CAM BENEFIT PROGRAM INSURANCE TRUST has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2018 : CAM BENEFIT PROGRAM 2018 401k financial data |
|---|
| Total income from all sources (including contributions) | 2018-12-31 | $9,970,843 |
| Total of all expenses incurred | 2018-12-31 | $9,970,843 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $8,783,312 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $9,970,843 |
| Value of total assets at end of year | 2018-12-31 | $29 |
| Value of total assets at beginning of year | 2018-12-31 | $29 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $1,187,531 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Total non interest bearing cash at end of year | 2018-12-31 | $29 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $29 |
| Value of net income/loss | 2018-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $29 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $29 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $8,783,312 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $9,970,843 |
| Contract administrator fees | 2018-12-31 | $1,187,531 |
| Did the plan have assets held for investment | 2018-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2018-12-31 | 382492570 |
| 2017 : CAM BENEFIT PROGRAM 2017 401k financial data |
|---|
| Total income from all sources (including contributions) | 2017-12-31 | $9,589,865 |
| Total of all expenses incurred | 2017-12-31 | $9,589,865 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $8,363,130 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $9,589,865 |
| Value of total assets at end of year | 2017-12-31 | $29 |
| Value of total assets at beginning of year | 2017-12-31 | $29 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $1,226,735 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Total non interest bearing cash at end of year | 2017-12-31 | $29 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $29 |
| Value of net income/loss | 2017-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $29 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $29 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $8,363,130 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $9,589,865 |
| Contract administrator fees | 2017-12-31 | $1,226,735 |
| Did the plan have assets held for investment | 2017-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2017-12-31 | 382492570 |
| 2016 : CAM BENEFIT PROGRAM 2016 401k financial data |
|---|
| Total income from all sources (including contributions) | 2016-12-31 | $15,002,271 |
| Total of all expenses incurred | 2016-12-31 | $15,002,271 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $13,044,171 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $15,002,271 |
| Value of total assets at end of year | 2016-12-31 | $29 |
| Value of total assets at beginning of year | 2016-12-31 | $29 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $1,958,100 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Total non interest bearing cash at end of year | 2016-12-31 | $29 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $29 |
| Value of net income/loss | 2016-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $29 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $29 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $13,044,171 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $15,002,271 |
| Contract administrator fees | 2016-12-31 | $1,958,100 |
| Did the plan have assets held for investment | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2016-12-31 | 382492570 |
| 2015 : CAM BENEFIT PROGRAM 2015 401k financial data |
|---|
| Total income from all sources (including contributions) | 2015-12-31 | $13,846,247 |
| Total of all expenses incurred | 2015-12-31 | $13,846,247 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $11,870,503 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $13,846,247 |
| Value of total assets at end of year | 2015-12-31 | $29 |
| Value of total assets at beginning of year | 2015-12-31 | $29 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $1,975,744 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Total non interest bearing cash at end of year | 2015-12-31 | $29 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $29 |
| Value of net income/loss | 2015-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $29 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $29 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $11,870,503 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $13,846,247 |
| Contract administrator fees | 2015-12-31 | $1,975,744 |
| Did the plan have assets held for investment | 2015-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2015-12-31 | 382492570 |
| 2014 : CAM BENEFIT PROGRAM 2014 401k financial data |
|---|
| Total income from all sources (including contributions) | 2014-12-31 | $15,333,439 |
| Total of all expenses incurred | 2014-12-31 | $15,333,439 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $13,561,205 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $15,333,439 |
| Value of total assets at end of year | 2014-12-31 | $29 |
| Value of total assets at beginning of year | 2014-12-31 | $29 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $1,772,234 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Administrative expenses (other) incurred | 2014-12-31 | $6,505 |
| Total non interest bearing cash at end of year | 2014-12-31 | $29 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $29 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $29 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $29 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $13,561,205 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $15,333,439 |
| Contract administrator fees | 2014-12-31 | $1,765,729 |
| Did the plan have assets held for investment | 2014-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2014-12-31 | 382492570 |
| 2013 : CAM BENEFIT PROGRAM 2013 401k financial data |
|---|
| Total income from all sources (including contributions) | 2013-12-31 | $19,242,573 |
| Total of all expenses incurred | 2013-12-31 | $19,242,569 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $16,498,973 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $19,242,569 |
| Value of total assets at end of year | 2013-12-31 | $29 |
| Value of total assets at beginning of year | 2013-12-31 | $25 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $2,743,596 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Other income not declared elsewhere | 2013-12-31 | $4 |
| Administrative expenses (other) incurred | 2013-12-31 | $195,459 |
| Total non interest bearing cash at end of year | 2013-12-31 | $29 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $25 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $4 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $29 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $25 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $16,498,973 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $19,242,569 |
| Contract administrator fees | 2013-12-31 | $2,548,137 |
| Did the plan have assets held for investment | 2013-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2013-12-31 | 382492570 |
| 2012 : CAM BENEFIT PROGRAM 2012 401k financial data |
|---|
| Total income from all sources (including contributions) | 2012-12-31 | $18,187,860 |
| Total of all expenses incurred | 2012-12-31 | $18,187,860 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $15,528,690 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $18,187,860 |
| Value of total assets at end of year | 2012-12-31 | $25 |
| Value of total assets at beginning of year | 2012-12-31 | $25 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $2,659,170 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Administrative expenses (other) incurred | 2012-12-31 | $197,685 |
| Total non interest bearing cash at end of year | 2012-12-31 | $25 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $25 |
| Value of net income/loss | 2012-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $25 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $25 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $15,528,690 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $18,187,860 |
| Contract administrator fees | 2012-12-31 | $2,461,485 |
| Did the plan have assets held for investment | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2012-12-31 | 382492570 |
| 2011 : CAM BENEFIT PROGRAM 2011 401k financial data |
|---|
| Total income from all sources (including contributions) | 2011-12-31 | $16,597,932 |
| Total of all expenses incurred | 2011-12-31 | $16,597,932 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $14,182,686 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $16,597,932 |
| Value of total assets at end of year | 2011-12-31 | $25 |
| Value of total assets at beginning of year | 2011-12-31 | $25 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $2,415,246 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Administrative expenses (other) incurred | 2011-12-31 | $182,984 |
| Total non interest bearing cash at end of year | 2011-12-31 | $25 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $25 |
| Value of net income/loss | 2011-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $25 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $25 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $14,182,686 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $16,597,932 |
| Contract administrator fees | 2011-12-31 | $2,232,262 |
| Did the plan have assets held for investment | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2011-12-31 | 382492570 |
| 2010 : CAM BENEFIT PROGRAM 2010 401k financial data |
|---|
| Total income from all sources (including contributions) | 2010-12-31 | $16,053,079 |
| Total of all expenses incurred | 2010-12-31 | $16,053,079 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $13,784,507 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $16,053,079 |
| Value of total assets at end of year | 2010-12-31 | $25 |
| Value of total assets at beginning of year | 2010-12-31 | $25 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $2,268,572 |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Administrative expenses (other) incurred | 2010-12-31 | $176,225 |
| Total non interest bearing cash at end of year | 2010-12-31 | $25 |
| Total non interest bearing cash at beginning of year | 2010-12-31 | $25 |
| Value of net income/loss | 2010-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $25 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $25 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $13,784,507 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $16,053,079 |
| Contract administrator fees | 2010-12-31 | $2,092,347 |
| Did the plan have assets held for investment | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
| Accountancy firm name | 2010-12-31 | DOEREN MAYHEW |
| Accountancy firm EIN | 2010-12-31 | 382492570 |
| AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
| Policy contract number | 26M101 |
| Policy instance | 4 |
| Insurance contract or identification number | 26M101 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,262 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,020 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRUASSURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92525 ) |
| Policy contract number | G-3935 |
| Policy instance | 3 |
| Insurance contract or identification number | G-3935 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $73,218 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 0 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,910,850 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,151 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1016 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,023,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRUASSURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92525 ) |
| Policy contract number | G-3935 |
| Policy instance | 3 |
| Insurance contract or identification number | G-3935 | | Number of Individuals Covered | 220 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $161,344 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
| Policy contract number | 26MI01 |
| Policy instance | 4 |
| Insurance contract or identification number | 26MI01 | | Number of Individuals Covered | 551 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,462 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1089 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,262,526 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
| Policy contract number | 26MI01 |
| Policy instance | 4 |
| Insurance contract or identification number | 26MI01 | | Number of Individuals Covered | 709 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,209 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRUASSURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92525 ) |
| Policy contract number | G-3935 |
| Policy instance | 3 |
| Insurance contract or identification number | G-3935 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $168,542 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) |
| Policy contract number | N/A |
| Policy instance | 3 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1729 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,484,809 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 ) |
| Policy contract number | GR-84 |
| Policy instance | 2 |
| Insurance contract or identification number | GR-84 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $229,534 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) |
| Policy contract number | N/A |
| Policy instance | 4 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1866 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,370,005 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 ) |
| Policy contract number | GR-84 |
| Policy instance | 3 |
| Insurance contract or identification number | GR-84 | | Number of Individuals Covered | 294 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $780,468 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 ) |
| Policy contract number | 24949 |
| Policy instance | 2 |
| Insurance contract or identification number | 24949 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $4,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 222 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,299 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 ) |
| Policy contract number | GR-84 |
| Policy instance | 3 |
| Insurance contract or identification number | GR-84 | | Number of Individuals Covered | 889 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,107,055 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 ) |
| Policy contract number | 24949 |
| Policy instance | 2 |
| Insurance contract or identification number | 24949 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $5,901 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 411 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,421 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 52050 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 363 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,162 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 ) |
| Policy contract number | GR-84 |
| Policy instance | 3 |
| Insurance contract or identification number | GR-84 | | Number of Individuals Covered | 2508 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,256,105 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 ) |
| Policy contract number | 24949 |
| Policy instance | 2 |
| Insurance contract or identification number | 24949 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $5,783 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 ) |
| Policy contract number | GR-84 |
| Policy instance | 3 |
| Insurance contract or identification number | GR-84 | | Number of Individuals Covered | 2463 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,000,922 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 ) |
| Policy contract number | 24949 |
| Policy instance | 2 |
| Insurance contract or identification number | 24949 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $7,237 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 52050 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 390 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,319 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 ) |
| Policy contract number | 24949 |
| Policy instance | 2 |
| Insurance contract or identification number | 24949 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2009-09-01 | | Insurance policy end date | 2010-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $13,790 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 52050 ) |
| Policy contract number | 12016984 |
| Policy instance | 1 |
| Insurance contract or identification number | 12016984 | | Number of Individuals Covered | 359 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,318 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 ) |
| Policy contract number | GR-84 |
| Policy instance | 3 |
| Insurance contract or identification number | GR-84 | | Number of Individuals Covered | 2254 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,571,759 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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