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$469,336
Total interest from all sources2010-12-31$186,429
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$0
Assets. Real estate other than employer real property at end of year2010-12-31$0
Assets. Real estate other than employer real property at beginning of year2010-12-31$0
Administrative expenses professional fees incurred2010-12-31$42,276
Assets. Corporate prefeered stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$9,722
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$254,943
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$109,988
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$2,390,216
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$122,096
Assets. Loans (other than to participants) at end of year2010-12-31$0
Assets. Loans (other than to participants) at beginning of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$2,360,355
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$76,859
Administrative expenses (other) incurred2010-12-31$302,596
Liabilities. Value of operating payables at end of year2010-12-31$202,604
Liabilities. Value of operating payables at beginning of year2010-12-31$27,095
Total non interest bearing cash at end of year2010-12-31$3,000
Total non interest bearing cash at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-297,475
Value of net assets at end of year (total assets less liabilities)2010-12-31$5,520,589
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$5,818,064
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Assets. partnership/joint venture interests at end of year2010-12-31$0
Assets. partnership/joint venture interests at beginning of year2010-12-31$0
Investment advisory and management fees2010-12-31$16,538
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$0
Value of interest in pooled separate accounts at end of year2010-12-31$0
Value of interest in pooled separate accounts at beginning of year2010-12-31$0
Interest earned on other investments2010-12-31$348
Income. Interest from US Government securities2010-12-31$92,906
Income. Interest from corporate debt instruments2010-12-31$60,119
Value of interest in master investment trust accounts at end of year2010-12-31$0
Value of interest in master investment trust accounts at beginning of year2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$960,848
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$1,301,496
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$1,301,496
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$33,056
Assets. Value of investments in 103.12 investment entities at end of year2010-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$68,767
Asset value of US Government securities at end of year2010-12-31$3,864,139
Asset value of US Government securities at beginning of year2010-12-31$3,421,167
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Assets. Invements in employer securities at end of year2010-12-31$0
Assets. Invements in employer securities at beginning of year2010-12-31$0
Assets. Value of employer real property at end of year2010-12-31$0
Assets. Value of employer real property at beginning of year2010-12-31$0
Contributions received in cash from employer2010-12-31$2,559,888
Employer contributions (assets) at end of year2010-12-31$223,786
Employer contributions (assets) at beginning of year2010-12-31$52,755
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,572,931
Asset. Corporate debt instrument preferred debt at end of year2010-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$744,520
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$1,117,023
Contract administrator fees2010-12-31$107,926
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$0
Liabilities. Value of benefit claims payable at end of year2010-12-31$360,000
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$206,000
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$2,096
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$3,493
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$19,303,046
Aggregate carrying amount (costs) on sale of assets2010-12-31$19,262,096
Liabilities. Value of acquisition indebtedness at end of year2010-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2010-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31MALONEY & NOVOTNY LLC
Accountancy firm EIN2010-12-31340677006

Form 5500 Responses for TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN

2022: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entityMulti-employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planYes
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: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
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: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
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: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
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: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
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: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: TEAMSTERS LOCAL 1164 HEALTH & WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 2
Insurance contract or identification number05389R
Number of Individuals Covered325
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $108,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered320
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $20,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered291
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $19,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 2
Insurance contract or identification number05389R
Number of Individuals Covered291
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $96,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered296
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $19,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 2
Insurance contract or identification number05389R
Number of Individuals Covered296
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $86,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 2
Insurance contract or identification number05389R
Number of Individuals Covered285
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $79,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered285
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $19,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered287
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $16,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 3
Insurance contract or identification number05389R
Number of Individuals Covered281
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $60,037
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberG13945
Policy instance 2
Insurance contract or identification numberG13945
Number of Individuals Covered281
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 3
Insurance contract or identification number05389R
Number of Individuals Covered281
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $43,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered278
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $14,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberG13945
Policy instance 2
Insurance contract or identification numberG13945
Number of Individuals Covered281
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 3
Insurance contract or identification number05389R
Number of Individuals Covered294
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $37,677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberG13945
Policy instance 2
Insurance contract or identification numberG13945
Number of Individuals Covered294
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered292
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $14,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 3
Insurance contract or identification number05389R
Number of Individuals Covered296
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $28,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered291
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $14,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberG13945
Policy instance 2
Insurance contract or identification numberG13945
Number of Individuals Covered296
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered289
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $12,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 3
Insurance contract or identification number05389R
Number of Individuals Covered291
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $22,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberG13945
Policy instance 2
Insurance contract or identification numberG13945
Number of Individuals Covered291
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number05389R
Policy instance 3
Insurance contract or identification number05389R
Number of Individuals Covered287
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $81,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberG13945
Policy instance 2
Insurance contract or identification numberG13945
Number of Individuals Covered287
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered281
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $12,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberG13945
Policy instance 2
Insurance contract or identification numberG13945
Number of Individuals Covered309
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG13945
Policy instance 1
Insurance contract or identification numberMG13945
Number of Individuals Covered309
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $12,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number05389R
Policy instance 3
Insurance contract or identification number05389R
Number of Individuals Covered309
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $93,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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