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MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 401k Plan overview

Plan NameMULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN
Plan identification number 506

MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

MULTIFAMILY INSURANCE TRUST has sponsored the creation of one or more 401k plans.

Company Name:MULTIFAMILY INSURANCE TRUST
Employer identification number (EIN):357086833
NAIC Classification:531310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062022-06-01
5062021-06-01
5062020-06-01
5062019-06-01SAMUEL ROTTER2021-03-12
5062019-06-01
5062018-06-01
5062017-06-01

Plan Statistics for MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN

401k plan membership statisitcs for MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN

Measure Date Value
2022: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01598
Total number of active participants reported on line 7a of the Form 55002022-06-01584
Number of retired or separated participants receiving benefits2022-06-013
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01587
2021: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01571
Total number of active participants reported on line 7a of the Form 55002021-06-01588
Number of retired or separated participants receiving benefits2021-06-0110
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01598
2020: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01577
Total number of active participants reported on line 7a of the Form 55002020-06-01545
Number of retired or separated participants receiving benefits2020-06-0126
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01571
2019: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01428
Total number of active participants reported on line 7a of the Form 55002019-06-01532
Number of retired or separated participants receiving benefits2019-06-010
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-01532
2018: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01505
Total number of active participants reported on line 7a of the Form 55002018-06-01539
Number of retired or separated participants receiving benefits2018-06-019
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01548
2017: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01428
Total number of active participants reported on line 7a of the Form 55002017-06-01497
Number of retired or separated participants receiving benefits2017-06-018
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01505

Financial Data on MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN

Measure Date Value
2023 : MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-05-31$145,996
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-05-31$176,414
Total income from all sources (including contributions)2023-05-31$8,749,897
Total loss/gain on sale of assets2023-05-31$0
Total of all expenses incurred2023-05-31$8,318,833
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-05-31$8,158,867
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-05-31$8,733,589
Value of total assets at end of year2023-05-31$1,192,492
Value of total assets at beginning of year2023-05-31$791,846
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-05-31$159,966
Total interest from all sources2023-05-31$16,308
Total dividends received (eg from common stock, registered investment company shares)2023-05-31$0
Administrative expenses professional fees incurred2023-05-31$95,460
Was this plan covered by a fidelity bond2023-05-31Yes
Value of fidelity bond cover2023-05-31$500,000
Were there any nonexempt tranactions with any party-in-interest2023-05-31No
Contributions received from participants2023-05-31$2,159,312
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-05-31$1,369
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-05-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-05-31$76,250
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-05-31$76,250
Liabilities. Value of operating payables at end of year2023-05-31$69,746
Liabilities. Value of operating payables at beginning of year2023-05-31$100,164
Total non interest bearing cash at end of year2023-05-31$88,747
Total non interest bearing cash at beginning of year2023-05-31$149,514
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-05-31No
Value of net income/loss2023-05-31$431,064
Value of net assets at end of year (total assets less liabilities)2023-05-31$1,046,496
Value of net assets at beginning of year (total assets less liabilities)2023-05-31$615,432
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-05-31No
Were any leases to which the plan was party in default or uncollectible2023-05-31No
Income. Interest from US Government securities2023-05-31$15,010
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-05-31$109,295
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-05-31$642,332
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-05-31$642,332
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-05-31$1,298
Expenses. Payments to insurance carriers foe the provision of benefits2023-05-31$8,158,867
Asset value of US Government securities at end of year2023-05-31$993,081
Asset value of US Government securities at beginning of year2023-05-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-05-31Yes
Was there a failure to transmit to the plan any participant contributions2023-05-31No
Has the plan failed to provide any benefit when due under the plan2023-05-31No
Contributions received in cash from employer2023-05-31$6,574,277
Contract administrator fees2023-05-31$64,506
Did the plan have assets held for investment2023-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-05-31No
Opinion of an independent qualified public accountant for this plan2023-05-31Unqualified
Accountancy firm name2023-05-31BDO USA, P.C.
Accountancy firm EIN2023-05-31135381590
2022 : MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-05-31$176,414
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-05-31$108,000
Total income from all sources (including contributions)2022-05-31$8,049,430
Total loss/gain on sale of assets2022-05-31$0
Total of all expenses incurred2022-05-31$8,034,501
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-05-31$7,924,103
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-05-31$8,049,373
Value of total assets at end of year2022-05-31$791,846
Value of total assets at beginning of year2022-05-31$708,503
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-05-31$110,398
Total interest from all sources2022-05-31$57
Total dividends received (eg from common stock, registered investment company shares)2022-05-31$0
Administrative expenses professional fees incurred2022-05-31$80,796
Was this plan covered by a fidelity bond2022-05-31Yes
Value of fidelity bond cover2022-05-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-05-31No
Contributions received from participants2022-05-31$1,885,816
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-05-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-05-31$2,833
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-05-31$76,250
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-05-31$49,250
Liabilities. Value of operating payables at end of year2022-05-31$100,164
Liabilities. Value of operating payables at beginning of year2022-05-31$58,750
Total non interest bearing cash at end of year2022-05-31$149,514
Total non interest bearing cash at beginning of year2022-05-31$82,395
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Value of net income/loss2022-05-31$14,929
Value of net assets at end of year (total assets less liabilities)2022-05-31$615,432
Value of net assets at beginning of year (total assets less liabilities)2022-05-31$600,503
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-05-31No
Were any leases to which the plan was party in default or uncollectible2022-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-05-31$642,332
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-05-31$623,275
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-05-31$623,275
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-05-31$57
Expenses. Payments to insurance carriers foe the provision of benefits2022-05-31$7,924,103
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-05-31No
Was there a failure to transmit to the plan any participant contributions2022-05-31No
Has the plan failed to provide any benefit when due under the plan2022-05-31No
Contributions received in cash from employer2022-05-31$6,163,557
Contract administrator fees2022-05-31$29,602
Did the plan have assets held for investment2022-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-05-31No
Opinion of an independent qualified public accountant for this plan2022-05-31Unqualified
Accountancy firm name2022-05-31BDO USA, LLP
Accountancy firm EIN2022-05-31135381590
2021 : MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-05-31$108,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-05-31$81,000
Total income from all sources (including contributions)2021-05-31$7,578,441
Total loss/gain on sale of assets2021-05-31$0
Total of all expenses incurred2021-05-31$7,790,517
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-05-31$7,756,772
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-05-31$7,578,282
Value of total assets at end of year2021-05-31$708,503
Value of total assets at beginning of year2021-05-31$893,579
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-05-31$33,745
Total interest from all sources2021-05-31$159
Total dividends received (eg from common stock, registered investment company shares)2021-05-31$0
Administrative expenses professional fees incurred2021-05-31$33,745
Was this plan covered by a fidelity bond2021-05-31Yes
Value of fidelity bond cover2021-05-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-05-31No
Contributions received from participants2021-05-31$1,748,933
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-05-31$2,833
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-05-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-05-31$49,250
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-05-31$0
Liabilities. Value of operating payables at end of year2021-05-31$58,750
Liabilities. Value of operating payables at beginning of year2021-05-31$81,000
Total non interest bearing cash at end of year2021-05-31$82,395
Total non interest bearing cash at beginning of year2021-05-31$138,694
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-05-31No
Value of net income/loss2021-05-31$-212,076
Value of net assets at end of year (total assets less liabilities)2021-05-31$600,503
Value of net assets at beginning of year (total assets less liabilities)2021-05-31$812,579
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-05-31No
Were any leases to which the plan was party in default or uncollectible2021-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-05-31$623,275
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-05-31$754,885
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-05-31$754,885
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-05-31$159
Expenses. Payments to insurance carriers foe the provision of benefits2021-05-31$7,756,772
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-05-31No
Was there a failure to transmit to the plan any participant contributions2021-05-31No
Has the plan failed to provide any benefit when due under the plan2021-05-31No
Contributions received in cash from employer2021-05-31$5,829,349
Did the plan have assets held for investment2021-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-05-31No
Opinion of an independent qualified public accountant for this plan2021-05-31Unqualified
Accountancy firm name2021-05-31BDO USA, LLP
Accountancy firm EIN2021-05-31135381590
2020 : MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-05-31$0
Total income from all sources (including contributions)2020-05-31$4,822,601
Total loss/gain on sale of assets2020-05-31$0
Total of all expenses incurred2020-05-31$4,822,601
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-05-31$4,822,601
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-05-31$4,822,601
Value of total assets at end of year2020-05-31$0
Value of total assets at beginning of year2020-05-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-05-31$0
Total interest from all sources2020-05-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-05-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-05-31No
Administrative expenses professional fees incurred2020-05-31$31,323
Was this plan covered by a fidelity bond2020-05-31No
Value of fidelity bond cover2020-05-31$500,000
Were there any nonexempt tranactions with any party-in-interest2020-05-31No
Contributions received from participants2020-05-31$1,460,873
Liabilities. Value of operating payables at end of year2020-05-31$81,000
Liabilities. Value of operating payables at beginning of year2020-05-31$54,000
Total non interest bearing cash at end of year2020-05-31$0
Total non interest bearing cash at beginning of year2020-05-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Value of net income/loss2020-05-31$0
Value of net assets at end of year (total assets less liabilities)2020-05-31$0
Value of net assets at beginning of year (total assets less liabilities)2020-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-05-31No
Were any leases to which the plan was party in default or uncollectible2020-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-05-31$754,885
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-05-31$488,160
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-05-31$488,160
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-05-31$487
Expenses. Payments to insurance carriers foe the provision of benefits2020-05-31$4,822,601
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-05-31No
Was there a failure to transmit to the plan any participant contributions2020-05-31No
Has the plan failed to provide any benefit when due under the plan2020-05-31No
Contributions received in cash from employer2020-05-31$3,361,728
Did the plan have assets held for investment2020-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-05-31No
Opinion of an independent qualified public accountant for this plan2020-05-31Unqualified
Accountancy firm name2020-05-31BDO USA, LLP
Accountancy firm EIN2020-05-31135381590
2019 : MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$54,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$0
Total income from all sources (including contributions)2019-05-31$7,180,032
Total loss/gain on sale of assets2019-05-31$0
Total of all expenses incurred2019-05-31$6,745,872
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-05-31$6,675,519
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-05-31$7,179,903
Value of total assets at end of year2019-05-31$488,160
Value of total assets at beginning of year2019-05-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-05-31$70,353
Total interest from all sources2019-05-31$129
Total dividends received (eg from common stock, registered investment company shares)2019-05-31$0
Administrative expenses professional fees incurred2019-05-31$70,353
Was this plan covered by a fidelity bond2019-05-31Yes
Value of fidelity bond cover2019-05-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-05-31No
Contributions received from participants2019-05-31$1,645,018
Liabilities. Value of operating payables at end of year2019-05-31$54,000
Liabilities. Value of operating payables at beginning of year2019-05-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Value of net income/loss2019-05-31$434,160
Value of net assets at end of year (total assets less liabilities)2019-05-31$434,160
Value of net assets at beginning of year (total assets less liabilities)2019-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-31No
Were any leases to which the plan was party in default or uncollectible2019-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-05-31$488,160
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-05-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-05-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-05-31$129
Expenses. Payments to insurance carriers foe the provision of benefits2019-05-31$6,675,519
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-31No
Was there a failure to transmit to the plan any participant contributions2019-05-31No
Has the plan failed to provide any benefit when due under the plan2019-05-31No
Contributions received in cash from employer2019-05-31$5,534,885
Did the plan have assets held for investment2019-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-31No
Opinion of an independent qualified public accountant for this plan2019-05-31Unqualified
Accountancy firm name2019-05-31BDO USA, LLP
Accountancy firm EIN2019-05-31135381590
2018 : MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-05-31$0
Total income from all sources (including contributions)2018-05-31$5,004,722
Total loss/gain on sale of assets2018-05-31$0
Total of all expenses incurred2018-05-31$5,004,722
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-05-31$4,947,063
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-05-31$5,004,722
Value of total assets at end of year2018-05-31$0
Value of total assets at beginning of year2018-05-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-05-31$57,659
Total interest from all sources2018-05-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-05-31$0
Administrative expenses professional fees incurred2018-05-31$57,659
Was this plan covered by a fidelity bond2018-05-31Yes
Value of fidelity bond cover2018-05-31$500,000
If this is an individual account plan, was there a blackout period2018-05-31No
Were there any nonexempt tranactions with any party-in-interest2018-05-31No
Contributions received from participants2018-05-31$1,349,827
Total non interest bearing cash at end of year2018-05-31$0
Total non interest bearing cash at beginning of year2018-05-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-05-31No
Value of net income/loss2018-05-31$0
Value of net assets at end of year (total assets less liabilities)2018-05-31$0
Value of net assets at beginning of year (total assets less liabilities)2018-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-05-31No
Were any leases to which the plan was party in default or uncollectible2018-05-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-05-31$4,947,063
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-05-31No
Was there a failure to transmit to the plan any participant contributions2018-05-31No
Has the plan failed to provide any benefit when due under the plan2018-05-31No
Contributions received in cash from employer2018-05-31$3,654,895
Did the plan have assets held for investment2018-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-05-31No
Opinion of an independent qualified public accountant for this plan2018-05-31Unqualified
Accountancy firm name2018-05-31BDO USA, LLP
Accountancy firm EIN2018-05-31135381590

Form 5500 Responses for MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN

2022: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Submission has been amendedNo
2022-06-01This submission is the final filingNo
2022-06-01This return/report is a short plan year return/report (less than 12 months)No
2022-06-01Plan is a collectively bargained planNo
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan funding arrangement – TrustYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement - TrustYes
2021: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Submission has been amendedNo
2021-06-01This submission is the final filingNo
2021-06-01This return/report is a short plan year return/report (less than 12 months)No
2021-06-01Plan is a collectively bargained planNo
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan funding arrangement – TrustYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement - TrustYes
2020: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Submission has been amendedNo
2020-06-01This submission is the final filingNo
2020-06-01This return/report is a short plan year return/report (less than 12 months)No
2020-06-01Plan is a collectively bargained planNo
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – TrustYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement - TrustYes
2019: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Submission has been amendedNo
2019-06-01This submission is the final filingNo
2019-06-01This return/report is a short plan year return/report (less than 12 months)No
2019-06-01Plan is a collectively bargained planNo
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan funding arrangement – TrustYes
2019-06-01Plan benefit arrangement – InsuranceYes
2019-06-01Plan benefit arrangement - TrustYes
2018: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Submission has been amendedNo
2018-06-01This submission is the final filingNo
2018-06-01This return/report is a short plan year return/report (less than 12 months)No
2018-06-01Plan is a collectively bargained planNo
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan funding arrangement – TrustYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-06-01Plan benefit arrangement - TrustYes
2017: MULTIFAMILY INSURANCE TRUST HEALTH AND WELFARE BENEFITS WRAP PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01First time form 5500 has been submittedYes
2017-06-01Submission has been amendedYes
2017-06-01This submission is the final filingNo
2017-06-01This return/report is a short plan year return/report (less than 12 months)No
2017-06-01Plan is a collectively bargained planNo
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan funding arrangement – TrustYes
2017-06-01Plan benefit arrangement – InsuranceYes
2017-06-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337965
Policy instance 2
Insurance contract or identification number3337965
Number of Individuals Covered771
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,360,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00478219
Policy instance 1
Insurance contract or identification number00478219
Number of Individuals Covered653
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $18,157
Total amount of fees paid to insurance companyUSD $3,947
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 BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $363,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,157
Amount paid for insurance broker fees3947
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337965
Policy instance 2
Insurance contract or identification number3337965
Number of Individuals Covered713
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,217,935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00478219
Policy instance 1
Insurance contract or identification number00478219
Number of Individuals Covered591
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $16,877
Total amount of fees paid to insurance companyUSD $3,768
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 BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $337,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,877
Amount paid for insurance broker fees3768
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337965
Policy instance 2
Insurance contract or identification number3337965
Number of Individuals Covered690
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?Yes
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,086,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00478219
Policy instance 1
Insurance contract or identification number00478219
Number of Individuals Covered576
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $16,071
Total amount of fees paid to insurance companyUSD $4,057
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 BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $321,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,071
Amount paid for insurance broker fees4057
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337965
Policy instance 2
Insurance contract or identification number3337965
Number of Individuals Covered733
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $7,506
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 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 $879,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,506
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number0009L433
Policy instance 1
Insurance contract or identification number0009L433
Number of Individuals Covered581
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $20,193
Total amount of fees paid to insurance companyUSD $6,002
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $340,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,193
Amount paid for insurance broker fees6002
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337965
Policy instance 2
Insurance contract or identification number3337965
Number of Individuals Covered784
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,058,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00478219
Policy instance 1
Insurance contract or identification number00478219
Number of Individuals Covered603
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $15,681
Total amount of fees paid to insurance companyUSD $8,289
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 BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $313,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,681
Amount paid for insurance broker fees8289
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337965
Policy instance 2
Insurance contract or identification number3337965
Number of Individuals Covered733
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $7,506
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 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 $879,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,506
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00478219
Policy instance 1
Insurance contract or identification number00478219
Number of Individuals Covered581
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $20,193
Total amount of fees paid to insurance companyUSD $6,002
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 BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $340,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,193
Amount paid for insurance broker fees6002
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3

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