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COOK GROUP HEALTH PLAN 401k Plan overview

Plan NameCOOK GROUP HEALTH PLAN
Plan identification number 501

COOK GROUP HEALTH PLAN Benefits

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

401k Sponsoring company profile

COOK GROUP INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name:COOK GROUP INCORPORATED
Employer identification number (EIN):351084188
NAIC Classification:339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COOK GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01 ROBERT SANTA2023-08-24
5012021-01-01JOHN R. KAMSTRA2022-09-22 JOHN R. KAMSTRA2022-09-22
5012020-01-01ROBERT L. SANTA2021-10-04
5012019-01-01ROBERT L. SANTA2020-08-24
5012018-01-01JOHN R KAMSTRA2019-09-25 JOHN R KAMSTRA2019-09-25
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01RON WYATT
5012013-01-01RON WYATT
5012012-01-01RON WYATT, CPA
5012011-01-01RON WYATT
5012010-01-01RON WYATT
5012009-01-01RON WYATT

Plan Statistics for COOK GROUP HEALTH PLAN

401k plan membership statisitcs for COOK GROUP HEALTH PLAN

Measure Date Value
2022: COOK GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-017,275
Total number of active participants reported on line 7a of the Form 55002022-01-017,328
Number of retired or separated participants receiving benefits2022-01-0130
Total of all active and inactive participants2022-01-017,358
Total participants2022-01-017,358
2021: COOK GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-017,188
Total number of active participants reported on line 7a of the Form 55002021-01-017,213
Number of retired or separated participants receiving benefits2021-01-0162
Total of all active and inactive participants2021-01-017,275
Total participants2021-01-017,275
2020: COOK GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-017,428
Total number of active participants reported on line 7a of the Form 55002020-01-017,188
Number of retired or separated participants receiving benefits2020-01-01149
Total of all active and inactive participants2020-01-017,337
Total participants2020-01-017,337
2019: COOK GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-017,428
Total number of active participants reported on line 7a of the Form 55002019-01-017,428
Number of retired or separated participants receiving benefits2019-01-0132
Total of all active and inactive participants2019-01-017,460
Total participants2019-01-017,460
2018: COOK GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-017,213
Total number of active participants reported on line 7a of the Form 55002018-01-017,405
Number of retired or separated participants receiving benefits2018-01-0135
Total of all active and inactive participants2018-01-017,440
Total participants2018-01-017,440
2017: COOK GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-017,607
Total number of active participants reported on line 7a of the Form 55002017-01-017,148
Number of retired or separated participants receiving benefits2017-01-0135
Total of all active and inactive participants2017-01-017,183
Total participants2017-01-017,183
2016: COOK GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-017,335
Total number of active participants reported on line 7a of the Form 55002016-01-017,513
Number of retired or separated participants receiving benefits2016-01-0131
Total of all active and inactive participants2016-01-017,544
Total participants2016-01-017,544
2015: COOK GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-017,696
Total number of active participants reported on line 7a of the Form 55002015-01-017,197
Number of retired or separated participants receiving benefits2015-01-015
Total of all active and inactive participants2015-01-017,202
Total participants2015-01-017,202
2014: COOK GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-016,971
Total number of active participants reported on line 7a of the Form 55002014-01-016,967
Number of retired or separated participants receiving benefits2014-01-01163
Total of all active and inactive participants2014-01-017,130
2013: COOK GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-016,795
Total number of active participants reported on line 7a of the Form 55002013-01-016,909
Number of retired or separated participants receiving benefits2013-01-01188
Total of all active and inactive participants2013-01-017,097
2012: COOK GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-016,192
Total number of active participants reported on line 7a of the Form 55002012-01-016,583
Number of retired or separated participants receiving benefits2012-01-0135
Total of all active and inactive participants2012-01-016,618
2011: COOK GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-015,999
Total number of active participants reported on line 7a of the Form 55002011-01-016,137
Number of retired or separated participants receiving benefits2011-01-0136
Total of all active and inactive participants2011-01-016,173
2010: COOK GROUP HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-015,649
Total number of active participants reported on line 7a of the Form 55002010-01-015,924
Number of retired or separated participants receiving benefits2010-01-0145
Total of all active and inactive participants2010-01-015,969
2009: COOK GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-015,047
Total number of active participants reported on line 7a of the Form 55002009-01-015,649
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 participants2009-01-015,649

Financial Data on COOK GROUP HEALTH PLAN

Measure Date Value
2022 : COOK GROUP HEALTH PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$7,258,067
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$14,012,426
Total income from all sources (including contributions)2022-12-31$123,361,194
Total of all expenses incurred2022-12-31$117,134,057
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$111,842,407
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$116,373,384
Value of total assets at end of year2022-12-31$7,591,114
Value of total assets at beginning of year2022-12-31$8,118,336
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$5,291,650
Total interest from all sources2022-12-31$1,185
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$17,281,256
Participant contributions at end of year2022-12-31$31,234
Participant contributions at beginning of year2022-12-31$64,137
Assets. Other investments not covered elsewhere at end of year2022-12-31$384,255
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$340,471
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$2,289,141
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$3,352,895
Other income not declared elsewhere2022-12-31$6,986,625
Administrative expenses (other) incurred2022-12-31$391,068
Total non interest bearing cash at end of year2022-12-31$4,680,846
Total non interest bearing cash at beginning of year2022-12-31$4,156,380
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$6,227,137
Value of net assets at end of year (total assets less liabilities)2022-12-31$333,047
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$-5,894,090
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$205,638
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$204,453
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$204,453
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$1,185
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$4,011,232
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
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$99,092,128
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$107,831,175
Contract administrator fees2022-12-31$4,900,582
Liabilities. Value of benefit claims payable at end of year2022-12-31$7,258,067
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$14,012,426
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
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31FORVIS, LLP
Accountancy firm EIN2022-12-31440160260
2021 : COOK GROUP HEALTH PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$14,012,426
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$12,254,297
Total income from all sources (including contributions)2021-12-31$121,299,897
Total of all expenses incurred2021-12-31$120,217,263
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$115,406,775
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$106,655,502
Value of total assets at end of year2021-12-31$8,118,336
Value of total assets at beginning of year2021-12-31$5,277,573
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$4,810,488
Total interest from all sources2021-12-31$20
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$17,506,797
Participant contributions at end of year2021-12-31$64,137
Participant contributions at beginning of year2021-12-31$180,013
Assets. Other investments not covered elsewhere at end of year2021-12-31$340,471
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$228,126
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$3,352,895
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$3,133,528
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$202,897
Other income not declared elsewhere2021-12-31$14,644,375
Administrative expenses (other) incurred2021-12-31$484,428
Total non interest bearing cash at end of year2021-12-31$4,156,380
Total non interest bearing cash at beginning of year2021-12-31$1,531,473
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$1,082,634
Value of net assets at end of year (total assets less liabilities)2021-12-31$-5,894,090
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$-6,976,724
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$204,453
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$204,433
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$204,433
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$20
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$2,720,021
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
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$89,148,705
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$112,686,754
Contract administrator fees2021-12-31$4,326,060
Liabilities. Value of benefit claims payable at end of year2021-12-31$14,012,426
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$12,051,400
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
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31FORVIS, LLP
Accountancy firm EIN2021-12-31440160260
2020 : COOK GROUP HEALTH PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$12,254,297
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$14,051,233
Total income from all sources (including contributions)2020-12-31$110,982,293
Total of all expenses incurred2020-12-31$108,345,748
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$103,236,922
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$103,914,394
Value of total assets at end of year2020-12-31$5,277,573
Value of total assets at beginning of year2020-12-31$4,437,964
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$5,108,826
Total interest from all sources2020-12-31$153
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$17,199,891
Participant contributions at end of year2020-12-31$180,013
Participant contributions at beginning of year2020-12-31$25,836
Assets. Other investments not covered elsewhere at end of year2020-12-31$228,126
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$3,133,528
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$2,593,760
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$202,897
Other income not declared elsewhere2020-12-31$7,067,746
Administrative expenses (other) incurred2020-12-31$499,016
Total non interest bearing cash at end of year2020-12-31$1,531,473
Total non interest bearing cash at beginning of year2020-12-31$1,614,089
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$2,636,545
Value of net assets at end of year (total assets less liabilities)2020-12-31$-6,976,724
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$-9,613,269
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$204,433
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$204,279
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$204,279
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$153
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$2,074,805
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$86,714,503
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$101,162,117
Contract administrator fees2020-12-31$4,609,810
Liabilities. Value of benefit claims payable at end of year2020-12-31$12,051,400
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$14,051,233
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
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BKD LLP
Accountancy firm EIN2020-12-31440160260
2019 : COOK GROUP HEALTH PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$14,051,233
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$9,948,477
Total income from all sources (including contributions)2019-12-31$101,878,102
Total of all expenses incurred2019-12-31$108,086,374
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$103,325,421
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$98,084,625
Value of total assets at end of year2019-12-31$4,437,964
Value of total assets at beginning of year2019-12-31$6,543,480
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$4,760,953
Total interest from all sources2019-12-31$920
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$18,869,641
Participant contributions at end of year2019-12-31$25,836
Participant contributions at beginning of year2019-12-31$19,452
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$2,593,760
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$2,739,289
Other income not declared elsewhere2019-12-31$3,792,557
Administrative expenses (other) incurred2019-12-31$490,883
Total non interest bearing cash at end of year2019-12-31$1,614,089
Total non interest bearing cash at beginning of year2019-12-31$3,581,380
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-6,208,272
Value of net assets at end of year (total assets less liabilities)2019-12-31$-9,613,269
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-3,404,997
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$204,279
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$203,359
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$203,359
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$920
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,828,734
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$79,214,984
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$101,496,687
Contract administrator fees2019-12-31$4,270,070
Liabilities. Value of benefit claims payable at end of year2019-12-31$14,051,233
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$9,948,477
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
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 name2019-12-31BKD LLP
Accountancy firm EIN2019-12-31440160260
2018 : COOK GROUP HEALTH PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$9,948,477
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$8,103,842
Total income from all sources (including contributions)2018-12-31$100,749,665
Total of all expenses incurred2018-12-31$98,285,414
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$94,176,604
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$97,365,696
Value of total assets at end of year2018-12-31$6,543,480
Value of total assets at beginning of year2018-12-31$2,234,594
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$4,108,810
Total interest from all sources2018-12-31$939
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$17,994,566
Participant contributions at end of year2018-12-31$19,452
Participant contributions at beginning of year2018-12-31$25,207
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$2,739,289
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$1,657,424
Other income not declared elsewhere2018-12-31$3,383,030
Administrative expenses (other) incurred2018-12-31$176,706
Total non interest bearing cash at end of year2018-12-31$3,581,380
Total non interest bearing cash at beginning of year2018-12-31$349,543
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$2,464,251
Value of net assets at end of year (total assets less liabilities)2018-12-31$-3,404,997
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$-5,869,248
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$203,359
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$202,420
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$202,420
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$939
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$1,555,339
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$79,371,130
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$92,621,265
Contract administrator fees2018-12-31$3,932,104
Liabilities. Value of benefit claims payable at end of year2018-12-31$9,948,477
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$8,103,842
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BKD LLP
Accountancy firm EIN2018-12-31440160260
2017 : COOK GROUP HEALTH PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$8,103,842
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$7,400,107
Total income from all sources (including contributions)2017-12-31$94,169,035
Total of all expenses incurred2017-12-31$96,809,760
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$92,135,887
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$90,381,267
Value of total assets at end of year2017-12-31$2,234,594
Value of total assets at beginning of year2017-12-31$4,171,584
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$4,673,873
Total interest from all sources2017-12-31$432
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$17,517,111
Participant contributions at end of year2017-12-31$25,207
Participant contributions at beginning of year2017-12-31$14,194
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$1,657,424
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$1,944,541
Other income not declared elsewhere2017-12-31$3,787,336
Administrative expenses (other) incurred2017-12-31$228,964
Total non interest bearing cash at end of year2017-12-31$349,543
Total non interest bearing cash at beginning of year2017-12-31$2,010,861
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-2,640,725
Value of net assets at end of year (total assets less liabilities)2017-12-31$-5,869,248
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-3,228,523
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$202,420
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$201,988
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$201,988
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$432
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$1,083,820
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$72,864,156
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$91,052,067
Contract administrator fees2017-12-31$4,444,909
Liabilities. Value of benefit claims payable at end of year2017-12-31$8,103,842
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$7,400,107
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BKD LLP
Accountancy firm EIN2017-12-31440160260
2016 : COOK GROUP HEALTH PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$7,400,107
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$7,321,699
Total income from all sources (including contributions)2016-12-31$82,875,927
Total of all expenses incurred2016-12-31$83,138,855
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$78,784,890
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$81,259,243
Value of total assets at end of year2016-12-31$4,171,584
Value of total assets at beginning of year2016-12-31$4,356,104
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$4,353,965
Total interest from all sources2016-12-31$20
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$16,308,949
Participant contributions at end of year2016-12-31$14,194
Participant contributions at beginning of year2016-12-31$24,194
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$83,383
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$1,944,541
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$274,745
Other income not declared elsewhere2016-12-31$1,616,664
Administrative expenses (other) incurred2016-12-31$453,110
Total non interest bearing cash at end of year2016-12-31$2,010,861
Total non interest bearing cash at beginning of year2016-12-31$3,771,814
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-262,928
Value of net assets at end of year (total assets less liabilities)2016-12-31$-3,228,523
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-2,965,595
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$201,988
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$201,968
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$201,968
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$20
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$1,130,805
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$64,950,294
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$77,654,085
Contract administrator fees2016-12-31$3,900,855
Liabilities. Value of benefit claims payable at end of year2016-12-31$7,400,107
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$7,321,699
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BKD LLP
Accountancy firm EIN2016-12-31440160260
2015 : COOK GROUP HEALTH PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$7,321,699
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$7,417,896
Total income from all sources (including contributions)2015-12-31$74,884,808
Total of all expenses incurred2015-12-31$74,037,213
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$70,189,217
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$74,097,127
Value of total assets at end of year2015-12-31$4,356,104
Value of total assets at beginning of year2015-12-31$3,604,706
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$3,847,996
Total interest from all sources2015-12-31$20
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$14,859,726
Participant contributions at end of year2015-12-31$24,194
Participant contributions at beginning of year2015-12-31$21,947
Assets. Other investments not covered elsewhere at end of year2015-12-31$83,383
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$274,745
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$605,693
Other income not declared elsewhere2015-12-31$787,661
Administrative expenses (other) incurred2015-12-31$513,409
Total non interest bearing cash at end of year2015-12-31$3,771,814
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$847,595
Value of net assets at end of year (total assets less liabilities)2015-12-31$-2,965,595
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-3,813,190
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$201,968
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$2,977,066
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$2,977,066
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$20
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$982,152
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$59,237,401
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$69,207,065
Contract administrator fees2015-12-31$3,334,587
Liabilities. Value of benefit claims payable at end of year2015-12-31$7,321,699
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$7,417,896
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
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 name2015-12-31BKD LLP
Accountancy firm EIN2015-12-31440160260
2014 : COOK GROUP HEALTH PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$7,417,896
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$7,974,042
Total income from all sources (including contributions)2014-12-31$78,515,317
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$77,010,946
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$77,010,946
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$77,171,410
Value of total assets at end of year2014-12-31$3,604,706
Value of total assets at beginning of year2014-12-31$2,656,481
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$0
Total interest from all sources2014-12-31$20
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
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$15,557,074
Participant contributions at end of year2014-12-31$21,947
Participant contributions at beginning of year2014-12-31$26,082
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$605,693
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$381,200
Other income not declared elsewhere2014-12-31$1,343,887
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$1,504,371
Value of net assets at end of year (total assets less liabilities)2014-12-31$-3,813,190
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-5,317,561
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$2,977,066
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$2,249,199
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$2,249,199
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$20
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$950,036
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$61,614,336
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$76,060,910
Liabilities. Value of benefit claims payable at end of year2014-12-31$7,417,896
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$7,974,042
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31RON WYATT, CPA
Accountancy firm EIN2014-12-31351477987
2013 : COOK GROUP HEALTH PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$7,974,042
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$6,028,549
Total income from all sources (including contributions)2013-12-31$73,508,727
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$77,578,788
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$77,578,750
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$72,158,741
Value of total assets at end of year2013-12-31$2,656,481
Value of total assets at beginning of year2013-12-31$4,781,049
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$38
Total interest from all sources2013-12-31$20
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
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$14,039,764
Participant contributions at end of year2013-12-31$26,082
Participant contributions at beginning of year2013-12-31$26,541
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$381,200
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$1,518,456
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$0
Other income not declared elsewhere2013-12-31$1,349,966
Administrative expenses (other) incurred2013-12-31$38
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-4,070,061
Value of net assets at end of year (total assets less liabilities)2013-12-31$-5,317,561
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-1,247,500
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$2,249,199
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$3,236,052
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$3,236,052
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$20
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$956,480
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$58,118,977
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$76,622,270
Liabilities. Value of benefit claims payable at end of year2013-12-31$7,974,042
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$6,028,549
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31RON WYATT, CPA
Accountancy firm EIN2013-12-31351477987
2012 : COOK GROUP HEALTH PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$6,028,549
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$5,178,565
Total income from all sources (including contributions)2012-12-31$69,620,434
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$66,471,319
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$66,471,303
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$67,611,803
Value of total assets at end of year2012-12-31$4,781,049
Value of total assets at beginning of year2012-12-31$781,950
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$16
Total interest from all sources2012-12-31$20
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
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$12,539,248
Participant contributions at end of year2012-12-31$26,541
Participant contributions at beginning of year2012-12-31$19,467
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$1,518,456
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$560,596
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$88,618
Other income not declared elsewhere2012-12-31$2,008,611
Administrative expenses (other) incurred2012-12-31$16
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$3,149,115
Value of net assets at end of year (total assets less liabilities)2012-12-31$-1,247,500
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-4,396,615
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$3,236,052
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$201,887
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$201,887
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$20
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$695,597
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$55,072,555
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$65,775,706
Liabilities. Value of benefit claims payable at end of year2012-12-31$6,028,549
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$5,089,947
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31RON WYATT, CPA
Accountancy firm EIN2012-12-31351477987
2011 : COOK GROUP HEALTH PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$5,178,565
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$7,209,173
Total income from all sources (including contributions)2011-12-31$62,613,472
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$61,334,824
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$61,321,850
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$60,706,692
Value of total assets at end of year2011-12-31$781,950
Value of total assets at beginning of year2011-12-31$1,533,910
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$12,974
Total interest from all sources2011-12-31$1,755
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
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$10,965,828
Participant contributions at end of year2011-12-31$19,467
Participant contributions at beginning of year2011-12-31$24,633
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$560,596
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$456,017
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$88,618
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$2,000,000
Other income not declared elsewhere2011-12-31$1,905,025
Administrative expenses (other) incurred2011-12-31$12,974
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$1,278,648
Value of net assets at end of year (total assets less liabilities)2011-12-31$-4,396,615
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-5,675,263
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$201,887
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$1,053,260
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$1,053,260
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,755
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$220,436
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$49,740,864
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$61,101,414
Liabilities. Value of benefit claims payable at end of year2011-12-31$5,089,947
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$5,209,173
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31RON WYATT, CPA
Accountancy firm EIN2011-12-31351477987
2010 : COOK GROUP HEALTH PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$7,209,173
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$3,551,987
Total income from all sources (including contributions)2010-12-31$49,417,134
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$52,789,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$52,771,917
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$48,289,431
Value of total assets at end of year2010-12-31$1,533,910
Value of total assets at beginning of year2010-12-31$1,249,250
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$17,744
Total interest from all sources2010-12-31$5,306
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
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$9,493,251
Participant contributions at end of year2010-12-31$24,633
Participant contributions at beginning of year2010-12-31$11,540
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$456,017
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$170,800
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$2,000,000
Other income not declared elsewhere2010-12-31$1,122,397
Administrative expenses (other) incurred2010-12-31$17,744
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-3,372,527
Value of net assets at end of year (total assets less liabilities)2010-12-31$-5,675,263
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-2,302,737
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,053,260
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$1,066,910
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$1,066,910
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$5,306
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$540,274
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$38,796,180
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$52,231,643
Liabilities. Value of benefit claims payable at end of year2010-12-31$5,209,173
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$3,551,987
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31RON WYATT, CPA
Accountancy firm EIN2010-12-31351477987

Form 5500 Responses for COOK GROUP HEALTH PLAN

2022: COOK GROUP HEALTH PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
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: COOK GROUP HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
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: COOK GROUP HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: COOK GROUP HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: COOK GROUP HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: COOK GROUP HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: COOK GROUP HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: COOK GROUP HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: COOK GROUP HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle 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 planNo
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: COOK GROUP HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle 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 planNo
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: COOK GROUP HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle 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 planNo
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: COOK GROUP HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle 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 planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: COOK GROUP HEALTH PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: COOK GROUP HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle 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 planNo
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

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number949355
Policy instance 1
Insurance contract or identification number949355
Number of Individuals Covered4095
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $80,000
Welfare Benefit Premiums Paid to CarrierUSD $4,011,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees80000
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 1
Insurance contract or identification numberEXRK
Number of Individuals Covered14791
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $50,000
Total amount of fees paid to insurance companyUSD $136,001
Welfare Benefit Premiums Paid to CarrierUSD $2,720,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees136001
Additional information about fees paid to insurance brokerADMINISTRATION FEE
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $50,000
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 1
Insurance contract or identification numberEXRK
Number of Individuals Covered11478
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $22,500
Total amount of fees paid to insurance companyUSD $103,740
Welfare Benefit Premiums Paid to CarrierUSD $2,074,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees103740
Additional information about fees paid to insurance brokerADMINISTRATION FEE
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $22,500
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 1
Insurance contract or identification numberEXRK
Number of Individuals Covered15298
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $30,000
Welfare Benefit Premiums Paid to CarrierUSD $1,828,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,000
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68626-3
Policy instance 1
Insurance contract or identification number68626-3
Number of Individuals Covered14940
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $30,000
Welfare Benefit Premiums Paid to CarrierUSD $1,555,339
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,000
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68626-3
Policy instance 1
Insurance contract or identification number68626-3
Number of Individuals Covered14587
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $30,000
Welfare Benefit Premiums Paid to CarrierUSD $1,083,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,000
Insurance broker organization code?3
Insurance broker nameM-J INSURANCE, INC
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68626-3
Policy instance 1
Insurance contract or identification number68626-3
Number of Individuals Covered6687
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Welfare Benefit Premiums Paid to CarrierUSD $982,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberMSL 3702344
Policy instance 1
Insurance contract or identification numberMSL 3702344
Number of Individuals Covered6767
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 $950,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberMSL 3702344
Policy instance 1
Insurance contract or identification numberMSL 3702344
Number of Individuals Covered6705
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 $956,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberMSL 3702344
Policy instance 1
Insurance contract or identification numberMSL 3702344
Number of Individuals Covered6509
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $13,911
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $695,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,911
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMJ INSURANCE, INC.
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberMSL 3702344
Policy instance 1
Insurance contract or identification numberMSL 3702344
Number of Individuals Covered6167
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,409
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $220,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number067624
Policy instance 2
Insurance contract or identification number067624
Number of Individuals Covered1277
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number067624
Policy instance 2
Insurance contract or identification number067624
Number of Individuals Covered1193
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberMSL 3702344
Policy instance 1
Insurance contract or identification numberMSL 3702344
Number of Individuals Covered5834
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $91,847
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $540,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $91,847
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMJ INSURANCE, INC.

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