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SBV HEALTH PLAN 401k Plan overview

Plan NameSBV HEALTH PLAN
Plan identification number 501

SBV HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

VOS ELECTRIC, INC. has sponsored the creation of one or more 401k plans.

Company Name:VOS ELECTRIC, INC.
Employer identification number (EIN):391526928
NAIC Classification:238210
NAIC Description:Electrical Contractors and Other Wiring Installation Contractors

Additional information about VOS ELECTRIC, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2070816

More information about VOS ELECTRIC, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SBV HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01DAVID VAN DEN HEUVEL2022-10-14
5012020-01-01JIM KELLAM2021-10-15
5012019-01-01JIM KELLAM2020-10-14
5012019-01-01JIM KELLAM2021-10-08
5012018-01-01JIM KELLAM2019-10-07
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01DAVID VAN DEN HEUVEL
5012011-01-01DAVID VAN DEN HEUVEL
5012010-01-01DAVID VAN DEN HEUVEL
5012009-01-01DAVID VAN DEN HEUVEL
5012009-01-01DAVID VAN DEN HEUVEL
5012009-01-01DAVID VAN DEN HEUVEL

Plan Statistics for SBV HEALTH PLAN

401k plan membership statisitcs for SBV HEALTH PLAN

Measure Date Value
2022: SBV HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01352
Total number of active participants reported on line 7a of the Form 55002022-01-01346
Number of retired or separated participants receiving benefits2022-01-015
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01351
2021: SBV HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01347
Total number of active participants reported on line 7a of the Form 55002021-01-01347
Number of retired or separated participants receiving benefits2021-01-015
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01352
2020: SBV HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01408
Total number of active participants reported on line 7a of the Form 55002020-01-01344
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01347
2019: SBV HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01404
Total number of active participants reported on line 7a of the Form 55002019-01-01391
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01393
2018: SBV HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01407
Total number of active participants reported on line 7a of the Form 55002018-01-01385
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01387
2017: SBV HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01386
Total number of active participants reported on line 7a of the Form 55002017-01-01401
Number of retired or separated participants receiving benefits2017-01-016
Total of all active and inactive participants2017-01-01407
2016: SBV HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01400
Total number of active participants reported on line 7a of the Form 55002016-01-01391
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-01392
2015: SBV HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01361
Total number of active participants reported on line 7a of the Form 55002015-01-01400
Number of retired or separated participants receiving benefits2015-01-011
Total of all active and inactive participants2015-01-01401
2014: SBV HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01333
Total number of active participants reported on line 7a of the Form 55002014-01-01360
Number of retired or separated participants receiving benefits2014-01-011
Total of all active and inactive participants2014-01-01361
2013: SBV HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01349
Total number of active participants reported on line 7a of the Form 55002013-01-01330
Number of retired or separated participants receiving benefits2013-01-013
Total of all active and inactive participants2013-01-01333
2012: SBV HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01356
Total number of active participants reported on line 7a of the Form 55002012-01-01349
Total of all active and inactive participants2012-01-01349
2011: SBV HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01342
Total number of active participants reported on line 7a of the Form 55002011-01-01356
Total of all active and inactive participants2011-01-01356
2010: SBV HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01351
Total number of active participants reported on line 7a of the Form 55002010-01-01342
Total of all active and inactive participants2010-01-01342
2009: SBV HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01386
Total number of active participants reported on line 7a of the Form 55002009-01-01351
Total of all active and inactive participants2009-01-01351

Financial Data on SBV HEALTH PLAN

Measure Date Value
2022 : SBV HEALTH PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$5,545,384
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$5,451,112
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$5,252,350
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$5,544,230
Value of total assets at end of year2022-12-31$582,886
Value of total assets at beginning of year2022-12-31$488,614
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$198,762
Total interest from all sources2022-12-31$1,154
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31No
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$893,982
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$448
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Total non interest bearing cash at end of year2022-12-31$-38,382
Total non interest bearing cash at beginning of year2022-12-31$-38,380
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$94,272
Value of net assets at end of year (total assets less liabilities)2022-12-31$582,886
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$488,614
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$620,820
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$526,994
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$526,994
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$1,154
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$476,558
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$4,650,248
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$4,775,792
Contract administrator fees2022-12-31$198,762
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WIPFLI LLP
Accountancy firm EIN2022-12-31390758449
2021 : SBV HEALTH PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$4,174,553
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$4,241,215
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$4,090,397
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$4,174,513
Value of total assets at end of year2021-12-31$488,614
Value of total assets at beginning of year2021-12-31$555,276
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$150,818
Total interest from all sources2021-12-31$40
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31No
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$890,595
Total non interest bearing cash at end of year2021-12-31$-38,380
Total non interest bearing cash at beginning of year2021-12-31$-38,379
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-66,662
Value of net assets at end of year (total assets less liabilities)2021-12-31$488,614
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$555,276
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$526,994
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$593,655
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$593,655
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$40
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$416,498
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$3,283,918
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$3,673,899
Contract administrator fees2021-12-31$150,818
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WIPFLI LLP
Accountancy firm EIN2021-12-31390758449
2020 : SBV HEALTH PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$5,359,094
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$4,896,169
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$4,802,356
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$5,358,171
Value of total assets at end of year2020-12-31$555,276
Value of total assets at beginning of year2020-12-31$92,351
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$93,813
Total interest from all sources2020-12-31$923
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31No
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$979,313
Total non interest bearing cash at end of year2020-12-31$-38,379
Total non interest bearing cash at beginning of year2020-12-31$-38,379
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$462,925
Value of net assets at end of year (total assets less liabilities)2020-12-31$555,276
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$92,351
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$593,655
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$130,730
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$130,730
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$923
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$437,346
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$4,378,858
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$4,365,010
Contract administrator fees2020-12-31$93,813
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31WIPFLI LLP
Accountancy firm EIN2020-12-31390758449
2019 : SBV HEALTH PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$5,012,996
Total income from all sources (including contributions)2019-12-31$5,012,996
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$4,926,124
Total of all expenses incurred2019-12-31$4,926,124
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$4,808,065
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$4,808,065
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,011,649
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,011,649
Value of total assets at end of year2019-12-31$92,351
Value of total assets at end of year2019-12-31$92,351
Value of total assets at beginning of year2019-12-31$5,479
Value of total assets at beginning of year2019-12-31$5,479
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$118,059
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$118,059
Total interest from all sources2019-12-31$1,347
Total interest from all sources2019-12-31$1,347
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$996,800
Contributions received from participants2019-12-31$996,800
Total non interest bearing cash at end of year2019-12-31$-38,379
Total non interest bearing cash at end of year2019-12-31$-38,379
Total non interest bearing cash at beginning of year2019-12-31$-38,378
Total non interest bearing cash at beginning of year2019-12-31$-38,378
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$86,872
Value of net income/loss2019-12-31$86,872
Value of net assets at end of year (total assets less liabilities)2019-12-31$92,351
Value of net assets at end of year (total assets less liabilities)2019-12-31$92,351
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,479
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,479
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$130,730
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$130,730
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$43,857
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$43,857
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$43,857
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$43,857
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$1,347
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$1,347
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$407,273
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$407,273
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$4,014,849
Contributions received in cash from employer2019-12-31$4,014,849
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$4,400,792
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$4,400,792
Contract administrator fees2019-12-31$118,059
Contract administrator fees2019-12-31$118,059
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31WIPFLI LLP
Accountancy firm name2019-12-31WIPFLI LLP
Accountancy firm EIN2019-12-31390758449
Accountancy firm EIN2019-12-31390758449
2018 : SBV HEALTH PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$4,648,776
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$4,643,693
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$4,356,399
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$4,647,741
Value of total assets at end of year2018-12-31$5,479
Value of total assets at beginning of year2018-12-31$396
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$287,294
Total interest from all sources2018-12-31$1,035
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$600,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,041,443
Total non interest bearing cash at end of year2018-12-31$-38,378
Total non interest bearing cash at beginning of year2018-12-31$-42,062
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$5,083
Value of net assets at end of year (total assets less liabilities)2018-12-31$5,479
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$396
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$1,112
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$43,857
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$42,458
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$42,458
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$1,035
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$755,101
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$3,606,298
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$3,601,298
Contract administrator fees2018-12-31$286,182
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2018-12-31410746749
2017 : SBV HEALTH PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$4,856,196
Total of all expenses incurred2017-12-31$4,852,720
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$4,589,783
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$4,855,753
Value of total assets at end of year2017-12-31$396
Value of total assets at beginning of year2017-12-31$-3,080
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$262,937
Total interest from all sources2017-12-31$443
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$600,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$994,908
Total non interest bearing cash at end of year2017-12-31$-42,062
Total non interest bearing cash at beginning of year2017-12-31$-42,627
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$3,476
Value of net assets at end of year (total assets less liabilities)2017-12-31$396
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-3,080
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$1,082
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$42,458
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$39,547
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$39,547
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$443
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$669,745
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$3,860,845
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$3,920,038
Contract administrator fees2017-12-31$261,855
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31SCHENCK SC
Accountancy firm EIN2017-12-31391173131
2016 : SBV HEALTH PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$4,187,646
Total of all expenses incurred2016-12-31$4,193,924
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,945,244
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$4,187,451
Value of total assets at end of year2016-12-31$-3,080
Value of total assets at beginning of year2016-12-31$3,198
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$248,680
Total interest from all sources2016-12-31$195
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$600,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$984,828
Total non interest bearing cash at end of year2016-12-31$-42,627
Total non interest bearing cash at beginning of year2016-12-31$-37,222
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-6,278
Value of net assets at end of year (total assets less liabilities)2016-12-31$-3,080
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$1,124
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$39,547
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$40,420
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$40,420
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$195
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$672,944
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$3,202,623
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$3,272,300
Contract administrator fees2016-12-31$247,556
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31SCHENCK SC
Accountancy firm EIN2016-12-31391173131
2015 : SBV HEALTH PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$4,019,560
Total of all expenses incurred2015-12-31$4,020,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,787,067
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$4,019,523
Value of total assets at end of year2015-12-31$3,198
Value of total assets at beginning of year2015-12-31$4,595
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$233,890
Total interest from all sources2015-12-31$37
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$600,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$889,826
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$1
Total non interest bearing cash at end of year2015-12-31$-37,222
Total non interest bearing cash at beginning of year2015-12-31$-38,206
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-1,397
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,198
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$4,595
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$1,130
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$40,420
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$42,800
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$42,800
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$37
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$587,838
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$3,129,697
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$3,199,229
Contract administrator fees2015-12-31$232,760
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31SCHENCK SC
Accountancy firm EIN2015-12-31391173131
2014 : SBV HEALTH PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$3,593,044
Total of all expenses incurred2014-12-31$3,876,958
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$3,665,038
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$3,593,030
Value of total assets at end of year2014-12-31$4,595
Value of total assets at beginning of year2014-12-31$288,509
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$211,920
Total interest from all sources2014-12-31$14
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$600,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$757,348
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$1
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$2
Total non interest bearing cash at end of year2014-12-31$-38,206
Total non interest bearing cash at beginning of year2014-12-31$-962
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-283,914
Value of net assets at end of year (total assets less liabilities)2014-12-31$4,595
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$288,509
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$1,172
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$42,800
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$289,469
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$289,469
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$14
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$515,881
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$2,835,682
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$3,149,157
Contract administrator fees2014-12-31$210,748
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31SCHENCK SC
Accountancy firm EIN2014-12-31391173131
2013 : SBV HEALTH PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$3,817,340
Total of all expenses incurred2013-12-31$3,521,348
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$3,371,251
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$3,817,322
Value of total assets at end of year2013-12-31$288,509
Value of total assets at beginning of year2013-12-31$-7,483
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$150,097
Total interest from all sources2013-12-31$18
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$600,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$655,850
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$2
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$3
Total non interest bearing cash at end of year2013-12-31$-962
Total non interest bearing cash at beginning of year2013-12-31$-86,419
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$295,992
Value of net assets at end of year (total assets less liabilities)2013-12-31$288,509
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-7,483
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$1,166
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$289,469
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$78,933
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$78,933
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$18
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$422,925
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$3,161,472
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$2,948,326
Contract administrator fees2013-12-31$148,931
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31SCHENCK SC
Accountancy firm EIN2013-12-31391173131
2012 : SBV HEALTH PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$3,887,876
Total of all expenses incurred2012-12-31$3,782,643
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,610,693
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$3,887,838
Value of total assets at end of year2012-12-31$-7,483
Value of total assets at beginning of year2012-12-31$-112,716
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$171,950
Total interest from all sources2012-12-31$38
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$600,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$446,715
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$3
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$2
Total non interest bearing cash at end of year2012-12-31$-86,419
Total non interest bearing cash at beginning of year2012-12-31$-129,479
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$105,233
Value of net assets at end of year (total assets less liabilities)2012-12-31$-7,483
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-112,716
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$1,124
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$78,933
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$16,761
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$16,761
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$38
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$576,890
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$3,441,123
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$3,033,803
Contract administrator fees2012-12-31$170,826
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31SCHENCK SC
Accountancy firm EIN2012-12-31391173131
2011 : SBV HEALTH PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$3,933,039
Total of all expenses incurred2011-12-31$4,001,448
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$3,814,198
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$3,933,016
Value of total assets at end of year2011-12-31$-112,716
Value of total assets at beginning of year2011-12-31$-44,307
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$187,250
Total interest from all sources2011-12-31$23
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$600,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$420,105
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$2
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$2
Total non interest bearing cash at end of year2011-12-31$-129,479
Total non interest bearing cash at beginning of year2011-12-31$-62,689
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-68,409
Value of net assets at end of year (total assets less liabilities)2011-12-31$-112,716
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-44,307
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$1,100
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$16,761
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$18,380
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$18,380
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$23
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$482,096
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$3,512,911
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$3,332,102
Contract administrator fees2011-12-31$186,150
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31SCHENCK SC
Accountancy firm EIN2011-12-31391173131
2010 : SBV HEALTH PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$3,272,091
Total of all expenses incurred2010-12-31$3,290,952
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$3,128,175
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$3,272,064
Value of total assets at end of year2010-12-31$-44,307
Value of total assets at beginning of year2010-12-31$-25,446
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$162,777
Total interest from all sources2010-12-31$27
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$600,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$436,665
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$2
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$1
Total non interest bearing cash at end of year2010-12-31$-62,689
Total non interest bearing cash at beginning of year2010-12-31$-52,830
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-18,861
Value of net assets at end of year (total assets less liabilities)2010-12-31$-44,307
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-25,446
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$1,023
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$18,380
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$27,383
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$27,383
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$27
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$393,723
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$2,835,399
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,734,452
Contract administrator fees2010-12-31$161,754
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31SCHENCK SC
Accountancy firm EIN2010-12-31391173131

Form 5500 Responses for SBV HEALTH PLAN

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

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00226765
Policy instance 2
Insurance contract or identification number00226765
Number of Individuals Covered811
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $662,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered381
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,148
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,148
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00226765
Policy instance 2
Insurance contract or identification number00226765
Number of Individuals Covered777
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $606,491
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered375
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,186
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,186
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered384
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,263
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,263
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00226765
Policy instance 2
Insurance contract or identification number00226765
Number of Individuals Covered793
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $604,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00226765
Policy instance 2
Insurance contract or identification number00226765
Number of Individuals Covered873
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $597,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered418
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,287
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedA D &D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,074
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number00226765
Policy instance 2
Insurance contract or identification number00226765
Number of Individuals Covered388
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $743,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered422
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,343
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedA D &D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $751
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number
Policy instance 2
Number of Individuals Covered405
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $657,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered425
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,459
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D &D
Welfare Benefit Premiums Paid to CarrierUSD $12,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,217
Insurance broker organization code?3
Insurance broker nameAON CONSULTING INC
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number
Policy instance 2
Number of Individuals Covered178
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $576,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered420
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,180
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D &D
Welfare Benefit Premiums Paid to CarrierUSD $11,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,180
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL INC
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number
Policy instance 2
Number of Individuals Covered358
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $27,731
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $504,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,731
Insurance broker organization code?3
Insurance broker nameAON CONSULTING INC.
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered393
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,105
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D &D
Welfare Benefit Premiums Paid to CarrierUSD $11,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,105
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL INC
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered359
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,175
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D &D
Welfare Benefit Premiums Paid to CarrierUSD $10,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,175
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL INC
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number
Policy instance 2
Number of Individuals Covered320
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $41,084
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $412,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,084
Insurance broker organization code?3
Insurance broker nameAON CONSULTING INC.
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number017006010673
Policy instance 2
Insurance contract or identification number017006010673
Number of Individuals Covered346
Insurance policy start date2012-01-01
Insurance policy end date2013-01-01
Total amount of commissions paid to insurance brokerUSD $26,375
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $329,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,375
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL INC
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered386
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $20,002
Total amount of fees paid to insurance companyUSD $11,792
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D &D
Welfare Benefit Premiums Paid to CarrierUSD $247,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,002
Insurance broker organization code?3
Amount paid for insurance broker fees11792
Additional information about fees paid to insurance brokerADMINISTRATION AND SERVICE FEE
Insurance broker nameUMR INC
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered390
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $44,491
Total amount of fees paid to insurance companyUSD $23,575
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D &D
Welfare Benefit Premiums Paid to CarrierUSD $482,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number63969-9
Policy instance 1
Insurance contract or identification number63969-9
Number of Individuals Covered377
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $19,180
Total amount of fees paid to insurance companyUSD $17,388
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D &D
Welfare Benefit Premiums Paid to CarrierUSD $237,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,180
Amount paid for insurance broker fees6076
Additional information about fees paid to insurance brokerWRITING AGENT AND KEY BROKER.
Insurance broker organization code?3
Insurance broker nameUMR INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number017004010673
Policy instance 2
Insurance contract or identification number017004010673
Number of Individuals Covered342
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $12,552
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $156,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,552
Additional information about fees paid to insurance brokerMANAGING PRODUCER FEE
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL INC

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