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MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 401k Plan overview

Plan NameMIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST
Plan identification number 501

MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST has sponsored the creation of one or more 401k plans.

Company Name:MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST
Employer identification number (EIN):416175413
NAIC Classification:423300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01STEPHANIE GREENINGER2024-02-14
5012021-05-01STEPHANIE GREENINGER2023-02-08
5012020-05-01RICHARD JOHNSON2022-02-09
5012019-05-01RICHARD JOHNSON2021-01-27 RICHARD JOHNSON2021-01-27
5012018-05-01RICHARD JOHNSON2020-02-13 RICHARD JOHNSON2020-02-13
5012017-05-01
5012016-05-01
5012015-05-01
5012014-05-01
5012013-05-01RICHARD JOHNSON
5012012-05-01RICHARD JOHNSON
5012011-05-01RICHARD JOHNSON
5012009-05-01RICHARD JOHNSON
5012009-05-01RICHARD JOHNSON

Plan Statistics for MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST

401k plan membership statisitcs for MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST

Measure Date Value
2022: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2022 401k membership
Total participants, beginning-of-year2022-05-01122
Total number of active participants reported on line 7a of the Form 55002022-05-01106
Number of retired or separated participants receiving benefits2022-05-011
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01107
Number of employers contributing to the scheme2022-05-014
2021: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2021 401k membership
Total participants, beginning-of-year2021-05-01124
Total number of active participants reported on line 7a of the Form 55002021-05-01119
Number of retired or separated participants receiving benefits2021-05-013
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01122
Number of employers contributing to the scheme2021-05-014
2020: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2020 401k membership
Total participants, beginning-of-year2020-05-01129
Total number of active participants reported on line 7a of the Form 55002020-05-01123
Number of retired or separated participants receiving benefits2020-05-011
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01124
Number of employers contributing to the scheme2020-05-014
2019: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2019 401k membership
Total participants, beginning-of-year2019-05-01137
Total number of active participants reported on line 7a of the Form 55002019-05-01128
Number of retired or separated participants receiving benefits2019-05-011
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01129
Number of employers contributing to the scheme2019-05-015
2018: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2018 401k membership
Total participants, beginning-of-year2018-05-01129
Total number of active participants reported on line 7a of the Form 55002018-05-01135
Number of retired or separated participants receiving benefits2018-05-012
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01137
2017: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2017 401k membership
Total participants, beginning-of-year2017-05-01121
Total number of active participants reported on line 7a of the Form 55002017-05-01124
Number of retired or separated participants receiving benefits2017-05-015
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01129
Number of employers contributing to the scheme2017-05-015
2016: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2016 401k membership
Total participants, beginning-of-year2016-05-01120
Total number of active participants reported on line 7a of the Form 55002016-05-01118
Number of retired or separated participants receiving benefits2016-05-013
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01121
Number of employers contributing to the scheme2016-05-015
2015: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2015 401k membership
Total participants, beginning-of-year2015-05-01119
Total number of active participants reported on line 7a of the Form 55002015-05-01116
Number of retired or separated participants receiving benefits2015-05-014
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-01120
Number of employers contributing to the scheme2015-05-015
2014: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2014 401k membership
Total participants, beginning-of-year2014-05-01124
Total number of active participants reported on line 7a of the Form 55002014-05-01114
Number of retired or separated participants receiving benefits2014-05-015
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-01119
Number of employers contributing to the scheme2014-05-015
2013: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2013 401k membership
Total participants, beginning-of-year2013-05-01189
Total number of active participants reported on line 7a of the Form 55002013-05-01116
Number of retired or separated participants receiving benefits2013-05-018
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-01124
Number of employers contributing to the scheme2013-05-016
2012: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2012 401k membership
Total participants, beginning-of-year2012-05-01186
Total number of active participants reported on line 7a of the Form 55002012-05-01176
Number of retired or separated participants receiving benefits2012-05-0113
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-01189
Number of employers contributing to the scheme2012-05-017
2011: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2011 401k membership
Total participants, beginning-of-year2011-05-01165
Total number of active participants reported on line 7a of the Form 55002011-05-01162
Number of retired or separated participants receiving benefits2011-05-0124
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-01186
Number of employers contributing to the scheme2011-05-017
2009: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year2009-05-01189
Total number of active participants reported on line 7a of the Form 55002009-05-01187
Number of retired or separated participants receiving benefits2009-05-0117
Total of all active and inactive participants2009-05-01204
Total participants2009-05-01204
Number of employers contributing to the scheme2009-05-018

Financial Data on MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST

Measure Date Value
2023 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-04-30$188,417
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-04-30$267,502
Total income from all sources (including contributions)2023-04-30$2,015,638
Total loss/gain on sale of assets2023-04-30$0
Total of all expenses incurred2023-04-30$2,003,523
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-04-30$1,834,395
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-04-30$1,943,988
Value of total assets at end of year2023-04-30$4,443,436
Value of total assets at beginning of year2023-04-30$4,510,406
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-04-30$169,128
Total interest from all sources2023-04-30$71,650
Total dividends received (eg from common stock, registered investment company shares)2023-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-04-30No
Administrative expenses professional fees incurred2023-04-30$48,112
Was this plan covered by a fidelity bond2023-04-30Yes
Value of fidelity bond cover2023-04-30$500,000
If this is an individual account plan, was there a blackout period2023-04-30No
Were there any nonexempt tranactions with any party-in-interest2023-04-30No
Contributions received from participants2023-04-30$737
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-04-30$76,437
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-04-30$58,239
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-04-30$0
Administrative expenses (other) incurred2023-04-30$42,641
Liabilities. Value of operating payables at end of year2023-04-30$65,417
Liabilities. Value of operating payables at beginning of year2023-04-30$144,502
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-04-30No
Value of net income/loss2023-04-30$12,115
Value of net assets at end of year (total assets less liabilities)2023-04-30$4,255,019
Value of net assets at beginning of year (total assets less liabilities)2023-04-30$4,242,904
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2023-04-30No
Were any leases to which the plan was party in default or uncollectible2023-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-04-30$4,366,999
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-04-30$4,452,167
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-04-30$4,452,167
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-04-30$71,650
Expenses. Payments to insurance carriers foe the provision of benefits2023-04-30$475,563
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-04-30No
Was there a failure to transmit to the plan any participant contributions2023-04-30No
Has the plan failed to provide any benefit when due under the plan2023-04-30No
Contributions received in cash from employer2023-04-30$1,943,251
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-04-30$1,358,832
Contract administrator fees2023-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2023-04-30$123,000
Liabilities. Value of benefit claims payable at beginning of year2023-04-30$123,000
Did the plan have assets held for investment2023-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-04-30No
Opinion of an independent qualified public accountant for this plan2023-04-30Unqualified
Accountancy firm name2023-04-30BETTS & HAYES, LTD
Accountancy firm EIN2023-04-30411619880
2022 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-04-30$267,502
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-04-30$174,480
Total income from all sources (including contributions)2022-04-30$1,947,839
Total loss/gain on sale of assets2022-04-30$0
Total of all expenses incurred2022-04-30$2,102,630
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-04-30$1,924,346
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-04-30$1,922,629
Value of total assets at end of year2022-04-30$4,510,406
Value of total assets at beginning of year2022-04-30$4,572,175
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-04-30$178,284
Total interest from all sources2022-04-30$25,210
Total dividends received (eg from common stock, registered investment company shares)2022-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-04-30No
Administrative expenses professional fees incurred2022-04-30$53,359
Was this plan covered by a fidelity bond2022-04-30Yes
Value of fidelity bond cover2022-04-30$500,000
If this is an individual account plan, was there a blackout period2022-04-30No
Were there any nonexempt tranactions with any party-in-interest2022-04-30No
Contributions received from participants2022-04-30$9,116
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-04-30$58,239
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-04-30$58,733
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-04-30$0
Administrative expenses (other) incurred2022-04-30$46,550
Liabilities. Value of operating payables at end of year2022-04-30$144,502
Liabilities. Value of operating payables at beginning of year2022-04-30$51,480
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-04-30No
Value of net income/loss2022-04-30$-154,791
Value of net assets at end of year (total assets less liabilities)2022-04-30$4,242,904
Value of net assets at beginning of year (total assets less liabilities)2022-04-30$4,397,695
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-04-30No
Were any leases to which the plan was party in default or uncollectible2022-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-04-30$4,452,167
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-04-30$4,513,442
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-04-30$4,513,442
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-04-30$25,210
Expenses. Payments to insurance carriers foe the provision of benefits2022-04-30$486,143
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-04-30No
Was there a failure to transmit to the plan any participant contributions2022-04-30No
Has the plan failed to provide any benefit when due under the plan2022-04-30No
Contributions received in cash from employer2022-04-30$1,913,513
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-04-30$1,438,203
Contract administrator fees2022-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2022-04-30$123,000
Liabilities. Value of benefit claims payable at beginning of year2022-04-30$123,000
Did the plan have assets held for investment2022-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-04-30No
Opinion of an independent qualified public accountant for this plan2022-04-30Unqualified
Accountancy firm name2022-04-30BETTS & HAYES, LTD
Accountancy firm EIN2022-04-30411619880
2021 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-04-30$174,480
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-04-30$319,511
Total income from all sources (including contributions)2021-04-30$2,250,500
Total loss/gain on sale of assets2021-04-30$0
Total of all expenses incurred2021-04-30$1,964,644
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-04-30$1,785,130
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-04-30$2,210,546
Value of total assets at end of year2021-04-30$4,572,175
Value of total assets at beginning of year2021-04-30$4,431,350
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-04-30$179,514
Total interest from all sources2021-04-30$39,954
Total dividends received (eg from common stock, registered investment company shares)2021-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-04-30No
Administrative expenses professional fees incurred2021-04-30$53,853
Was this plan covered by a fidelity bond2021-04-30Yes
Value of fidelity bond cover2021-04-30$500,000
If this is an individual account plan, was there a blackout period2021-04-30No
Were there any nonexempt tranactions with any party-in-interest2021-04-30No
Contributions received from participants2021-04-30$914
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-04-30$58,733
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-04-30$36,038
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-04-30$144,734
Administrative expenses (other) incurred2021-04-30$47,286
Liabilities. Value of operating payables at end of year2021-04-30$51,480
Liabilities. Value of operating payables at beginning of year2021-04-30$51,777
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-04-30No
Value of net income/loss2021-04-30$285,856
Value of net assets at end of year (total assets less liabilities)2021-04-30$4,397,695
Value of net assets at beginning of year (total assets less liabilities)2021-04-30$4,111,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-04-30No
Were any leases to which the plan was party in default or uncollectible2021-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-04-30$4,513,442
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-04-30$4,395,312
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-04-30$4,395,312
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-04-30$39,954
Expenses. Payments to insurance carriers foe the provision of benefits2021-04-30$498,346
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-04-30No
Was there a failure to transmit to the plan any participant contributions2021-04-30No
Has the plan failed to provide any benefit when due under the plan2021-04-30No
Contributions received in cash from employer2021-04-30$2,209,632
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-04-30$1,286,784
Contract administrator fees2021-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2021-04-30$123,000
Liabilities. Value of benefit claims payable at beginning of year2021-04-30$123,000
Did the plan have assets held for investment2021-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-04-30No
Opinion of an independent qualified public accountant for this plan2021-04-30Unqualified
Accountancy firm name2021-04-30BETTS & HAYES, LTD
Accountancy firm EIN2021-04-30411619880
2020 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$319,511
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$238,457
Total income from all sources (including contributions)2020-04-30$2,340,213
Total loss/gain on sale of assets2020-04-30$0
Total of all expenses incurred2020-04-30$1,619,272
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-04-30$1,447,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-04-30$2,275,081
Value of total assets at end of year2020-04-30$4,431,350
Value of total assets at beginning of year2020-04-30$3,629,355
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-04-30$172,031
Total interest from all sources2020-04-30$65,132
Total dividends received (eg from common stock, registered investment company shares)2020-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-04-30No
Administrative expenses professional fees incurred2020-04-30$54,219
Was this plan covered by a fidelity bond2020-04-30Yes
Value of fidelity bond cover2020-04-30$500,000
If this is an individual account plan, was there a blackout period2020-04-30No
Were there any nonexempt tranactions with any party-in-interest2020-04-30No
Contributions received from participants2020-04-30$540
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-04-30$36,038
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-04-30$30,817
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-04-30$144,734
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-04-30$0
Administrative expenses (other) incurred2020-04-30$39,437
Liabilities. Value of operating payables at end of year2020-04-30$51,777
Liabilities. Value of operating payables at beginning of year2020-04-30$107,457
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Value of net income/loss2020-04-30$720,941
Value of net assets at end of year (total assets less liabilities)2020-04-30$4,111,839
Value of net assets at beginning of year (total assets less liabilities)2020-04-30$3,390,898
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-04-30No
Were any leases to which the plan was party in default or uncollectible2020-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-04-30$4,395,312
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-04-30$3,598,538
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-04-30$3,598,538
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-04-30$65,132
Expenses. Payments to insurance carriers foe the provision of benefits2020-04-30$495,451
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-04-30No
Was there a failure to transmit to the plan any participant contributions2020-04-30No
Has the plan failed to provide any benefit when due under the plan2020-04-30No
Contributions received in cash from employer2020-04-30$2,274,541
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-04-30$951,790
Contract administrator fees2020-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2020-04-30$123,000
Liabilities. Value of benefit claims payable at beginning of year2020-04-30$131,000
Did the plan have assets held for investment2020-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-04-30No
Opinion of an independent qualified public accountant for this plan2020-04-30Unqualified
Accountancy firm name2020-04-30BETTS & HAYES, LTD
Accountancy firm EIN2020-04-30411619880
2019 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-04-30$238,457
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-04-30$256,033
Total income from all sources (including contributions)2019-04-30$2,395,966
Total loss/gain on sale of assets2019-04-30$0
Total of all expenses incurred2019-04-30$2,147,290
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-04-30$1,980,904
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-04-30$2,347,243
Value of total assets at end of year2019-04-30$3,629,355
Value of total assets at beginning of year2019-04-30$3,398,255
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-04-30$166,386
Total interest from all sources2019-04-30$48,723
Total dividends received (eg from common stock, registered investment company shares)2019-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-04-30No
Administrative expenses professional fees incurred2019-04-30$54,257
Was this plan covered by a fidelity bond2019-04-30Yes
Value of fidelity bond cover2019-04-30$500,000
If this is an individual account plan, was there a blackout period2019-04-30No
Were there any nonexempt tranactions with any party-in-interest2019-04-30No
Contributions received from participants2019-04-30$393
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-04-30$30,817
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-04-30$9,131
Administrative expenses (other) incurred2019-04-30$33,754
Liabilities. Value of operating payables at end of year2019-04-30$107,457
Liabilities. Value of operating payables at beginning of year2019-04-30$125,033
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Value of net income/loss2019-04-30$248,676
Value of net assets at end of year (total assets less liabilities)2019-04-30$3,390,898
Value of net assets at beginning of year (total assets less liabilities)2019-04-30$3,142,222
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-04-30No
Were any leases to which the plan was party in default or uncollectible2019-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-04-30$3,598,538
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-04-30$3,389,124
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-04-30$3,389,124
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-04-30$48,723
Expenses. Payments to insurance carriers foe the provision of benefits2019-04-30$511,170
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-04-30No
Was there a failure to transmit to the plan any participant contributions2019-04-30No
Has the plan failed to provide any benefit when due under the plan2019-04-30No
Contributions received in cash from employer2019-04-30$2,346,850
Employer contributions (assets) at end of year2019-04-30$0
Employer contributions (assets) at beginning of year2019-04-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-04-30$1,469,734
Contract administrator fees2019-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2019-04-30$131,000
Liabilities. Value of benefit claims payable at beginning of year2019-04-30$131,000
Did the plan have assets held for investment2019-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-04-30No
Opinion of an independent qualified public accountant for this plan2019-04-30Unqualified
Accountancy firm name2019-04-30BETTS & HAYES, LTD
Accountancy firm EIN2019-04-30411619880
2018 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-04-30$256,033
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-04-30$155,680
Total income from all sources (including contributions)2018-04-30$2,211,781
Total loss/gain on sale of assets2018-04-30$0
Total of all expenses incurred2018-04-30$1,862,818
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-04-30$1,702,298
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-04-30$2,192,850
Value of total assets at end of year2018-04-30$3,398,255
Value of total assets at beginning of year2018-04-30$2,948,939
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-04-30$160,520
Total interest from all sources2018-04-30$18,931
Total dividends received (eg from common stock, registered investment company shares)2018-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-04-30No
Administrative expenses professional fees incurred2018-04-30$49,951
Was this plan covered by a fidelity bond2018-04-30Yes
Value of fidelity bond cover2018-04-30$500,000
If this is an individual account plan, was there a blackout period2018-04-30No
Were there any nonexempt tranactions with any party-in-interest2018-04-30No
Contributions received from participants2018-04-30$786
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-04-30$9,131
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-04-30$19,191
Administrative expenses (other) incurred2018-04-30$32,194
Liabilities. Value of operating payables at end of year2018-04-30$125,033
Liabilities. Value of operating payables at beginning of year2018-04-30$24,680
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-04-30No
Value of net income/loss2018-04-30$348,963
Value of net assets at end of year (total assets less liabilities)2018-04-30$3,142,222
Value of net assets at beginning of year (total assets less liabilities)2018-04-30$2,793,259
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-04-30No
Were any leases to which the plan was party in default or uncollectible2018-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-04-30$3,389,124
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-04-30$2,910,921
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-04-30$2,910,921
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-04-30$18,931
Expenses. Payments to insurance carriers foe the provision of benefits2018-04-30$393,861
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-04-30No
Was there a failure to transmit to the plan any participant contributions2018-04-30No
Has the plan failed to provide any benefit when due under the plan2018-04-30No
Contributions received in cash from employer2018-04-30$2,192,064
Employer contributions (assets) at end of year2018-04-30$0
Employer contributions (assets) at beginning of year2018-04-30$18,827
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-04-30$1,308,437
Contract administrator fees2018-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2018-04-30$131,000
Liabilities. Value of benefit claims payable at beginning of year2018-04-30$131,000
Did the plan have assets held for investment2018-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-04-30No
Opinion of an independent qualified public accountant for this plan2018-04-30Unqualified
Accountancy firm name2018-04-30BETTS & HAYES, LTD
Accountancy firm EIN2018-04-30411619880
2017 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-04-30$155,680
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-04-30$171,588
Total income from all sources (including contributions)2017-04-30$2,295,885
Total loss/gain on sale of assets2017-04-30$0
Total of all expenses incurred2017-04-30$1,790,066
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-04-30$1,614,858
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-04-30$2,288,496
Value of total assets at end of year2017-04-30$2,948,939
Value of total assets at beginning of year2017-04-30$2,459,028
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-04-30$175,208
Total interest from all sources2017-04-30$7,389
Total dividends received (eg from common stock, registered investment company shares)2017-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-04-30No
Administrative expenses professional fees incurred2017-04-30$55,549
Was this plan covered by a fidelity bond2017-04-30Yes
Value of fidelity bond cover2017-04-30$500,000
If this is an individual account plan, was there a blackout period2017-04-30No
Were there any nonexempt tranactions with any party-in-interest2017-04-30No
Contributions received from participants2017-04-30$1,227
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-04-30$19,191
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-04-30$66,269
Administrative expenses (other) incurred2017-04-30$41,284
Liabilities. Value of operating payables at end of year2017-04-30$24,680
Liabilities. Value of operating payables at beginning of year2017-04-30$40,588
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-04-30No
Value of net income/loss2017-04-30$505,819
Value of net assets at end of year (total assets less liabilities)2017-04-30$2,793,259
Value of net assets at beginning of year (total assets less liabilities)2017-04-30$2,287,440
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-04-30No
Were any leases to which the plan was party in default or uncollectible2017-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-04-30$2,910,921
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-04-30$2,392,759
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-04-30$2,392,759
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-04-30$7,389
Expenses. Payments to insurance carriers foe the provision of benefits2017-04-30$370,385
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-04-30No
Was there a failure to transmit to the plan any participant contributions2017-04-30No
Has the plan failed to provide any benefit when due under the plan2017-04-30No
Contributions received in cash from employer2017-04-30$2,287,269
Employer contributions (assets) at end of year2017-04-30$18,827
Employer contributions (assets) at beginning of year2017-04-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-04-30$1,244,473
Contract administrator fees2017-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2017-04-30$131,000
Liabilities. Value of benefit claims payable at beginning of year2017-04-30$131,000
Did the plan have assets held for investment2017-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-04-30No
Opinion of an independent qualified public accountant for this plan2017-04-30Unqualified
Accountancy firm name2017-04-30BETTS & HAYES, LTD
Accountancy firm EIN2017-04-30411619880
2016 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-04-30$171,588
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-04-30$208,199
Total income from all sources (including contributions)2016-04-30$2,506,933
Total loss/gain on sale of assets2016-04-30$0
Total of all expenses incurred2016-04-30$1,746,059
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-04-30$1,555,852
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-04-30$2,501,002
Value of total assets at end of year2016-04-30$2,459,028
Value of total assets at beginning of year2016-04-30$1,734,765
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-04-30$190,207
Total interest from all sources2016-04-30$5,931
Total dividends received (eg from common stock, registered investment company shares)2016-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-04-30No
Administrative expenses professional fees incurred2016-04-30$66,349
Was this plan covered by a fidelity bond2016-04-30Yes
Value of fidelity bond cover2016-04-30$500,000
If this is an individual account plan, was there a blackout period2016-04-30No
Were there any nonexempt tranactions with any party-in-interest2016-04-30No
Contributions received from participants2016-04-30$1,086
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-04-30$66,269
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-04-30$29,028
Administrative expenses (other) incurred2016-04-30$45,367
Liabilities. Value of operating payables at end of year2016-04-30$40,588
Liabilities. Value of operating payables at beginning of year2016-04-30$77,199
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-04-30No
Value of net income/loss2016-04-30$760,874
Value of net assets at end of year (total assets less liabilities)2016-04-30$2,287,440
Value of net assets at beginning of year (total assets less liabilities)2016-04-30$1,526,566
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-04-30No
Were any leases to which the plan was party in default or uncollectible2016-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-04-30$2,392,759
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-04-30$1,705,737
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-04-30$1,705,737
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-04-30$5,931
Expenses. Payments to insurance carriers foe the provision of benefits2016-04-30$327,753
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-04-30No
Was there a failure to transmit to the plan any participant contributions2016-04-30No
Has the plan failed to provide any benefit when due under the plan2016-04-30No
Contributions received in cash from employer2016-04-30$2,499,916
Employer contributions (assets) at end of year2016-04-30$0
Employer contributions (assets) at beginning of year2016-04-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-04-30$1,228,099
Contract administrator fees2016-04-30$78,491
Liabilities. Value of benefit claims payable at end of year2016-04-30$131,000
Liabilities. Value of benefit claims payable at beginning of year2016-04-30$131,000
Did the plan have assets held for investment2016-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-04-30No
Opinion of an independent qualified public accountant for this plan2016-04-30Unqualified
Accountancy firm name2016-04-30BETTS & HAYES, LTD
Accountancy firm EIN2016-04-30411619880
2015 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-04-30$208,199
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-04-30$215,967
Total income from all sources (including contributions)2015-04-30$2,170,937
Total loss/gain on sale of assets2015-04-30$0
Total of all expenses incurred2015-04-30$1,999,166
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-04-30$1,715,934
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-04-30$2,166,593
Value of total assets at end of year2015-04-30$1,734,765
Value of total assets at beginning of year2015-04-30$1,570,762
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-04-30$283,232
Total interest from all sources2015-04-30$4,344
Total dividends received (eg from common stock, registered investment company shares)2015-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-04-30No
Administrative expenses professional fees incurred2015-04-30$124,816
Was this plan covered by a fidelity bond2015-04-30Yes
Value of fidelity bond cover2015-04-30$500,000
If this is an individual account plan, was there a blackout period2015-04-30No
Were there any nonexempt tranactions with any party-in-interest2015-04-30No
Contributions received from participants2015-04-30$1,358
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-04-30$29,028
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-04-30$309,197
Administrative expenses (other) incurred2015-04-30$80,041
Liabilities. Value of operating payables at end of year2015-04-30$77,199
Liabilities. Value of operating payables at beginning of year2015-04-30$40,967
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-04-30No
Value of net income/loss2015-04-30$171,771
Value of net assets at end of year (total assets less liabilities)2015-04-30$1,526,566
Value of net assets at beginning of year (total assets less liabilities)2015-04-30$1,354,795
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-04-30No
Were any leases to which the plan was party in default or uncollectible2015-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-04-30$1,705,737
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-04-30$961,565
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-04-30$961,565
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-04-30$4,344
Expenses. Payments to insurance carriers foe the provision of benefits2015-04-30$280,687
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-04-30No
Was there a failure to transmit to the plan any participant contributions2015-04-30No
Has the plan failed to provide any benefit when due under the plan2015-04-30No
Contributions received in cash from employer2015-04-30$2,165,235
Employer contributions (assets) at end of year2015-04-30$0
Employer contributions (assets) at beginning of year2015-04-30$300,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-04-30$1,435,247
Contract administrator fees2015-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2015-04-30$131,000
Liabilities. Value of benefit claims payable at beginning of year2015-04-30$175,000
Did the plan have assets held for investment2015-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-04-30No
Opinion of an independent qualified public accountant for this plan2015-04-30Unqualified
Accountancy firm name2015-04-30BETTS & HAYES, LTD
Accountancy firm EIN2015-04-30411619880
2014 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-04-30$215,967
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-04-30$347,045
Total income from all sources (including contributions)2014-04-30$3,777,408
Total loss/gain on sale of assets2014-04-30$0
Total of all expenses incurred2014-04-30$2,709,718
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-04-30$2,472,733
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-04-30$3,774,741
Value of total assets at end of year2014-04-30$1,570,762
Value of total assets at beginning of year2014-04-30$634,150
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-04-30$236,985
Total interest from all sources2014-04-30$2,667
Total dividends received (eg from common stock, registered investment company shares)2014-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-04-30No
Administrative expenses professional fees incurred2014-04-30$44,694
Was this plan covered by a fidelity bond2014-04-30Yes
Value of fidelity bond cover2014-04-30$500,000
If this is an individual account plan, was there a blackout period2014-04-30No
Were there any nonexempt tranactions with any party-in-interest2014-04-30No
Contributions received from participants2014-04-30$1,533
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-04-30$309,197
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-04-30$13,413
Administrative expenses (other) incurred2014-04-30$113,916
Liabilities. Value of operating payables at end of year2014-04-30$40,967
Liabilities. Value of operating payables at beginning of year2014-04-30$152,045
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-04-30No
Value of net income/loss2014-04-30$1,067,690
Value of net assets at end of year (total assets less liabilities)2014-04-30$1,354,795
Value of net assets at beginning of year (total assets less liabilities)2014-04-30$287,105
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-04-30No
Were any leases to which the plan was party in default or uncollectible2014-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-04-30$961,565
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-04-30$620,737
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-04-30$620,737
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-04-30$2,667
Expenses. Payments to insurance carriers foe the provision of benefits2014-04-30$351,872
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-04-30No
Was there a failure to transmit to the plan any participant contributions2014-04-30No
Has the plan failed to provide any benefit when due under the plan2014-04-30No
Contributions received in cash from employer2014-04-30$3,773,208
Employer contributions (assets) at end of year2014-04-30$300,000
Employer contributions (assets) at beginning of year2014-04-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-04-30$2,120,861
Contract administrator fees2014-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2014-04-30$175,000
Liabilities. Value of benefit claims payable at beginning of year2014-04-30$195,000
Did the plan have assets held for investment2014-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-04-30No
Opinion of an independent qualified public accountant for this plan2014-04-30Unqualified
Accountancy firm name2014-04-30BETTS & HAYES, LTD
Accountancy firm EIN2014-04-30411619880
2013 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-04-30$347,045
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-04-30$336,774
Total income from all sources (including contributions)2013-04-30$3,219,364
Total loss/gain on sale of assets2013-04-30$0
Total of all expenses incurred2013-04-30$2,733,141
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-04-30$2,521,423
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-04-30$3,217,743
Value of total assets at end of year2013-04-30$634,150
Value of total assets at beginning of year2013-04-30$137,656
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-04-30$211,718
Total interest from all sources2013-04-30$1,621
Total dividends received (eg from common stock, registered investment company shares)2013-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-04-30No
Administrative expenses professional fees incurred2013-04-30$28,416
Was this plan covered by a fidelity bond2013-04-30Yes
Value of fidelity bond cover2013-04-30$500,000
If this is an individual account plan, was there a blackout period2013-04-30No
Were there any nonexempt tranactions with any party-in-interest2013-04-30No
Contributions received from participants2013-04-30$12,043
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-04-30$13,413
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-04-30$31,169
Administrative expenses (other) incurred2013-04-30$104,699
Liabilities. Value of operating payables at end of year2013-04-30$152,045
Liabilities. Value of operating payables at beginning of year2013-04-30$121,774
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Value of net income/loss2013-04-30$486,223
Value of net assets at end of year (total assets less liabilities)2013-04-30$287,105
Value of net assets at beginning of year (total assets less liabilities)2013-04-30$-199,118
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-04-30No
Were any leases to which the plan was party in default or uncollectible2013-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-04-30$620,737
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-04-30$106,487
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-04-30$106,487
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-04-30$1,621
Expenses. Payments to insurance carriers foe the provision of benefits2013-04-30$377,702
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-04-30No
Was there a failure to transmit to the plan any participant contributions2013-04-30No
Has the plan failed to provide any benefit when due under the plan2013-04-30No
Contributions received in cash from employer2013-04-30$3,205,700
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-04-30$2,143,721
Contract administrator fees2013-04-30$78,603
Liabilities. Value of benefit claims payable at end of year2013-04-30$195,000
Liabilities. Value of benefit claims payable at beginning of year2013-04-30$215,000
Did the plan have assets held for investment2013-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-04-30No
Opinion of an independent qualified public accountant for this plan2013-04-30Unqualified
Accountancy firm name2013-04-30BETTS & HAYES, LTD
Accountancy firm EIN2013-04-30411619880
2012 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-04-30$336,774
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-04-30$291,247
Total income from all sources (including contributions)2012-04-30$2,714,578
Total loss/gain on sale of assets2012-04-30$0
Total of all expenses incurred2012-04-30$3,010,178
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-04-30$2,821,323
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-04-30$2,710,216
Value of total assets at end of year2012-04-30$137,656
Value of total assets at beginning of year2012-04-30$387,729
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-04-30$188,855
Total interest from all sources2012-04-30$4,362
Total dividends received (eg from common stock, registered investment company shares)2012-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-04-30No
Administrative expenses professional fees incurred2012-04-30$21,260
Was this plan covered by a fidelity bond2012-04-30Yes
Value of fidelity bond cover2012-04-30$500,000
If this is an individual account plan, was there a blackout period2012-04-30No
Were there any nonexempt tranactions with any party-in-interest2012-04-30No
Contributions received from participants2012-04-30$26,747
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-04-30$31,169
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-04-30$791
Administrative expenses (other) incurred2012-04-30$89,220
Liabilities. Value of operating payables at end of year2012-04-30$121,774
Liabilities. Value of operating payables at beginning of year2012-04-30$41,247
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Value of net income/loss2012-04-30$-295,600
Value of net assets at end of year (total assets less liabilities)2012-04-30$-199,118
Value of net assets at beginning of year (total assets less liabilities)2012-04-30$96,482
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-04-30No
Were any leases to which the plan was party in default or uncollectible2012-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-04-30$106,487
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-04-30$386,938
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-04-30$386,938
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-04-30$4,362
Expenses. Payments to insurance carriers foe the provision of benefits2012-04-30$389,002
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-04-30No
Was there a failure to transmit to the plan any participant contributions2012-04-30No
Has the plan failed to provide any benefit when due under the plan2012-04-30No
Contributions received in cash from employer2012-04-30$2,683,469
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-04-30$2,432,321
Contract administrator fees2012-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2012-04-30$215,000
Liabilities. Value of benefit claims payable at beginning of year2012-04-30$250,000
Did the plan have assets held for investment2012-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-04-30No
Opinion of an independent qualified public accountant for this plan2012-04-30Unqualified
Accountancy firm name2012-04-30BETTS & HAYES, LTD
Accountancy firm EIN2012-04-30411619880
2011 : MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-04-30$291,247
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-04-30$335,774
Total income from all sources (including contributions)2011-04-30$2,488,011
Total loss/gain on sale of assets2011-04-30$0
Total of all expenses incurred2011-04-30$2,397,851
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-04-30$2,215,837
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-04-30$2,480,968
Value of total assets at end of year2011-04-30$387,729
Value of total assets at beginning of year2011-04-30$342,096
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-04-30$182,014
Total interest from all sources2011-04-30$7,043
Total dividends received (eg from common stock, registered investment company shares)2011-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-04-30No
Administrative expenses professional fees incurred2011-04-30$25,735
Was this plan covered by a fidelity bond2011-04-30Yes
Value of fidelity bond cover2011-04-30$500,000
If this is an individual account plan, was there a blackout period2011-04-30No
Were there any nonexempt tranactions with any party-in-interest2011-04-30No
Contributions received from participants2011-04-30$32,334
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-04-30$791
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-04-30$59,472
Administrative expenses (other) incurred2011-04-30$77,904
Liabilities. Value of operating payables at end of year2011-04-30$41,247
Liabilities. Value of operating payables at beginning of year2011-04-30$95,774
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Value of net income/loss2011-04-30$90,160
Value of net assets at end of year (total assets less liabilities)2011-04-30$96,482
Value of net assets at beginning of year (total assets less liabilities)2011-04-30$6,322
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-04-30No
Were any leases to which the plan was party in default or uncollectible2011-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-04-30$386,938
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-04-30$282,624
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-04-30$282,624
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-04-30$7,043
Expenses. Payments to insurance carriers foe the provision of benefits2011-04-30$340,662
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-04-30No
Was there a failure to transmit to the plan any participant contributions2011-04-30No
Has the plan failed to provide any benefit when due under the plan2011-04-30No
Contributions received in cash from employer2011-04-30$2,448,634
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-04-30$1,875,175
Contract administrator fees2011-04-30$78,375
Liabilities. Value of benefit claims payable at end of year2011-04-30$250,000
Liabilities. Value of benefit claims payable at beginning of year2011-04-30$240,000
Did the plan have assets held for investment2011-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-04-30No
Opinion of an independent qualified public accountant for this plan2011-04-30Unqualified
Accountancy firm name2011-04-30BETTS & HAYES, LTD
Accountancy firm EIN2011-04-30411619880

Form 5500 Responses for MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST

2022: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2022 form 5500 responses
2022-05-01Type of plan entityMulti-employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planYes
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2021 form 5500 responses
2021-05-01Type of plan entityMulti-employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planYes
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2020 form 5500 responses
2020-05-01Type of plan entityMulti-employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planYes
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2019 form 5500 responses
2019-05-01Type of plan entityMulti-employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planYes
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2018 form 5500 responses
2018-05-01Type of plan entityMulti-employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planYes
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2017 form 5500 responses
2017-05-01Type of plan entityMulti-employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planYes
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2016: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2016 form 5500 responses
2016-05-01Type of plan entityMulti-employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planYes
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – TrustYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement - TrustYes
2015: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2015 form 5500 responses
2015-05-01Type of plan entityMulti-employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planYes
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement - TrustYes
2014: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2014 form 5500 responses
2014-05-01Type of plan entityMulti-employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planYes
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2013: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2013 form 5500 responses
2013-05-01Type of plan entityMulti-employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planYes
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2012 form 5500 responses
2012-05-01Type of plan entityMulti-employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planYes
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2011 form 5500 responses
2011-05-01Type of plan entityMulti-employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planYes
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes
2009: MIDWEST CONSTRUCTION & DISTRIBUTION INDUSTRY BENEFIT TRUST 2009 form 5500 responses
2009-05-01Type of plan entityMulti-employer plan
2009-05-01Plan is a collectively bargained planYes
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan funding arrangement – TrustYes
2009-05-01Plan benefit arrangement – InsuranceYes
2009-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00518012
Policy instance 2
Insurance contract or identification number00518012
Number of Individuals Covered123
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $553
Total amount of fees paid to insurance companyUSD $76
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 $11,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $553
Insurance broker organization code?3
Amount paid for insurance broker fees76
Additional information about fees paid to insurance brokerFEES
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number211869
Policy instance 1
Insurance contract or identification number211869
Number of Individuals Covered116
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
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 $467,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00518012
Policy instance 2
Insurance contract or identification number00518012
Number of Individuals Covered135
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $606
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 $12,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $606
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number211869
Policy instance 1
Insurance contract or identification number211869
Number of Individuals Covered124
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
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 $480,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00518012
Policy instance 2
Insurance contract or identification number00518012
Number of Individuals Covered126
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $553
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 $11,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $553
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number211869
Policy instance 1
Insurance contract or identification number211869
Number of Individuals Covered127
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
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 $481,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number211869
Policy instance 1
Insurance contract or identification number211869
Number of Individuals Covered122
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
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 $505,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00518012
Policy instance 2
Insurance contract or identification number00518012
Number of Individuals Covered124
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $565
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 $11,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $565
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00518012
Policy instance 2
Insurance contract or identification number00518012
Number of Individuals Covered134
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $1,042
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 $12,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $603
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number211869
Policy instance 1
Insurance contract or identification number211869
Number of Individuals Covered134
Insurance policy start date2018-01-01
Insurance policy end date2018-11-30
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 $438,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00518012
Policy instance 2
Insurance contract or identification number00518012
Number of Individuals Covered125
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $1,073
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 $11,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberSL186
Policy instance 1
Insurance contract or identification numberSL186
Number of Individuals Covered124
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
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 $387,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 144818
Policy instance 2
Insurance contract or identification numberGL 144818
Number of Individuals Covered118
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $1,887
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $10,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,048
Insurance broker organization code?3
Insurance broker nameBENEUSA LLC
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberSL186
Policy instance 1
Insurance contract or identification numberSL186
Number of Individuals Covered120
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $296,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 144818
Policy instance 2
Insurance contract or identification numberGL 144818
Number of Individuals Covered202
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $1,887
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $10,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,048
Insurance broker organization code?3
Insurance broker nameBENEUSA LLC
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberSL186
Policy instance 1
Insurance contract or identification numberSL186
Number of Individuals Covered134
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $3,430
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $268,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,430
Insurance broker organization code?3
Insurance broker nameRISK ANALYSIS & MANAGEMENT CORP
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberSL186
Policy instance 1
Insurance contract or identification numberSL186
Number of Individuals Covered186
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $36,288
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $362,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,288
Insurance broker organization code?3
Insurance broker nameRISK ANALYSIS & MANAGEMENT CORP
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 144818
Policy instance 2
Insurance contract or identification numberGL 144818
Number of Individuals Covered186
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $2,387
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $13,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,326
Insurance broker organization code?3
Insurance broker nameBENEUSA LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 144818
Policy instance 2
Insurance contract or identification numberGL 144818
Number of Individuals Covered198
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $2,385
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $13,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,325
Insurance broker organization code?3
Insurance broker nameBENEUSA LLC
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberSL186
Policy instance 1
Insurance contract or identification numberSL186
Number of Individuals Covered189
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $37,704
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $376,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,704
Insurance broker organization code?3
Insurance broker nameRISK ANALYSIS & MANAGEMENT CORP
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberSL186
Policy instance 1
Insurance contract or identification numberSL186
Number of Individuals Covered184
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Total amount of commissions paid to insurance brokerUSD $37,254
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $372,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 144818
Policy instance 2
Insurance contract or identification numberGL 144818
Number of Individuals Covered190
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Total amount of commissions paid to insurance brokerUSD $2,245
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $12,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPREHENSIVE CARE SERVICES, INC (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberSL186
Policy instance 1
Insurance contract or identification numberSL186
Number of Individuals Covered165
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Total amount of commissions paid to insurance brokerUSD $30,822
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $291,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 144818
Policy instance 2
Insurance contract or identification numberGL 144818
Number of Individuals Covered190
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Total amount of commissions paid to insurance brokerUSD $1,962
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $10,909
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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