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DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 401k Plan overview

Plan NameDANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN
Plan identification number 501

DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN Benefits

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

401k Sponsoring company profile

DANFOSS POWER SOLUTIONS US COMPANY has sponsored the creation of one or more 401k plans.

Company Name:DANFOSS POWER SOLUTIONS US COMPANY
Employer identification number (EIN):421345015
NAIC Classification:333610

Additional information about DANFOSS POWER SOLUTIONS US COMPANY

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C1657411

More information about DANFOSS POWER SOLUTIONS US COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01CASSIE DELANEY2023-08-21
5012021-01-01JOEL RINDERKNECHT2022-10-07
5012020-01-01JOEL RINDERKENCHT2021-10-03
5012019-01-01JOEL RINDERKNECHT2020-10-05
5012018-01-01JOEL RINDERKNECHT2019-10-03
5012017-01-01
5012016-01-01
5012015-01-01JOEL RINDERKNECHT
5012014-01-01WALTER C. SLEEPER
5012013-01-01WALTER C. SLEEPER
5012012-01-01WALTER C. SLEEPER
5012011-01-01WALTER C. SLEEPER
5012010-01-01WALTER C. SLEEPER
5012009-01-01WALTER C. SLEEPER

Plan Statistics for DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN

401k plan membership statisitcs for DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN

Measure Date Value
2022: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01604
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-01598
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01598
2021: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01587
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-01604
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01604
2020: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01556
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-01587
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01587
2019: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01563
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-01556
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01556
2018: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01549
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-01563
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01563
2017: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01539
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-01549
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01549
2016: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01529
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-01539
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01539
2015: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01518
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-01529
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01529
2014: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01510
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-01518
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01518
2013: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01498
Number of retired or separated participants receiving benefits2013-01-01510
Total of all active and inactive participants2013-01-01510
Total participants2013-01-01510
2012: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01503
Number of retired or separated participants receiving benefits2012-01-01498
Total of all active and inactive participants2012-01-01498
Total participants2012-01-01498
2011: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01511
Number of retired or separated participants receiving benefits2011-01-01503
Total of all active and inactive participants2011-01-01503
Total participants2011-01-01503
2010: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-010
Total number of active participants reported on line 7a of the Form 55002010-01-011,327
Number of retired or separated participants receiving benefits2010-01-01520
Total of all active and inactive participants2010-01-011,847
Total participants2010-01-011,847
2009: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-012,074
Total number of active participants reported on line 7a of the Form 55002009-01-011,157
Number of retired or separated participants receiving benefits2009-01-01325
Total of all active and inactive participants2009-01-011,482
Total participants2009-01-011,482

Form 5500 Responses for DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN

2022: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01First time form 5500 has been submittedYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: DANFOSS POWER SOLUTIONS RETIREE MEDICAL BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10036971001
Policy instance 1
Insurance contract or identification number10036971001
Number of Individuals Covered88
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
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 $7,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10036971001
Policy instance 1
Insurance contract or identification number10036971001
Number of Individuals Covered129
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
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 $8,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10036971001
Policy instance 1
Insurance contract or identification number10036971001
Number of Individuals Covered128
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitYes
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 $8,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10036971001
Policy instance 1
Insurance contract or identification number10036971001
Number of Individuals Covered147
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitYes
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 $9,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number717513
Policy instance 1
Insurance contract or identification number717513
Number of Individuals Covered510
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $710,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number717513
Policy instance 1
Insurance contract or identification number717513
Number of Individuals Covered498
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $603,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number717513
Policy instance 1
Insurance contract or identification number717513
Number of Individuals Covered503
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $560,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0028309
Policy instance 4
Insurance contract or identification number0028309
Number of Individuals Covered3188
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,387
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOL ACCIDENTAL DEATH & DISMEMBERMT
Welfare Benefit Premiums Paid to CarrierUSD $653,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0122525
Policy instance 3
Insurance contract or identification number0122525
Number of Individuals Covered276
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $851
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number717513
Policy instance 2
Insurance contract or identification number717513
Number of Individuals Covered1541
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $445,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number02911A
Policy instance 1
Insurance contract or identification number02911A
Number of Individuals Covered5
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $89,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0122158
Policy instance 5
Insurance contract or identification number0122158
Number of Individuals Covered1314
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedBUSINESS TRAVEL
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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