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THE IMG HEALTH BENEFIT PLAN 401k Plan overview

Plan NameTHE IMG HEALTH BENEFIT PLAN
Plan identification number 501

THE IMG HEALTH 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)
  • Long-term disability cover

401k Sponsoring company profile

INTERNATIONAL MEDICAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:INTERNATIONAL MEDICAL GROUP, INC.
Employer identification number (EIN):351785962
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Additional information about INTERNATIONAL MEDICAL GROUP, INC.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1999-12-28
Company Identification Number: 602001300
Legal Registered Office Address: 9612 17TH AVE SW # 23

SEATTLE
United States of America (USA)
98106

More information about INTERNATIONAL MEDICAL GROUP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE IMG HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01CHAD SECRIST2021-09-22 MATT ALBER2021-09-22
5012019-01-01CHAD SECRIST2020-10-15 MATT ALBER2020-10-15
5012018-07-01CHAD SECRIST2020-10-15 MATT ALBER2020-10-15
5012017-07-01
5012016-07-01KURT F. KIPFER
5012015-07-01KURT F. KIPFER STACIE ELLIOTT2017-04-11
5012014-07-01KURT F. KIPFER STACIE ELLIOTT2016-04-14
5012013-07-01KAREN A. MAXEY KURT F. KIPFER2015-01-30
5012012-07-01KAREN A. MAXEY KURT F. KIPFER2014-04-14
5012011-07-01KAREN A. MAXEY KURT F. KIPFER2013-02-07
5012010-07-01KAREN A. MAXEY KURT F. KIPFER2012-01-11
5012009-07-01KAREN A. MAXEY KURT F. KIPFER2011-01-07

Plan Statistics for THE IMG HEALTH BENEFIT PLAN

401k plan membership statisitcs for THE IMG HEALTH BENEFIT PLAN

Measure Date Value
2022: THE IMG HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01266
Total number of active participants reported on line 7a of the Form 55002022-01-010
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 participants2022-01-010
2021: THE IMG HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01328
Total number of active participants reported on line 7a of the Form 55002021-01-01265
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01266
2020: THE IMG HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01301
Total number of active participants reported on line 7a of the Form 55002020-01-01328
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 participants2020-01-01328
2019: THE IMG HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01290
Total number of active participants reported on line 7a of the Form 55002019-01-01301
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 participants2019-01-01301
2018: THE IMG HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01278
Total number of active participants reported on line 7a of the Form 55002018-07-01284
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-016
Total of all active and inactive participants2018-07-01290
2017: THE IMG HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01269
Total number of active participants reported on line 7a of the Form 55002017-07-01279
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01279
2016: THE IMG HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01249
Total number of active participants reported on line 7a of the Form 55002016-07-01265
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01265
2015: THE IMG HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01244
Total number of active participants reported on line 7a of the Form 55002015-07-01251
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01251
2014: THE IMG HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01221
Total number of active participants reported on line 7a of the Form 55002014-07-01237
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01237
2013: THE IMG HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01232
Total number of active participants reported on line 7a of the Form 55002013-07-01221
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01221
2012: THE IMG HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01231
Total number of active participants reported on line 7a of the Form 55002012-07-01233
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01233
2011: THE IMG HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01223
Total number of active participants reported on line 7a of the Form 55002011-07-01232
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01232
2010: THE IMG HEALTH BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-01227
Total number of active participants reported on line 7a of the Form 55002010-07-01220
Number of retired or separated participants receiving benefits2010-07-013
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01223
2009: THE IMG HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01229
Total number of active participants reported on line 7a of the Form 55002009-07-01221
Number of retired or separated participants receiving benefits2009-07-016
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01227
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-01227

Financial Data on THE IMG HEALTH BENEFIT PLAN

Measure Date Value
2022 : THE IMG HEALTH BENEFIT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$4,470,906
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$4,759,885
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$4,516,498
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$4,470,906
Value of total assets at end of year2022-12-31$0
Value of total assets at beginning of year2022-12-31$288,979
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$243,387
Total interest from all sources2022-12-31$0
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 year2022-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2022-12-31$0
Administrative expenses professional fees incurred2022-12-31$197,255
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,258,133
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Administrative expenses (other) incurred2022-12-31$8,535
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$288,979
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-288,979
Value of net assets at end of year (total assets less liabilities)2022-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$288,979
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 in registered invesment companies (eg mutual funds) at end of year2022-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$1,625,700
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$3,212,773
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,890,798
Contract administrator fees2022-12-31$37,597
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31Yes
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2022-12-31351090346
2021 : THE IMG HEALTH BENEFIT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$4,884,046
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$4,731,330
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$4,475,369
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$4,884,046
Value of total assets at end of year2021-12-31$288,979
Value of total assets at beginning of year2021-12-31$136,263
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$255,961
Total interest from all sources2021-12-31$0
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$205,519
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,176,002
Assets. Other investments not covered elsewhere at end of year2021-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Administrative expenses (other) incurred2021-12-31$12,456
Total non interest bearing cash at end of year2021-12-31$288,979
Total non interest bearing cash at beginning of year2021-12-31$136,263
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$152,716
Value of net assets at end of year (total assets less liabilities)2021-12-31$288,979
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$136,263
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 in registered invesment companies (eg mutual funds) at end of year2021-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,509,799
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$3,708,044
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$2,965,570
Contract administrator fees2021-12-31$37,986
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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 name2021-12-31KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2021-12-31351090346
2020 : THE IMG HEALTH BENEFIT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$5,320,695
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$5,282,089
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$5,021,905
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$5,320,695
Value of total assets at end of year2020-12-31$136,263
Value of total assets at beginning of year2020-12-31$97,657
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$260,184
Total interest from all sources2020-12-31$0
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$217,004
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,262,469
Administrative expenses (other) incurred2020-12-31$43,180
Total non interest bearing cash at end of year2020-12-31$136,263
Total non interest bearing cash at beginning of year2020-12-31$97,657
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$38,606
Value of net assets at end of year (total assets less liabilities)2020-12-31$136,263
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$97,657
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,603,069
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$4,058,226
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$3,418,836
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31GREENWALT CPAS, INC.
Accountancy firm EIN2020-12-31351489521
2019 : THE IMG HEALTH BENEFIT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$5,362,221
Total income from all sources (including contributions)2019-12-31$5,362,221
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$5,478,545
Total of all expenses incurred2019-12-31$5,478,545
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$5,276,899
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$5,276,899
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,362,221
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,362,221
Value of total assets at end of year2019-12-31$97,657
Value of total assets at end of year2019-12-31$97,657
Value of total assets at beginning of year2019-12-31$213,981
Value of total assets at beginning of year2019-12-31$213,981
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$201,646
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$201,646
Total interest from all sources2019-12-31$0
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
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
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$201,646
Administrative expenses professional fees incurred2019-12-31$201,646
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,363,822
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$940,893
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$940,893
Total non interest bearing cash at end of year2019-12-31$97,657
Total non interest bearing cash at end of year2019-12-31$97,657
Total non interest bearing cash at beginning of year2019-12-31$213,981
Total non interest bearing cash at beginning of year2019-12-31$213,981
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-116,324
Value of net income/loss2019-12-31$-116,324
Value of net assets at end of year (total assets less liabilities)2019-12-31$97,657
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$213,981
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$213,981
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$866,807
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$866,807
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$3,998,399
Contributions received in cash from employer2019-12-31$3,998,399
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$3,469,199
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$3,469,199
Did the plan have assets held for investment2019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31GREENWALT CPAS, INC.
Accountancy firm name2019-12-31GREENWALT CPAS, INC.
Accountancy firm EIN2019-12-31351489521
2018 : THE IMG HEALTH BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,963,789
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,678,552
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,538,469
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,963,789
Value of total assets at end of year2018-12-31$213,981
Value of total assets at beginning of year2018-12-31$-71,256
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$140,083
Total interest from all sources2018-12-31$0
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
Administrative expenses professional fees incurred2018-12-31$140,083
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$353,627
Total non interest bearing cash at end of year2018-12-31$213,981
Total non interest bearing cash at beginning of year2018-12-31$-71,256
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$285,237
Value of net assets at end of year (total assets less liabilities)2018-12-31$213,981
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$-71,256
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$216,993
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$1,610,162
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,321,476
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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 name2018-12-31GREENWALT CPAS, INC.
Accountancy firm EIN2018-12-31351489521
Total unrealized appreciation/depreciation of assets2018-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total income from all sources (including contributions)2018-06-30$4,005,001
Total loss/gain on sale of assets2018-06-30$0
Total of all expenses incurred2018-06-30$5,038,883
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-06-30$4,770,272
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-06-30$4,005,001
Value of total assets at end of year2018-06-30$-71,256
Value of total assets at beginning of year2018-06-30$962,626
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-06-30$268,611
Total interest from all sources2018-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2018-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Administrative expenses professional fees incurred2018-06-30$10,700
Was this plan covered by a fidelity bond2018-06-30Yes
Value of fidelity bond cover2018-06-30$500,000
If this is an individual account plan, was there a blackout period2018-06-30No
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Contributions received from participants2018-06-30$595,662
Assets. Other investments not covered elsewhere at end of year2018-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2018-06-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-06-30$96,719
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-06-30$0
Administrative expenses (other) incurred2018-06-30$85,776
Total non interest bearing cash at end of year2018-06-30$-71,256
Total non interest bearing cash at beginning of year2018-06-30$962,626
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net income/loss2018-06-30$-1,033,882
Value of net assets at end of year (total assets less liabilities)2018-06-30$-71,256
Value of net assets at beginning of year (total assets less liabilities)2018-06-30$962,626
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-06-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-06-30$368,804
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30No
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Contributions received in cash from employer2018-06-30$3,409,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-06-30$4,304,749
Contract administrator fees2018-06-30$172,135
Did the plan have assets held for investment2018-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-06-30No
Opinion of an independent qualified public accountant for this plan2018-06-30Unqualified
Accountancy firm name2018-06-30KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2018-06-30351090346
2017 : THE IMG HEALTH BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total income from all sources (including contributions)2017-06-30$3,723,031
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$3,540,333
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$3,329,273
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$3,723,031
Value of total assets at end of year2017-06-30$962,626
Value of total assets at beginning of year2017-06-30$779,928
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$211,060
Total interest from all sources2017-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Administrative expenses professional fees incurred2017-06-30$13,420
Was this plan covered by a fidelity bond2017-06-30Yes
Value of fidelity bond cover2017-06-30$500,000
If this is an individual account plan, was there a blackout period2017-06-30No
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Contributions received from participants2017-06-30$646,295
Assets. Other investments not covered elsewhere at end of year2017-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2017-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-06-30$0
Administrative expenses (other) incurred2017-06-30$50,582
Total non interest bearing cash at end of year2017-06-30$962,626
Total non interest bearing cash at beginning of year2017-06-30$779,928
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net income/loss2017-06-30$182,698
Value of net assets at end of year (total assets less liabilities)2017-06-30$962,626
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$779,928
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-06-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2017-06-30$319,542
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Contributions received in cash from employer2017-06-30$3,076,736
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-06-30$3,009,731
Contract administrator fees2017-06-30$147,058
Did the plan have assets held for investment2017-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-06-30No
Opinion of an independent qualified public accountant for this plan2017-06-30Unqualified
Accountancy firm name2017-06-30KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2017-06-30351090346
2016 : THE IMG HEALTH BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total income from all sources (including contributions)2016-06-30$3,946,554
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$3,998,107
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$3,822,523
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$3,946,554
Value of total assets at end of year2016-06-30$779,928
Value of total assets at beginning of year2016-06-30$831,481
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$175,584
Total interest from all sources2016-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Administrative expenses professional fees incurred2016-06-30$9,680
Was this plan covered by a fidelity bond2016-06-30Yes
Value of fidelity bond cover2016-06-30$500,000
If this is an individual account plan, was there a blackout period2016-06-30No
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Contributions received from participants2016-06-30$750,407
Assets. Other investments not covered elsewhere at end of year2016-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2016-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-06-30$0
Administrative expenses (other) incurred2016-06-30$42,195
Total non interest bearing cash at end of year2016-06-30$779,928
Total non interest bearing cash at beginning of year2016-06-30$831,481
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$-51,553
Value of net assets at end of year (total assets less liabilities)2016-06-30$779,928
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$831,481
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-06-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2016-06-30$269,141
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Contributions received in cash from employer2016-06-30$3,196,147
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-06-30$3,553,382
Contract administrator fees2016-06-30$123,709
Did the plan have assets held for investment2016-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-06-30No
Opinion of an independent qualified public accountant for this plan2016-06-30Unqualified
Accountancy firm name2016-06-30KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2016-06-30351090346
2015 : THE IMG HEALTH BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$0
Total income from all sources (including contributions)2015-06-30$4,172,130
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$3,398,026
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$3,214,778
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$4,172,130
Value of total assets at end of year2015-06-30$831,481
Value of total assets at beginning of year2015-06-30$57,377
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$183,248
Total interest from all sources2015-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Administrative expenses professional fees incurred2015-06-30$11,200
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$500,000
If this is an individual account plan, was there a blackout period2015-06-30No
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Contributions received from participants2015-06-30$642,705
Assets. Other investments not covered elsewhere at end of year2015-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2015-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-06-30$0
Administrative expenses (other) incurred2015-06-30$38,427
Total non interest bearing cash at end of year2015-06-30$831,481
Total non interest bearing cash at beginning of year2015-06-30$57,377
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$774,104
Value of net assets at end of year (total assets less liabilities)2015-06-30$831,481
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$57,377
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-06-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2015-06-30$224,986
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Contributions received in cash from employer2015-06-30$3,529,425
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$2,989,792
Contract administrator fees2015-06-30$133,621
Did the plan have assets held for investment2015-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30No
Opinion of an independent qualified public accountant for this plan2015-06-30Unqualified
Accountancy firm name2015-06-30KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2015-06-30351090346
2014 : THE IMG HEALTH BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total income from all sources (including contributions)2014-06-30$3,431,091
Total loss/gain on sale of assets2014-06-30$0
Total of all expenses incurred2014-06-30$3,510,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$3,346,256
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$3,350,231
Value of total assets at end of year2014-06-30$57,377
Value of total assets at beginning of year2014-06-30$136,696
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$164,154
Total interest from all sources2014-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Administrative expenses professional fees incurred2014-06-30$15,750
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$500,000
If this is an individual account plan, was there a blackout period2014-06-30No
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Contributions received from participants2014-06-30$522,452
Assets. Other investments not covered elsewhere at end of year2014-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2014-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-06-30$86,499
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-06-30$0
Other income not declared elsewhere2014-06-30$80,860
Administrative expenses (other) incurred2014-06-30$15,609
Liabilities. Value of operating payables at end of year2014-06-30$0
Liabilities. Value of operating payables at beginning of year2014-06-30$0
Total non interest bearing cash at end of year2014-06-30$57,377
Total non interest bearing cash at beginning of year2014-06-30$48,673
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$-79,319
Value of net assets at end of year (total assets less liabilities)2014-06-30$57,377
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$136,696
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-06-30$1,524
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-06-30$1,524
Expenses. Payments to insurance carriers foe the provision of benefits2014-06-30$240,014
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$2,827,779
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$3,106,242
Contract administrator fees2014-06-30$132,795
Did the plan have assets held for investment2014-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30No
Opinion of an independent qualified public accountant for this plan2014-06-30Unqualified
Accountancy firm name2014-06-30KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2014-06-30351090346
2013 : THE IMG HEALTH BENEFIT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$82,847
Total income from all sources (including contributions)2013-06-30$3,073,124
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$3,202,701
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$3,047,640
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$2,843,197
Value of total assets at end of year2013-06-30$136,696
Value of total assets at beginning of year2013-06-30$349,120
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$155,061
Total interest from all sources2013-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$6,656
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-06-30$6,656
Administrative expenses professional fees incurred2013-06-30$10,200
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$500,000
If this is an individual account plan, was there a blackout period2013-06-30No
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Contributions received from participants2013-06-30$394,269
Assets. Other investments not covered elsewhere at end of year2013-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2013-06-30$54,902
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-06-30$86,499
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-06-30$0
Other income not declared elsewhere2013-06-30$217,974
Administrative expenses (other) incurred2013-06-30$49,429
Liabilities. Value of operating payables at end of year2013-06-30$0
Liabilities. Value of operating payables at beginning of year2013-06-30$82,847
Total non interest bearing cash at end of year2013-06-30$48,673
Total non interest bearing cash at beginning of year2013-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$-129,577
Value of net assets at end of year (total assets less liabilities)2013-06-30$136,696
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$266,273
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$189,079
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-06-30$1,524
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-06-30$105,139
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-06-30$105,139
Expenses. Payments to insurance carriers foe the provision of benefits2013-06-30$217,224
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-06-30$5,297
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30Yes
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$2,448,928
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$2,830,416
Contract administrator fees2013-06-30$95,432
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30No
Opinion of an independent qualified public accountant for this plan2013-06-30Unqualified
Accountancy firm name2013-06-30KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2013-06-30351090346
2012 : THE IMG HEALTH BENEFIT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$82,847
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total income from all sources (including contributions)2012-06-30$2,632,231
Total loss/gain on sale of assets2012-06-30$0
Total of all expenses incurred2012-06-30$3,008,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$2,832,576
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$2,468,625
Value of total assets at end of year2012-06-30$349,120
Value of total assets at beginning of year2012-06-30$642,780
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$176,162
Total interest from all sources2012-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$15,949
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-06-30$15,949
Administrative expenses professional fees incurred2012-06-30$10,275
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$500,000
If this is an individual account plan, was there a blackout period2012-06-30No
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Contributions received from participants2012-06-30$387,349
Assets. Other investments not covered elsewhere at end of year2012-06-30$54,902
Assets. Other investments not covered elsewhere at beginning of year2012-06-30$87,787
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-06-30$0
Other income not declared elsewhere2012-06-30$157,159
Administrative expenses (other) incurred2012-06-30$75,143
Liabilities. Value of operating payables at end of year2012-06-30$82,847
Liabilities. Value of operating payables at beginning of year2012-06-30$0
Total non interest bearing cash at end of year2012-06-30$0
Total non interest bearing cash at beginning of year2012-06-30$110,311
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$-376,507
Value of net assets at end of year (total assets less liabilities)2012-06-30$266,273
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$642,780
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$189,079
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-06-30$441,835
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-06-30$105,139
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-06-30$2,847
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-06-30$2,847
Expenses. Payments to insurance carriers foe the provision of benefits2012-06-30$182,205
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-06-30$-9,502
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30Yes
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$2,081,276
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$2,650,371
Contract administrator fees2012-06-30$90,744
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30No
Opinion of an independent qualified public accountant for this plan2012-06-30Unqualified
Accountancy firm name2012-06-30KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2012-06-30351090346
2011 : THE IMG HEALTH BENEFIT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$3,266
Total income from all sources (including contributions)2011-06-30$3,089,401
Total loss/gain on sale of assets2011-06-30$34,977
Total of all expenses incurred2011-06-30$2,938,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$2,775,222
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$2,988,972
Value of total assets at end of year2011-06-30$642,780
Value of total assets at beginning of year2011-06-30$494,693
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$162,826
Total interest from all sources2011-06-30$57
Total dividends received (eg from common stock, registered investment company shares)2011-06-30$18,766
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2011-06-30$18,766
Administrative expenses professional fees incurred2011-06-30$11,875
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$500,000
If this is an individual account plan, was there a blackout period2011-06-30No
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Contributions received from participants2011-06-30$448,336
Assets. Other investments not covered elsewhere at end of year2011-06-30$87,787
Assets. Other investments not covered elsewhere at beginning of year2011-06-30$25,124
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-06-30$3,266
Administrative expenses (other) incurred2011-06-30$78,967
Total non interest bearing cash at end of year2011-06-30$110,311
Total non interest bearing cash at beginning of year2011-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$151,353
Value of net assets at end of year (total assets less liabilities)2011-06-30$642,780
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$491,427
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-06-30$441,835
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-06-30$461,988
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-06-30$2,847
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-06-30$7,581
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-06-30$7,581
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-06-30$57
Expenses. Payments to insurance carriers foe the provision of benefits2011-06-30$151,856
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-06-30$46,629
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30Yes
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$2,540,636
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$2,623,366
Contract administrator fees2011-06-30$71,984
Did the plan have assets held for investment2011-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Aggregate proceeds on sale of assets2011-06-30$337,179
Aggregate carrying amount (costs) on sale of assets2011-06-30$302,202
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30No
Opinion of an independent qualified public accountant for this plan2011-06-30Unqualified
Accountancy firm name2011-06-30KATZ, SAPPER & MILLER, LLP
Accountancy firm EIN2011-06-30351090346

Form 5500 Responses for THE IMG HEALTH BENEFIT PLAN

2022: THE IMG HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingYes
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
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: THE IMG HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle 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 planNo
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: THE IMG HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle 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 planNo
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: THE IMG HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle 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 planNo
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: THE IMG HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes
2017: THE IMG HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: THE IMG HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: THE IMG HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: THE IMG HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: THE IMG HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: THE IMG HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: THE IMG HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2010: THE IMG HEALTH BENEFIT PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement - TrustYes
2009: THE IMG HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number61907
Policy instance 4
Insurance contract or identification number61907
Number of Individuals Covered341
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,940
Total amount of fees paid to insurance companyUSD $68
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, FAMILY LEAVE
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 $139,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,940
Insurance broker organization code?3
Amount paid for insurance broker fees68
Additional information about fees paid to insurance brokerFEES
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10102171001
Policy instance 3
Insurance contract or identification number10102171001
Number of Individuals Covered341
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 BenefitYes
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 $33,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number0001111
Policy instance 2
Insurance contract or identification number0001111
Number of Individuals Covered341
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 BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberIN2109
Policy instance 1
Insurance contract or identification numberIN2109
Number of Individuals Covered341
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 $200,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number0001111
Policy instance 2
Insurance contract or identification number0001111
Number of Individuals Covered532
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 BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10102171001
Policy instance 3
Insurance contract or identification number10102171001
Number of Individuals Covered462
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 BenefitYes
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 $29,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number61907
Policy instance 4
Insurance contract or identification number61907
Number of Individuals Covered303
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,354
Total amount of fees paid to insurance companyUSD $61
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, FAMILY LEAVE
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 $151,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,354
Insurance broker organization code?3
Amount paid for insurance broker fees61
Additional information about fees paid to insurance brokerFEES
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberIN2109
Policy instance 1
Insurance contract or identification numberIN2109
Number of Individuals Covered265
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 $439,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberIN2109
Policy instance 1
Insurance contract or identification numberIN2109
Number of Individuals Covered284
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 $428,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number0001111
Policy instance 3
Insurance contract or identification number0001111
Number of Individuals Covered574
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 BenefitYes
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
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number61907
Policy instance 4
Insurance contract or identification number61907
Number of Individuals Covered328
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,087
Total amount of fees paid to insurance companyUSD $69
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D; FAMILY LEAVE
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 $108,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,087
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10102171001
Policy instance 2
Insurance contract or identification number10102171001
Number of Individuals Covered429
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 BenefitYes
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 $33,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number0001111
Policy instance 3
Insurance contract or identification number0001111
Number of Individuals Covered556
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 BenefitYes
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
Insurance broker organization code?3
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberIN2109
Policy instance 1
Insurance contract or identification numberIN2109
Number of Individuals Covered296
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 $366,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10102171001
Policy instance 2
Insurance contract or identification number10102171001
Number of Individuals Covered467
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 BenefitYes
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 $26,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number0001111
Policy instance 3
Insurance contract or identification number0001111
Number of Individuals Covered531
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 BenefitYes
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
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10102171001
Policy instance 2
Insurance contract or identification number10102171001
Number of Individuals Covered431
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 BenefitYes
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 $27,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number000646-18
Policy instance 1
Insurance contract or identification number000646-18
Number of Individuals Covered292
Insurance policy start date2018-07-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $14,034
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $200,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,034
Insurance broker organization code?3
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number000646-17
Policy instance 1
Insurance contract or identification number000646-17
Number of Individuals Covered279
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $25,816
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $368,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number000646-15
Policy instance 1
Insurance contract or identification number000646-15
Number of Individuals Covered251
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $19,011
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 $269,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,011
Insurance broker organization code?3
Insurance broker nameASR HEALTH BENEFITS 32-2651185
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number000646-09
Policy instance 1
Insurance contract or identification number000646-09
Number of Individuals Covered237
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $15,749
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 $224,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,749
Insurance broker organization code?3
Insurance broker nameASR HEALTH BENEFITS 32-2651185
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number000646-09
Policy instance 1
Insurance contract or identification number000646-09
Number of Individuals Covered221
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $16,801
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 $240,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,801
Insurance broker organization code?3
Insurance broker nameASR HEALTH BENEFITS
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number000646-09
Policy instance 1
Insurance contract or identification number000646-09
Number of Individuals Covered232
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $15,206
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 $217,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,206
Insurance broker organization code?3
Insurance broker nameASR HEALTH BENEFITS
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number000646-09
Policy instance 1
Insurance contract or identification number000646-09
Number of Individuals Covered232
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $18,221
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 $182,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number000646-09
Policy instance 1
Insurance contract or identification number000646-09
Number of Individuals Covered220
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $33,478
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $151,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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