NATIONAL EMPLOYEE HEALTH PLAN has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan NATIONAL EMPLOYEES HEALTH PLAN
| Measure | Date | Value |
|---|
| 2021 : NATIONAL EMPLOYEES HEALTH PLAN 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-10-31 | $598,151 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-10-31 | $598,151 |
| Total income from all sources (including contributions) | 2021-10-31 | $0 |
| Value of total assets at end of year | 2021-10-31 | $9,098,495 |
| Value of total assets at beginning of year | 2021-10-31 | $9,098,495 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-10-31 | No |
| Was this plan covered by a fidelity bond | 2021-10-31 | No |
| If this is an individual account plan, was there a blackout period | 2021-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-10-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2021-10-31 | $18,243 |
| Assets. Other investments not covered elsewhere at beginning of year | 2021-10-31 | $18,243 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-10-31 | $4,428 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-10-31 | $4,428 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-10-31 | $462,209 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-10-31 | $462,209 |
| Liabilities. Value of operating payables at end of year | 2021-10-31 | $135,942 |
| Liabilities. Value of operating payables at beginning of year | 2021-10-31 | $135,942 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-10-31 | No |
| Value of net assets at end of year (total assets less liabilities) | 2021-10-31 | $8,500,344 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-10-31 | $8,500,344 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-10-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-10-31 | $7,558,812 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-10-31 | $7,558,812 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-10-31 | $882,621 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-10-31 | $882,621 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-10-31 | $882,621 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-10-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-10-31 | No |
| Employer contributions (assets) at end of year | 2021-10-31 | $634,391 |
| Employer contributions (assets) at beginning of year | 2021-10-31 | $634,391 |
| Did the plan have assets held for investment | 2021-10-31 | Yes |
| 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 | 2021-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-10-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-10-31 | Unqualified |
| Accountancy firm name | 2021-10-31 | LAPADULA CARLSON & CO |
| Accountancy firm EIN | 2021-10-31 | 650292391 |
| 2020 : NATIONAL EMPLOYEES HEALTH PLAN 2020 401k financial data |
|---|
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-10-31 | $1,302,007 |
| Value of total assets at end of year | 2020-10-31 | $7,568,287 |
| Value of total assets at beginning of year | 2020-10-31 | $8,870,294 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-10-31 | No |
| Was this plan covered by a fidelity bond | 2020-10-31 | Yes |
| Value of fidelity bond cover | 2020-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-10-31 | No |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-10-31 | $18,243 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-10-31 | $4,421 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-10-31 | $805,163 |
| Liabilities. Value of operating payables at beginning of year | 2020-10-31 | $263,044 |
| Total non interest bearing cash at beginning of year | 2020-10-31 | $288,239 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-10-31 | No |
| Value of net assets at end of year (total assets less liabilities) | 2020-10-31 | $7,568,287 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-10-31 | $7,568,287 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-10-31 | No |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-10-31 | $463,115 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-10-31 | $463,115 |
| Asset value of US Government securities at beginning of year | 2020-10-31 | $1,422,293 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-10-31 | No |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2020-10-31 | $459,006 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2020-10-31 | $7,568,287 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2020-10-31 | $6,214,977 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-10-31 | $233,800 |
| Did the plan have assets held for investment | 2020-10-31 | Yes |
| 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 | 2020-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-10-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2020-10-31 | Disclaimer |
| Accountancy firm name | 2020-10-31 | COHEN & COMPANY, LTD |
| Accountancy firm EIN | 2020-10-31 | 341912691 |
| 2019 : NATIONAL EMPLOYEES HEALTH PLAN 2019 401k financial data |
|---|
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-10-31 | $2,058,367 |
| Value of total assets at end of year | 2019-10-31 | $7,336,730 |
| Value of total assets at beginning of year | 2019-10-31 | $9,395,097 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-10-31 | No |
| Was this plan covered by a fidelity bond | 2019-10-31 | Yes |
| Value of fidelity bond cover | 2019-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-10-31 | No |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-10-31 | $18,243 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-10-31 | $5,696 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-10-31 | $763,517 |
| Liabilities. Value of operating payables at beginning of year | 2019-10-31 | $1,036,550 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-10-31 | No |
| Value of net assets at end of year (total assets less liabilities) | 2019-10-31 | $7,336,730 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-10-31 | $7,336,730 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-10-31 | No |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-10-31 | $1,551,703 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-10-31 | $1,551,703 |
| Asset value of US Government securities at beginning of year | 2019-10-31 | $1,251,360 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-10-31 | No |
| Employer contributions (assets) at beginning of year | 2019-10-31 | $370,177 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-10-31 | $825,170 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2019-10-31 | $7,336,730 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2019-10-31 | $5,372,748 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-10-31 | $258,300 |
| Did the plan have assets held for investment | 2019-10-31 | Yes |
| 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 | 2019-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-10-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2019-10-31 | Disclaimer |
| Accountancy firm name | 2019-10-31 | COHEN & COMPANY, LTD |
| Accountancy firm EIN | 2019-10-31 | 341912691 |
| 2018 : NATIONAL EMPLOYEES HEALTH PLAN 2018 401k financial data |
|---|
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-10-31 | $1,516,105 |
| Value of total assets at end of year | 2018-10-31 | $8,040,049 |
| Value of total assets at beginning of year | 2018-10-31 | $9,556,154 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-10-31 | No |
| Was this plan covered by a fidelity bond | 2018-10-31 | Yes |
| Value of fidelity bond cover | 2018-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-10-31 | No |
| Assets. Other investments not covered elsewhere at beginning of year | 2018-10-31 | $18,274 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-10-31 | $8,670 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-10-31 | $726,670 |
| Liabilities. Value of operating payables at beginning of year | 2018-10-31 | $568,535 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-10-31 | No |
| Value of net assets at end of year (total assets less liabilities) | 2018-10-31 | $8,040,049 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-10-31 | $8,040,049 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-10-31 | No |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-10-31 | $480,849 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-10-31 | $480,849 |
| Asset value of US Government securities at beginning of year | 2018-10-31 | $1,907,605 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-10-31 | No |
| Employer contributions (assets) at beginning of year | 2018-10-31 | $270,109 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2018-10-31 | $1,191,481 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2018-10-31 | $8,040,049 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2018-10-31 | $5,679,166 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-10-31 | $220,900 |
| Did the plan have assets held for investment | 2018-10-31 | Yes |
| 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 | 2018-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-10-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2018-10-31 | Disclaimer |
| Accountancy firm name | 2018-10-31 | COHEN & COMPANY, LTD |
| Accountancy firm EIN | 2018-10-31 | 341912691 |
| 2017 : NATIONAL EMPLOYEES HEALTH PLAN 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-10-31 | $550,738 |
| Total unrealized appreciation/depreciation of assets | 2017-10-31 | $550,738 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-10-31 | $1,516,105 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-10-31 | $1,436,772 |
| Total income from all sources (including contributions) | 2017-10-31 | $32,512,027 |
| Total loss/gain on sale of assets | 2017-10-31 | $341,451 |
| Total of all expenses incurred | 2017-10-31 | $33,556,939 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-10-31 | $32,098,250 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-10-31 | $31,498,446 |
| Value of total assets at end of year | 2017-10-31 | $9,084,961 |
| Value of total assets at beginning of year | 2017-10-31 | $10,521,733 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-10-31 | $1,458,689 |
| Total interest from all sources | 2017-10-31 | $121,392 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-10-31 | No |
| Administrative expenses professional fees incurred | 2017-10-31 | $492,140 |
| Was this plan covered by a fidelity bond | 2017-10-31 | Yes |
| Value of fidelity bond cover | 2017-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-10-31 | No |
| Contributions received from participants | 2017-10-31 | $3,156,483 |
| Assets. Other investments not covered elsewhere at end of year | 2017-10-31 | $18,274 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-10-31 | $18,374 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-10-31 | $8,670 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-10-31 | $10,035 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-10-31 | $726,670 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-10-31 | $843,445 |
| Liabilities. Value of operating payables at end of year | 2017-10-31 | $568,535 |
| Liabilities. Value of operating payables at beginning of year | 2017-10-31 | $366,227 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-10-31 | No |
| Value of net income/loss | 2017-10-31 | $-1,044,912 |
| Value of net assets at end of year (total assets less liabilities) | 2017-10-31 | $9,084,961 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-10-31 | $9,084,961 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-10-31 | No |
| Investment advisory and management fees | 2017-10-31 | $55,801 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-10-31 | $480,849 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-10-31 | $873,620 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-10-31 | $873,620 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-10-31 | $121,392 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-10-31 | $13,085,814 |
| Asset value of US Government securities at end of year | 2017-10-31 | $1,907,605 |
| Asset value of US Government securities at beginning of year | 2017-10-31 | $2,480,153 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-10-31 | No |
| Contributions received in cash from employer | 2017-10-31 | $28,341,963 |
| Employer contributions (assets) at end of year | 2017-10-31 | $270,109 |
| Employer contributions (assets) at beginning of year | 2017-10-31 | $383,757 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-10-31 | $19,012,436 |
| Asset. Corporate debt instrument debt (other) at end of year | 2017-10-31 | $1,191,481 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2017-10-31 | $1,342,126 |
| Contract administrator fees | 2017-10-31 | $910,748 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2017-10-31 | $9,084,961 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2017-10-31 | $5,413,668 |
| Liabilities. Value of benefit claims payable at end of year | 2017-10-31 | $220,900 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-10-31 | $227,100 |
| Did the plan have assets held for investment | 2017-10-31 | Yes |
| 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 | 2017-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-10-31 | No |
| Aggregate proceeds on sale of assets | 2017-10-31 | $14,202,449 |
| Aggregate carrying amount (costs) on sale of assets | 2017-10-31 | $13,860,998 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2017-10-31 | Disclaimer |
| Accountancy firm name | 2017-10-31 | COHEN & COMPANY, LTD |
| Accountancy firm EIN | 2017-10-31 | 341912691 |
| 2016 : NATIONAL EMPLOYEES HEALTH PLAN 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-10-31 | $226,740 |
| Total unrealized appreciation/depreciation of assets | 2016-10-31 | $226,740 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-10-31 | $1,436,772 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-10-31 | $1,587,525 |
| Total income from all sources (including contributions) | 2016-10-31 | $34,809,200 |
| Total loss/gain on sale of assets | 2016-10-31 | $-96,887 |
| Total of all expenses incurred | 2016-10-31 | $35,897,831 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-10-31 | $34,321,053 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-10-31 | $34,545,142 |
| Value of total assets at end of year | 2016-10-31 | $10,521,733 |
| Value of total assets at beginning of year | 2016-10-31 | $11,761,117 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-10-31 | $1,576,778 |
| Total interest from all sources | 2016-10-31 | $134,205 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-10-31 | No |
| Administrative expenses professional fees incurred | 2016-10-31 | $499,510 |
| Was this plan covered by a fidelity bond | 2016-10-31 | Yes |
| Value of fidelity bond cover | 2016-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-10-31 | No |
| Contributions received from participants | 2016-10-31 | $2,982,485 |
| Assets. Other investments not covered elsewhere at end of year | 2016-10-31 | $18,374 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-10-31 | $17,546 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-10-31 | $10,035 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-10-31 | $200,784 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-10-31 | $843,445 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-10-31 | $826,737 |
| Liabilities. Value of operating payables at end of year | 2016-10-31 | $366,227 |
| Liabilities. Value of operating payables at beginning of year | 2016-10-31 | $576,988 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-10-31 | No |
| Value of net income/loss | 2016-10-31 | $-1,088,631 |
| Value of net assets at end of year (total assets less liabilities) | 2016-10-31 | $9,084,961 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-10-31 | $10,173,592 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-10-31 | No |
| Investment advisory and management fees | 2016-10-31 | $56,545 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-10-31 | $873,620 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-10-31 | $1,642,648 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-10-31 | $1,642,648 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-10-31 | $134,205 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-10-31 | $16,468,154 |
| Asset value of US Government securities at end of year | 2016-10-31 | $2,480,153 |
| Asset value of US Government securities at beginning of year | 2016-10-31 | $2,881,986 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-10-31 | No |
| Contributions received in cash from employer | 2016-10-31 | $31,562,657 |
| Employer contributions (assets) at end of year | 2016-10-31 | $383,757 |
| Employer contributions (assets) at beginning of year | 2016-10-31 | $353,849 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-10-31 | $17,852,899 |
| Asset. Corporate debt instrument debt (other) at end of year | 2016-10-31 | $1,342,126 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2016-10-31 | $1,445,471 |
| Contract administrator fees | 2016-10-31 | $1,020,723 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2016-10-31 | $5,413,668 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2016-10-31 | $5,218,833 |
| Liabilities. Value of benefit claims payable at end of year | 2016-10-31 | $227,100 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-10-31 | $183,800 |
| Did the plan have assets held for investment | 2016-10-31 | Yes |
| 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 | 2016-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-10-31 | No |
| Aggregate proceeds on sale of assets | 2016-10-31 | $8,037,942 |
| Aggregate carrying amount (costs) on sale of assets | 2016-10-31 | $8,134,829 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-10-31 | Disclaimer |
| Accountancy firm name | 2016-10-31 | COHEN & COMPANY, LTD |
| Accountancy firm EIN | 2016-10-31 | 341912961 |
| 2015 : NATIONAL EMPLOYEES HEALTH PLAN 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-10-31 | $-769,138 |
| Total unrealized appreciation/depreciation of assets | 2015-10-31 | $-769,138 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-10-31 | $1,587,525 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-10-31 | $1,480,615 |
| Total income from all sources (including contributions) | 2015-10-31 | $32,623,341 |
| Total loss/gain on sale of assets | 2015-10-31 | $978,653 |
| Total of all expenses incurred | 2015-10-31 | $32,048,925 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-10-31 | $30,638,762 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-10-31 | $32,300,892 |
| Value of total assets at end of year | 2015-10-31 | $11,761,117 |
| Value of total assets at beginning of year | 2015-10-31 | $11,079,791 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-10-31 | $1,410,163 |
| Total interest from all sources | 2015-10-31 | $112,934 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-10-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-10-31 | No |
| Administrative expenses professional fees incurred | 2015-10-31 | $357,328 |
| Was this plan covered by a fidelity bond | 2015-10-31 | Yes |
| Value of fidelity bond cover | 2015-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-10-31 | No |
| Contributions received from participants | 2015-10-31 | $2,933,326 |
| Assets. Other investments not covered elsewhere at end of year | 2015-10-31 | $17,546 |
| Assets. Other investments not covered elsewhere at beginning of year | 2015-10-31 | $83,318 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-10-31 | $200,784 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-10-31 | $108,513 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-10-31 | $826,737 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-10-31 | $719,886 |
| Liabilities. Value of operating payables at end of year | 2015-10-31 | $576,988 |
| Liabilities. Value of operating payables at beginning of year | 2015-10-31 | $575,229 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-10-31 | No |
| Value of net income/loss | 2015-10-31 | $574,416 |
| Value of net assets at end of year (total assets less liabilities) | 2015-10-31 | $10,173,592 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-10-31 | $9,599,176 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-10-31 | No |
| Investment advisory and management fees | 2015-10-31 | $49,425 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-10-31 | $1,642,648 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-10-31 | $1,292,644 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-10-31 | $1,292,644 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-10-31 | $112,934 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-10-31 | $16,938,413 |
| Asset value of US Government securities at end of year | 2015-10-31 | $2,881,986 |
| Asset value of US Government securities at beginning of year | 2015-10-31 | $2,845,696 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-10-31 | No |
| Contributions received in cash from employer | 2015-10-31 | $29,367,566 |
| Employer contributions (assets) at end of year | 2015-10-31 | $353,849 |
| Employer contributions (assets) at beginning of year | 2015-10-31 | $455,365 |
| Income. Dividends from common stock | 2015-10-31 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-10-31 | $13,700,349 |
| Asset. Corporate debt instrument debt (other) at end of year | 2015-10-31 | $1,445,471 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2015-10-31 | $955,083 |
| Contract administrator fees | 2015-10-31 | $1,003,410 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2015-10-31 | $5,218,833 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2015-10-31 | $5,339,172 |
| Liabilities. Value of benefit claims payable at end of year | 2015-10-31 | $183,800 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-10-31 | $185,500 |
| Did the plan have assets held for investment | 2015-10-31 | Yes |
| 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 | 2015-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-10-31 | No |
| Aggregate proceeds on sale of assets | 2015-10-31 | $16,111,451 |
| Aggregate carrying amount (costs) on sale of assets | 2015-10-31 | $15,132,798 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2015-10-31 | Disclaimer |
| Accountancy firm name | 2015-10-31 | COHEN & COMPANY, LTD |
| Accountancy firm EIN | 2015-10-31 | 341912961 |
| 2014 : NATIONAL EMPLOYEES HEALTH PLAN 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-10-31 | $77,857 |
| Total unrealized appreciation/depreciation of assets | 2014-10-31 | $77,857 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-10-31 | $1,480,615 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-10-31 | $862,345 |
| Total income from all sources (including contributions) | 2014-10-31 | $30,573,829 |
| Total loss/gain on sale of assets | 2014-10-31 | $464,069 |
| Total of all expenses incurred | 2014-10-31 | $30,543,513 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-10-31 | $29,105,890 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-10-31 | $29,943,218 |
| Value of total assets at end of year | 2014-10-31 | $11,079,791 |
| Value of total assets at beginning of year | 2014-10-31 | $10,431,205 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-10-31 | $1,437,623 |
| Total interest from all sources | 2014-10-31 | $88,473 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-10-31 | $212 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-10-31 | No |
| Administrative expenses professional fees incurred | 2014-10-31 | $331,315 |
| Was this plan covered by a fidelity bond | 2014-10-31 | Yes |
| Value of fidelity bond cover | 2014-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-10-31 | No |
| Contributions received from participants | 2014-10-31 | $2,840,953 |
| Assets. Other investments not covered elsewhere at end of year | 2014-10-31 | $83,318 |
| Assets. Other investments not covered elsewhere at beginning of year | 2014-10-31 | $81,652 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-10-31 | $108,513 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-10-31 | $98,431 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-10-31 | $719,886 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-10-31 | $569,467 |
| Liabilities. Value of operating payables at end of year | 2014-10-31 | $575,229 |
| Liabilities. Value of operating payables at beginning of year | 2014-10-31 | $93,578 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-10-31 | No |
| Value of net income/loss | 2014-10-31 | $30,316 |
| Value of net assets at end of year (total assets less liabilities) | 2014-10-31 | $9,599,176 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-10-31 | $9,568,860 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-10-31 | No |
| Investment advisory and management fees | 2014-10-31 | $62,354 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-10-31 | $1,292,644 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-10-31 | $664,292 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-10-31 | $664,292 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-10-31 | $88,473 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-10-31 | $17,608,904 |
| Asset value of US Government securities at end of year | 2014-10-31 | $2,845,696 |
| Asset value of US Government securities at beginning of year | 2014-10-31 | $2,030,489 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-10-31 | No |
| Contributions received in cash from employer | 2014-10-31 | $27,102,265 |
| Employer contributions (assets) at end of year | 2014-10-31 | $455,365 |
| Employer contributions (assets) at beginning of year | 2014-10-31 | $1,063,985 |
| Income. Dividends from common stock | 2014-10-31 | $212 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-10-31 | $11,496,986 |
| Asset. Corporate debt instrument debt (other) at end of year | 2014-10-31 | $955,083 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2014-10-31 | $1,019,092 |
| Contract administrator fees | 2014-10-31 | $1,043,954 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2014-10-31 | $5,339,172 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2014-10-31 | $5,473,264 |
| Liabilities. Value of benefit claims payable at end of year | 2014-10-31 | $185,500 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-10-31 | $199,300 |
| Did the plan have assets held for investment | 2014-10-31 | Yes |
| 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 | 2014-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-10-31 | No |
| Aggregate proceeds on sale of assets | 2014-10-31 | $5,821,571 |
| Aggregate carrying amount (costs) on sale of assets | 2014-10-31 | $5,357,502 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2014-10-31 | Disclaimer |
| Accountancy firm name | 2014-10-31 | GODFREY HAMMEL, DANNEELS & CO., P.C |
| Accountancy firm EIN | 2014-10-31 | 381878652 |
| 2013 : NATIONAL EMPLOYEES HEALTH PLAN 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-10-31 | $487,595 |
| Total unrealized appreciation/depreciation of assets | 2013-10-31 | $487,595 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-10-31 | $862,345 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-10-31 | $482,535 |
| Total income from all sources (including contributions) | 2013-10-31 | $23,493,952 |
| Total loss/gain on sale of assets | 2013-10-31 | $355,547 |
| Total of all expenses incurred | 2013-10-31 | $22,709,911 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-10-31 | $21,618,350 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-10-31 | $22,535,735 |
| Value of total assets at end of year | 2013-10-31 | $10,431,205 |
| Value of total assets at beginning of year | 2013-10-31 | $9,267,354 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-10-31 | $1,091,561 |
| Total interest from all sources | 2013-10-31 | $114,584 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-10-31 | $491 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-10-31 | No |
| Administrative expenses professional fees incurred | 2013-10-31 | $367,735 |
| Was this plan covered by a fidelity bond | 2013-10-31 | Yes |
| Value of fidelity bond cover | 2013-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-10-31 | No |
| Contributions received from participants | 2013-10-31 | $1,139,904 |
| Assets. Other investments not covered elsewhere at end of year | 2013-10-31 | $130,663 |
| Assets. Other investments not covered elsewhere at beginning of year | 2013-10-31 | $499,173 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-10-31 | $49,420 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-10-31 | $10,214 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-10-31 | $569,467 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-10-31 | $181,979 |
| Liabilities. Value of operating payables at end of year | 2013-10-31 | $93,578 |
| Liabilities. Value of operating payables at beginning of year | 2013-10-31 | $110,356 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-10-31 | No |
| Value of net income/loss | 2013-10-31 | $784,041 |
| Value of net assets at end of year (total assets less liabilities) | 2013-10-31 | $9,568,860 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-10-31 | $8,784,819 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-10-31 | No |
| Investment advisory and management fees | 2013-10-31 | $50,660 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-10-31 | $664,292 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-10-31 | $893,515 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-10-31 | $893,515 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-10-31 | $114,584 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-10-31 | $10,652,792 |
| Asset value of US Government securities at end of year | 2013-10-31 | $2,030,489 |
| Asset value of US Government securities at beginning of year | 2013-10-31 | $2,489,171 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-10-31 | No |
| Contributions received in cash from employer | 2013-10-31 | $21,395,831 |
| Employer contributions (assets) at end of year | 2013-10-31 | $1,063,985 |
| Employer contributions (assets) at beginning of year | 2013-10-31 | $553,756 |
| Income. Dividends from common stock | 2013-10-31 | $491 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-10-31 | $10,965,558 |
| Asset. Corporate debt instrument debt (other) at end of year | 2013-10-31 | $1,019,092 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2013-10-31 | $1,459,796 |
| Contract administrator fees | 2013-10-31 | $673,166 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2013-10-31 | $5,473,264 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2013-10-31 | $3,361,729 |
| Liabilities. Value of benefit claims payable at end of year | 2013-10-31 | $199,300 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-10-31 | $190,200 |
| Did the plan have assets held for investment | 2013-10-31 | Yes |
| 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 | 2013-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-10-31 | No |
| Aggregate proceeds on sale of assets | 2013-10-31 | $9,170,054 |
| Aggregate carrying amount (costs) on sale of assets | 2013-10-31 | $8,814,507 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2013-10-31 | Disclaimer |
| Accountancy firm name | 2013-10-31 | GODFREY HAMMEL, DANNEELS & CO., P.C |
| Accountancy firm EIN | 2013-10-31 | 381878652 |
| 2012 : NATIONAL EMPLOYEES HEALTH PLAN 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-10-31 | $156,703 |
| Total unrealized appreciation/depreciation of assets | 2012-10-31 | $156,703 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-10-31 | $482,535 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-10-31 | $399,818 |
| Total income from all sources (including contributions) | 2012-10-31 | $17,972,549 |
| Total loss/gain on sale of assets | 2012-10-31 | $71,693 |
| Total of all expenses incurred | 2012-10-31 | $16,996,746 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-10-31 | $16,243,183 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-10-31 | $17,636,000 |
| Value of total assets at end of year | 2012-10-31 | $9,267,354 |
| Value of total assets at beginning of year | 2012-10-31 | $8,208,834 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-10-31 | $753,563 |
| Total interest from all sources | 2012-10-31 | $107,514 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-10-31 | $639 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-10-31 | No |
| Administrative expenses professional fees incurred | 2012-10-31 | $255,752 |
| Was this plan covered by a fidelity bond | 2012-10-31 | Yes |
| Value of fidelity bond cover | 2012-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-10-31 | No |
| Contributions received from participants | 2012-10-31 | $252,787 |
| Assets. Other investments not covered elsewhere at end of year | 2012-10-31 | $499,173 |
| Assets. Other investments not covered elsewhere at beginning of year | 2012-10-31 | $754,527 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-10-31 | $10,214 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-10-31 | $29,514 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-10-31 | $181,979 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-10-31 | $137,348 |
| Liabilities. Value of operating payables at end of year | 2012-10-31 | $110,356 |
| Liabilities. Value of operating payables at beginning of year | 2012-10-31 | $100,370 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-10-31 | No |
| Value of net income/loss | 2012-10-31 | $975,803 |
| Value of net assets at end of year (total assets less liabilities) | 2012-10-31 | $8,784,819 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-10-31 | $7,809,016 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-10-31 | No |
| Investment advisory and management fees | 2012-10-31 | $35,193 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-10-31 | $893,515 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-10-31 | $524,973 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-10-31 | $524,973 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-10-31 | $107,514 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-10-31 | $6,478,616 |
| Asset value of US Government securities at end of year | 2012-10-31 | $2,489,171 |
| Asset value of US Government securities at beginning of year | 2012-10-31 | $2,099,152 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-10-31 | No |
| Contributions received in cash from employer | 2012-10-31 | $17,383,213 |
| Employer contributions (assets) at end of year | 2012-10-31 | $553,756 |
| Employer contributions (assets) at beginning of year | 2012-10-31 | $232,508 |
| Income. Dividends from common stock | 2012-10-31 | $639 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-10-31 | $9,764,567 |
| Asset. Corporate debt instrument debt (other) at end of year | 2012-10-31 | $1,459,796 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2012-10-31 | $1,543,767 |
| Contract administrator fees | 2012-10-31 | $462,618 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2012-10-31 | $3,361,729 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2012-10-31 | $3,024,393 |
| Liabilities. Value of benefit claims payable at end of year | 2012-10-31 | $190,200 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-10-31 | $162,100 |
| Did the plan have assets held for investment | 2012-10-31 | Yes |
| 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 | 2012-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-10-31 | No |
| Aggregate proceeds on sale of assets | 2012-10-31 | $7,580,599 |
| Aggregate carrying amount (costs) on sale of assets | 2012-10-31 | $7,508,906 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-10-31 | Disclaimer |
| Accountancy firm name | 2012-10-31 | GODFREY HAMMEL, DANNEELS & CO., P.C |
| Accountancy firm EIN | 2012-10-31 | 381878652 |
| 2011 : NATIONAL EMPLOYEES HEALTH PLAN 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-10-31 | $-49,605 |
| Total unrealized appreciation/depreciation of assets | 2011-10-31 | $-49,605 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-10-31 | $399,818 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-10-31 | $385,210 |
| Total income from all sources (including contributions) | 2011-10-31 | $15,175,345 |
| Total loss/gain on sale of assets | 2011-10-31 | $230,781 |
| Total of all expenses incurred | 2011-10-31 | $15,091,376 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-10-31 | $14,402,201 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-10-31 | $14,869,152 |
| Value of total assets at end of year | 2011-10-31 | $8,208,834 |
| Value of total assets at beginning of year | 2011-10-31 | $8,110,257 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-10-31 | $689,175 |
| Total interest from all sources | 2011-10-31 | $124,717 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-10-31 | $300 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-10-31 | No |
| Administrative expenses professional fees incurred | 2011-10-31 | $250,464 |
| Was this plan covered by a fidelity bond | 2011-10-31 | Yes |
| Value of fidelity bond cover | 2011-10-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-10-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-10-31 | No |
| Contributions received from participants | 2011-10-31 | $193,492 |
| Assets. Other investments not covered elsewhere at end of year | 2011-10-31 | $754,527 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-10-31 | $180,245 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-10-31 | $29,514 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-10-31 | $41,156 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-10-31 | $137,348 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-10-31 | $142,142 |
| Liabilities. Value of operating payables at end of year | 2011-10-31 | $100,370 |
| Liabilities. Value of operating payables at beginning of year | 2011-10-31 | $98,368 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-10-31 | No |
| Value of net income/loss | 2011-10-31 | $83,969 |
| Value of net assets at end of year (total assets less liabilities) | 2011-10-31 | $7,809,016 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-10-31 | $7,725,047 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-10-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-10-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-10-31 | No |
| Investment advisory and management fees | 2011-10-31 | $34,961 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-10-31 | $524,973 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-10-31 | $1,023,921 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-10-31 | $1,023,921 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-10-31 | $124,717 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-10-31 | $6,419,198 |
| Asset value of US Government securities at end of year | 2011-10-31 | $2,099,152 |
| Asset value of US Government securities at beginning of year | 2011-10-31 | $2,117,021 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-10-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-10-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-10-31 | No |
| Contributions received in cash from employer | 2011-10-31 | $14,675,660 |
| Employer contributions (assets) at end of year | 2011-10-31 | $232,508 |
| Employer contributions (assets) at beginning of year | 2011-10-31 | $354,292 |
| Income. Dividends from common stock | 2011-10-31 | $300 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-10-31 | $7,983,003 |
| Asset. Corporate debt instrument debt (other) at end of year | 2011-10-31 | $1,543,767 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2011-10-31 | $1,590,853 |
| Contract administrator fees | 2011-10-31 | $403,750 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-10-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2011-10-31 | $3,024,393 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2011-10-31 | $2,802,769 |
| Liabilities. Value of benefit claims payable at end of year | 2011-10-31 | $162,100 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-10-31 | $144,700 |
| Did the plan have assets held for investment | 2011-10-31 | Yes |
| 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 | 2011-10-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-10-31 | No |
| Aggregate proceeds on sale of assets | 2011-10-31 | $7,545,626 |
| Aggregate carrying amount (costs) on sale of assets | 2011-10-31 | $7,314,845 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-10-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-10-31 | Disclaimer |
| Accountancy firm name | 2011-10-31 | GODFREY HAMMEL, DANNEELS & CO., P.C |
| Accountancy firm EIN | 2011-10-31 | 381878652 |
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10002386 |
| Policy instance | 2 |
| Insurance contract or identification number | 10002386 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 914816 |
| Policy instance | 6 |
| Insurance contract or identification number | 914816 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3252 & C4516 |
| Policy instance | 5 |
| Insurance contract or identification number | G3252 & C4516 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 311804 |
| Policy instance | 4 |
| Insurance contract or identification number | 311804 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 304452 |
| Policy instance | 3 |
| Insurance contract or identification number | 304452 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 007004559 |
| Policy instance | 1 |
| Insurance contract or identification number | 007004559 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3252 & C4516 |
| Policy instance | 1 |
| Insurance contract or identification number | G3252 & C4516 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | 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 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 007004559 |
| Policy instance | 2 |
| Insurance contract or identification number | 007004559 | | Number of Individuals Covered | 1028 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | HEARING | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 285534 |
| Policy instance | 4 |
| Insurance contract or identification number | 285534 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 304452 |
| Policy instance | 6 |
| Insurance contract or identification number | 304452 | | Number of Individuals Covered | 423 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $46,100 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,071,872 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,100 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 914816 |
| Policy instance | 5 |
| Insurance contract or identification number | 914816 | | Number of Individuals Covered | 187 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $48 | | Total amount of fees paid to insurance company | USD $108,521 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,923,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48 | | Amount paid for insurance broker fees | 108521 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10002386 |
| Policy instance | 3 |
| Insurance contract or identification number | 10002386 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 311804 |
| Policy instance | 7 |
| Insurance contract or identification number | 311804 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $700 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,747 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $700 | | Insurance broker organization code? | 3 |
|
| ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 ) |
| Policy contract number | 10005035 |
| Policy instance | 6 |
| Insurance contract or identification number | 10005035 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10005034 |
| Policy instance | 5 |
| Insurance contract or identification number | 10005034 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3252 & C4516 |
| Policy instance | 1 |
| Insurance contract or identification number | G3252 & C4516 | | Number of Individuals Covered | 574 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $4,397 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $43,974 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,397 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 44116 |
| Policy instance | 2 |
| Insurance contract or identification number | 44116 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | HEARING | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10002386 |
| Policy instance | 3 |
| Insurance contract or identification number | 10002386 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $17,968 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $523,903 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,968 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 285534 |
| Policy instance | 4 |
| Insurance contract or identification number | 285534 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10005034 |
| Policy instance | 5 |
| Insurance contract or identification number | 10005034 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 285534 |
| Policy instance | 4 |
| Insurance contract or identification number | 285534 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10002386 |
| Policy instance | 3 |
| Insurance contract or identification number | 10002386 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 44116 |
| Policy instance | 2 |
| Insurance contract or identification number | 44116 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | HEARING | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3252 & C4516 |
| Policy instance | 1 |
| Insurance contract or identification number | G3252 & C4516 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | 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 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 ) |
| Policy contract number | 10005035 |
| Policy instance | 6 |
| Insurance contract or identification number | 10005035 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0009 |
| Policy instance | 10 |
| Insurance contract or identification number | 00120600/0009 | | Number of Individuals Covered | 139 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | 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 $973,244 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0008 |
| Policy instance | 9 |
| Insurance contract or identification number | 00120600/0008 | | Number of Individuals Covered | 1212 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $124,416 | | 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 $7,044,512 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $124,416 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| COVENTRY HEALTH CARE OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 95114 ) |
| Policy contract number | 6037120000 |
| Policy instance | 7 |
| Insurance contract or identification number | 6037120000 | | Number of Individuals Covered | 515 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $156,752 | | 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 $3,114,931 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $156,752 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0007 |
| Policy instance | 8 |
| Insurance contract or identification number | 00120600/0007 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | 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 $2,152,332 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0005 |
| Policy instance | 6 |
| Insurance contract or identification number | 00120600/0005 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | 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 $20,628 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3252 & C4516 |
| Policy instance | 1 |
| Insurance contract or identification number | G3252 & C4516 | | Number of Individuals Covered | 509 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $5,046 | | 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 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $50,461 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,046 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT SUDLER |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0002 |
| Policy instance | 2 |
| Insurance contract or identification number | 00120600/0002 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | 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 | | Other welfare benefits provided | HEARING | | Welfare Benefit Premiums Paid to Carrier | USD $16,479 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 44116 |
| Policy instance | 3 |
| Insurance contract or identification number | 44116 | | Number of Individuals Covered | 1137 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $12,837 | | Total amount of fees paid to insurance company | USD $350 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | HEARING | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,837 | | Amount paid for insurance broker fees | 350 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT A SUDLER |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10002386 |
| Policy instance | 4 |
| Insurance contract or identification number | 10002386 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $19,987 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $501,699 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,987 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT A SUDLER |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0004 |
| Policy instance | 5 |
| Insurance contract or identification number | 00120600/0004 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | 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 $82,270 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0002 |
| Policy instance | 2 |
| Insurance contract or identification number | 00120600/0002 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | 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 | | Other welfare benefits provided | HEARING | | Welfare Benefit Premiums Paid to Carrier | USD $21,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 44116 |
| Policy instance | 3 |
| Insurance contract or identification number | 44116 | | Number of Individuals Covered | 937 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $12,728 | | Total amount of fees paid to insurance company | USD $31,531 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,728 | | Amount paid for insurance broker fees | 31531 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT A SUDLER |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10002386 |
| Policy instance | 4 |
| Insurance contract or identification number | 10002386 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $22,906 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $624,962 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,906 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT A SUDLER |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0003 |
| Policy instance | 5 |
| Insurance contract or identification number | 00120600/0003 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $11,967 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $-2,300 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,967 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0007 |
| Policy instance | 10 |
| Insurance contract or identification number | 00120600/0007 | | Number of Individuals Covered | 326 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,215,881 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0004 |
| Policy instance | 6 |
| Insurance contract or identification number | 00120600/0004 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | 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 $104,233 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0005 |
| Policy instance | 7 |
| Insurance contract or identification number | 00120600/0005 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | 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 $49,152 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COVENTRY HEALTH CARE OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 95114 ) |
| Policy contract number | 6037120000 |
| Policy instance | 8 |
| Insurance contract or identification number | 6037120000 | | Number of Individuals Covered | 523 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $154,831 | | 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 $2,829,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $154,831 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0006 |
| Policy instance | 9 |
| Insurance contract or identification number | 00120600/0006 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $-241 | | 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 $-6,310 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $-241 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0008 |
| Policy instance | 11 |
| Insurance contract or identification number | 00120600/0008 | | Number of Individuals Covered | 1303 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $124,253 | | 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 $7,260,604 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $124,253 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0009 |
| Policy instance | 12 |
| Insurance contract or identification number | 00120600/0009 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | 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 $1,151,777 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F640001 |
| Policy instance | 1 |
| Insurance contract or identification number | F640001 | | Number of Individuals Covered | 546 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $3,318 | | Total amount of fees paid to insurance company | USD $995 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEPENDENT SPOUSE/AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $33,176 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,318 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 995 | | Insurance broker name | AMERICAN BENEFITS AGENCY |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0002 |
| Policy instance | 2 |
| Insurance contract or identification number | 00120600/0002 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $11,862 | | 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 | | Other welfare benefits provided | HEARING | | Welfare Benefit Premiums Paid to Carrier | USD $15,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,862 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F640001 |
| Policy instance | 1 |
| Insurance contract or identification number | F640001 | | Number of Individuals Covered | 497 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $8,808 | | Total amount of fees paid to insurance company | USD $2,643 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEPENDENT SPOUSE/AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $88,084 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,808 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2643 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | AMERICAN BENEFITS AGENCY |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0006 |
| Policy instance | 9 |
| Insurance contract or identification number | 00120600/0006 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $1,265 | | 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 $34,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,265 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| COVENTRY HEALTH CARE OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 95114 ) |
| Policy contract number | 6037120000 |
| Policy instance | 8 |
| Insurance contract or identification number | 6037120000 | | Number of Individuals Covered | 498 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $131,221 | | 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 $2,624,428 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $131,221 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0004 |
| Policy instance | 6 |
| Insurance contract or identification number | 00120600/0004 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $4,065 | | 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 $117,116 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,065 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0005 |
| Policy instance | 7 |
| Insurance contract or identification number | 00120600/0005 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $36,172 | | 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 $1,068,963 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,172 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0003 |
| Policy instance | 5 |
| Insurance contract or identification number | 00120600/0003 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $36,621 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $777,918 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,621 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10002386 |
| Policy instance | 4 |
| Insurance contract or identification number | 10002386 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $20,505 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $557,231 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,505 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT A SUDLER |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 44116 |
| Policy instance | 3 |
| Insurance contract or identification number | 44116 | | Number of Individuals Covered | 927 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $55,886 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,536 | | Insurance broker organization code? | 3 | | Insurance broker name | LOUIS W. LAPIANA |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0007 |
| Policy instance | 10 |
| Insurance contract or identification number | 00120600/0007 | | Number of Individuals Covered | 309 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $31,121 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $687,960 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,121 | | Insurance broker organization code? | 3 | | Insurance broker name | SUDLER INSURANCE SERVICES |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00120600/0004 |
| Policy instance | 6 |
| Insurance contract or identification number | 00120600/0004 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $5,121 | | 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 $108,103 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00120600/0005 |
| Policy instance | 7 |
| Insurance contract or identification number | 00120600/0005 | | Number of Individuals Covered | 240 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $48,481 | | 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 $1,023,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00120600/0002 |
| Policy instance | 2 |
| Insurance contract or identification number | 00120600/0002 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $683 | | 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 | | Other welfare benefits provided | HEARING | | Welfare Benefit Premiums Paid to Carrier | USD $14,416 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COVENTRY HEALTH CARE OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 95114 ) |
| Policy contract number | 6037120000 |
| Policy instance | 8 |
| Insurance contract or identification number | 6037120000 | | Number of Individuals Covered | 430 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $127,047 | | 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 $2,532,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00120600/0006 |
| Policy instance | 9 |
| Insurance contract or identification number | 00120600/0006 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $1,680 | | 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 $35,465 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00120600/0003 |
| Policy instance | 5 |
| Insurance contract or identification number | 00120600/0003 | | Number of Individuals Covered | 315 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $13,157 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,536,213 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 1-95128AA/LT/RA |
| Policy instance | 4 |
| Insurance contract or identification number | 1-95128AA/LT/RA | | Number of Individuals Covered | 67 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $6,779 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $596,533 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 44116 |
| Policy instance | 3 |
| Insurance contract or identification number | 44116 | | Number of Individuals Covered | 1612 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $58,066 | | Total amount of fees paid to insurance company | USD $4,819 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F640001 |
| Policy instance | 1 |
| Insurance contract or identification number | F640001 | | Number of Individuals Covered | 613 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $9,095 | | Total amount of fees paid to insurance company | USD $2,728 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEPENDENT SPOUSE/AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $90,951 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0004 |
| Policy instance | 6 |
| Insurance contract or identification number | 00120600/0004 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $3,097 | | 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 $70,755 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0005 |
| Policy instance | 7 |
| Insurance contract or identification number | 00120600/0005 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $39,006 | | 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 $926,844 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0006 |
| Policy instance | 9 |
| Insurance contract or identification number | 00120600/0006 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $1,837 | | 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 $43,899 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F640001 |
| Policy instance | 1 |
| Insurance contract or identification number | F640001 | | Number of Individuals Covered | 873 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $9,375 | | Total amount of fees paid to insurance company | USD $2,812 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEPENDENT SPOUSE/AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $93,748 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0002 |
| Policy instance | 2 |
| Insurance contract or identification number | 00120600/0002 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $5,684 | | 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 | | Other welfare benefits provided | HEARING | | Welfare Benefit Premiums Paid to Carrier | USD $13,236 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 44116 |
| Policy instance | 3 |
| Insurance contract or identification number | 44116 | | Number of Individuals Covered | 1502 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $51,810 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COVENTRY HEALTH CARE OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 95114 ) |
| Policy contract number | 6037120000 |
| Policy instance | 8 |
| Insurance contract or identification number | 6037120000 | | Number of Individuals Covered | 489 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $133,137 | | 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 $2,617,963 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00120600/0003 |
| Policy instance | 5 |
| Insurance contract or identification number | 00120600/0003 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $29,697 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,545,869 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 1-95128AA/LT/RA |
| Policy instance | 4 |
| Insurance contract or identification number | 1-95128AA/LT/RA | | Number of Individuals Covered | 67 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $608,837 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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