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VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 401k Plan overview

Plan NameVOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN
Plan identification number 501

VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

LOCAL 4911 V.E.B.A. has sponsored the creation of one or more 401k plans.

Company Name:LOCAL 4911 V.E.B.A.
Employer identification number (EIN):421572846
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01RICHARD LICHTENSTEIN
5012016-01-01RICHARD LICHTENSTEIN
5012015-01-01RICHARD LICHTENSTEIN
5012014-01-01RICHARD LICHTENSTEIN
5012013-01-01RICHARD L. LICHTENSTEIN, PHD
5012012-01-01RICHARD L. LICHTENSTEIN, PHD
5012011-01-01RICHARD L. LICHTENSTEIN, PHD
5012010-01-01RICHARD L. LICHTENSTEIN, PHD
5012009-01-01RICHARD L. LICHTENSTEIN, PHD

Plan Statistics for VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN

401k plan membership statisitcs for VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN

Measure Date Value
2022: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-012,918
Total number of active participants reported on line 7a of the Form 55002022-01-012,650
Number of retired or separated participants receiving benefits2022-01-01211
Number of other retired or separated participants entitled to future benefits2022-01-01377
Total of all active and inactive participants2022-01-013,238
2021: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-012,966
Total number of active participants reported on line 7a of the Form 55002021-01-012,374
Number of retired or separated participants receiving benefits2021-01-01213
Number of other retired or separated participants entitled to future benefits2021-01-01331
Total of all active and inactive participants2021-01-012,918
2020: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-012,931
Total number of active participants reported on line 7a of the Form 55002020-01-012,470
Number of retired or separated participants receiving benefits2020-01-01208
Number of other retired or separated participants entitled to future benefits2020-01-01288
Total of all active and inactive participants2020-01-012,966
2019: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-012,784
Total number of active participants reported on line 7a of the Form 55002019-01-012,461
Number of retired or separated participants receiving benefits2019-01-01210
Number of other retired or separated participants entitled to future benefits2019-01-01260
Total of all active and inactive participants2019-01-012,931
2018: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-013,228
Total number of active participants reported on line 7a of the Form 55002018-01-012,366
Number of retired or separated participants receiving benefits2018-01-01189
Number of other retired or separated participants entitled to future benefits2018-01-01229
Total of all active and inactive participants2018-01-012,784
2017: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-013,091
Total number of active participants reported on line 7a of the Form 55002017-01-012,507
Number of retired or separated participants receiving benefits2017-01-01544
Number of other retired or separated participants entitled to future benefits2017-01-01177
Total of all active and inactive participants2017-01-013,228
2016: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-012,903
Total number of active participants reported on line 7a of the Form 55002016-01-012,780
Number of retired or separated participants receiving benefits2016-01-01146
Number of other retired or separated participants entitled to future benefits2016-01-01165
Total of all active and inactive participants2016-01-013,091
2015: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-012,724
Total number of active participants reported on line 7a of the Form 55002015-01-012,594
Number of retired or separated participants receiving benefits2015-01-01140
Number of other retired or separated participants entitled to future benefits2015-01-01169
Total of all active and inactive participants2015-01-012,903
2014: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-012,740
Total number of active participants reported on line 7a of the Form 55002014-01-012,457
Number of retired or separated participants receiving benefits2014-01-01121
Number of other retired or separated participants entitled to future benefits2014-01-01146
Total of all active and inactive participants2014-01-012,724
2013: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-012,777
Total number of active participants reported on line 7a of the Form 55002013-01-012,491
Number of retired or separated participants receiving benefits2013-01-01111
Number of other retired or separated participants entitled to future benefits2013-01-01138
Total of all active and inactive participants2013-01-012,740
2012: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-012,612
Total number of active participants reported on line 7a of the Form 55002012-01-012,567
Number of retired or separated participants receiving benefits2012-01-0192
Number of other retired or separated participants entitled to future benefits2012-01-01118
Total of all active and inactive participants2012-01-012,777
2011: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-012,657
Total number of active participants reported on line 7a of the Form 55002011-01-012,450
Number of retired or separated participants receiving benefits2011-01-0179
Number of other retired or separated participants entitled to future benefits2011-01-0183
Total of all active and inactive participants2011-01-012,612
2010: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-012,496
Total number of active participants reported on line 7a of the Form 55002010-01-012,525
Number of retired or separated participants receiving benefits2010-01-0171
Number of other retired or separated participants entitled to future benefits2010-01-0161
Total of all active and inactive participants2010-01-012,657
2009: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-012,402
Total number of active participants reported on line 7a of the Form 55002009-01-012,378
Number of retired or separated participants receiving benefits2009-01-0164
Number of other retired or separated participants entitled to future benefits2009-01-0154
Total of all active and inactive participants2009-01-012,496

Financial Data on VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN

Measure Date Value
2022 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$48,624
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$12,024
Total income from all sources (including contributions)2022-12-31$-3,780,449
Total loss/gain on sale of assets2022-12-31$-1,114,932
Total of all expenses incurred2022-12-31$932,807
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$612,458
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,460,750
Value of total assets at end of year2022-12-31$26,060,595
Value of total assets at beginning of year2022-12-31$30,737,251
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$320,349
Total interest from all sources2022-12-31$185,869
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$436,993
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$134,042
Administrative expenses professional fees incurred2022-12-31$75,138
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,460,750
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$52,786
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$40,343
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Other income not declared elsewhere2022-12-31$23,622
Administrative expenses (other) incurred2022-12-31$40,748
Liabilities. Value of operating payables at end of year2022-12-31$8,281
Liabilities. Value of operating payables at beginning of year2022-12-31$12,024
Total non interest bearing cash at end of year2022-12-31$280,853
Total non interest bearing cash at beginning of year2022-12-31$309,834
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-4,713,256
Value of net assets at end of year (total assets less liabilities)2022-12-31$26,011,971
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$30,725,227
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$175,932
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,315,681
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$3,650,747
Income. Interest from US Government securities2022-12-31$50,588
Income. Interest from corporate debt instruments2022-12-31$135,005
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$850,107
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$521,968
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$521,968
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$276
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$612,458
Asset value of US Government securities at end of year2022-12-31$2,558,800
Asset value of US Government securities at beginning of year2022-12-31$2,488,808
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-4,772,751
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Income. Dividends from common stock2022-12-31$302,951
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$3,222,100
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$3,547,510
Contract administrator fees2022-12-31$28,531
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$15,833,054
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$20,165,598
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$6,872,803
Aggregate carrying amount (costs) on sale of assets2022-12-31$7,987,735
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BDO USA, P.C.
Accountancy firm EIN2022-12-31135381590
2021 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$12,024
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$26,497
Total income from all sources (including contributions)2021-12-31$4,308,586
Total loss/gain on sale of assets2021-12-31$17,780
Total of all expenses incurred2021-12-31$951,697
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$618,147
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,501,826
Value of total assets at end of year2021-12-31$30,737,251
Value of total assets at beginning of year2021-12-31$27,394,835
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$333,550
Total interest from all sources2021-12-31$172,140
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$370,926
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$123,192
Administrative expenses professional fees incurred2021-12-31$68,471
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,501,826
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$0
Assets. Other investments not covered elsewhere at end of year2021-12-31$52,786
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$50,180
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$22,747
Other income not declared elsewhere2021-12-31$297,698
Administrative expenses (other) incurred2021-12-31$19,662
Liabilities. Value of operating payables at end of year2021-12-31$12,024
Liabilities. Value of operating payables at beginning of year2021-12-31$3,750
Total non interest bearing cash at end of year2021-12-31$309,834
Total non interest bearing cash at beginning of year2021-12-31$347,528
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$3,356,889
Value of net assets at end of year (total assets less liabilities)2021-12-31$30,725,227
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$27,368,338
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$212,903
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$3,650,747
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$3,497,370
Income. Interest from loans (other than to participants)2021-12-31$2,491
Income. Interest from US Government securities2021-12-31$39,853
Income. Interest from corporate debt instruments2021-12-31$129,706
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$521,968
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$840,728
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$840,728
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$90
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$618,147
Asset value of US Government securities at end of year2021-12-31$2,488,808
Asset value of US Government securities at beginning of year2021-12-31$1,951,910
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,948,216
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Income. Dividends from common stock2021-12-31$247,734
Asset. Corporate debt instrument debt (other) at end of year2021-12-31$3,547,510
Asset. Corporate debt instrument debt (other) at beginning of year2021-12-31$3,531,739
Contract administrator fees2021-12-31$32,514
Assets. Corporate common stocks other than exployer securities at end of year2021-12-31$20,165,598
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$17,175,380
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$10,506,231
Aggregate carrying amount (costs) on sale of assets2021-12-31$10,488,451
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BDO USA, LLP
Accountancy firm EIN2021-12-31135381590
2020 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$26,497
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$62,193
Total income from all sources (including contributions)2020-12-31$5,621,186
Total loss/gain on sale of assets2020-12-31$-165,607
Total of all expenses incurred2020-12-31$1,103,640
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$812,549
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,494,072
Value of total assets at end of year2020-12-31$27,394,835
Value of total assets at beginning of year2020-12-31$22,912,985
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$291,091
Total interest from all sources2020-12-31$169,404
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$251,442
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$73,101
Administrative expenses professional fees incurred2020-12-31$74,865
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,494,072
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$52,586
Assets. Other investments not covered elsewhere at end of year2020-12-31$50,180
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$68,389
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$22,747
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$57,943
Other income not declared elsewhere2020-12-31$35,497
Administrative expenses (other) incurred2020-12-31$24,618
Liabilities. Value of operating payables at end of year2020-12-31$3,750
Liabilities. Value of operating payables at beginning of year2020-12-31$4,250
Total non interest bearing cash at end of year2020-12-31$347,528
Total non interest bearing cash at beginning of year2020-12-31$127,383
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$4,517,546
Value of net assets at end of year (total assets less liabilities)2020-12-31$27,368,338
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$22,850,792
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$159,418
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$3,497,370
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$4,718,858
Income. Interest from loans (other than to participants)2020-12-31$29
Income. Interest from US Government securities2020-12-31$44,167
Income. Interest from corporate debt instruments2020-12-31$125,058
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$840,728
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$924,283
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$924,283
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$150
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$812,549
Asset value of US Government securities at end of year2020-12-31$1,951,910
Asset value of US Government securities at beginning of year2020-12-31$1,502,454
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$3,836,378
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Income. Dividends from common stock2020-12-31$178,341
Asset. Corporate debt instrument debt (other) at end of year2020-12-31$3,531,739
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$2,632,039
Contract administrator fees2020-12-31$32,190
Assets. Corporate common stocks other than exployer securities at end of year2020-12-31$17,175,380
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$12,886,993
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$10,314,111
Aggregate carrying amount (costs) on sale of assets2020-12-31$10,479,718
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BDO USA, LLP
Accountancy firm EIN2020-12-31135381590
2019 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$62,193
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$62,193
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,000
Total income from all sources (including contributions)2019-12-31$5,327,260
Total income from all sources (including contributions)2019-12-31$5,327,260
Total loss/gain on sale of assets2019-12-31$452,908
Total loss/gain on sale of assets2019-12-31$452,908
Total of all expenses incurred2019-12-31$1,042,312
Total of all expenses incurred2019-12-31$1,042,312
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$784,810
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$784,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,511,920
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,511,920
Value of total assets at end of year2019-12-31$22,912,985
Value of total assets at end of year2019-12-31$22,912,985
Value of total assets at beginning of year2019-12-31$18,568,844
Value of total assets at beginning of year2019-12-31$18,568,844
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$257,502
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$257,502
Total interest from all sources2019-12-31$150,751
Total interest from all sources2019-12-31$150,751
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$407,080
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$407,080
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$204,846
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$204,846
Administrative expenses professional fees incurred2019-12-31$49,102
Administrative expenses professional fees incurred2019-12-31$49,102
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,511,920
Contributions received from participants2019-12-31$1,511,920
Participant contributions at end of year2019-12-31$52,586
Participant contributions at end of year2019-12-31$52,586
Participant contributions at beginning of year2019-12-31$51,161
Participant contributions at beginning of year2019-12-31$51,161
Assets. Other investments not covered elsewhere at end of year2019-12-31$68,389
Assets. Other investments not covered elsewhere at end of year2019-12-31$68,389
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$61,710
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$61,710
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$2,566
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$2,566
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$57,943
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$57,943
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Other income not declared elsewhere2019-12-31$21,166
Other income not declared elsewhere2019-12-31$21,166
Administrative expenses (other) incurred2019-12-31$16,995
Administrative expenses (other) incurred2019-12-31$16,995
Liabilities. Value of operating payables at end of year2019-12-31$4,250
Liabilities. Value of operating payables at end of year2019-12-31$4,250
Liabilities. Value of operating payables at beginning of year2019-12-31$3,000
Liabilities. Value of operating payables at beginning of year2019-12-31$3,000
Total non interest bearing cash at end of year2019-12-31$127,383
Total non interest bearing cash at end of year2019-12-31$127,383
Total non interest bearing cash at beginning of year2019-12-31$120,204
Total non interest bearing cash at beginning of year2019-12-31$120,204
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$4,284,948
Value of net income/loss2019-12-31$4,284,948
Value of net assets at end of year (total assets less liabilities)2019-12-31$22,850,792
Value of net assets at end of year (total assets less liabilities)2019-12-31$22,850,792
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$18,565,844
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$18,565,844
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$161,374
Investment advisory and management fees2019-12-31$161,374
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$4,718,858
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$4,718,858
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,969,628
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,969,628
Income. Interest from US Government securities2019-12-31$39,463
Income. Interest from US Government securities2019-12-31$39,463
Income. Interest from corporate debt instruments2019-12-31$109,544
Income. Interest from corporate debt instruments2019-12-31$109,544
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$924,283
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$924,283
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$681,009
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$681,009
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$681,009
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$681,009
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$1,744
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$1,744
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$784,810
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$784,810
Asset value of US Government securities at end of year2019-12-31$1,502,454
Asset value of US Government securities at end of year2019-12-31$1,502,454
Asset value of US Government securities at beginning of year2019-12-31$1,297,263
Asset value of US Government securities at beginning of year2019-12-31$1,297,263
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$2,783,435
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$2,783,435
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Income. Dividends from common stock2019-12-31$202,234
Income. Dividends from common stock2019-12-31$202,234
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$2,632,039
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$2,632,039
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$2,285,648
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$2,285,648
Contract administrator fees2019-12-31$30,031
Contract administrator fees2019-12-31$30,031
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$12,886,993
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$12,886,993
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$10,099,655
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$10,099,655
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$5,962,093
Aggregate proceeds on sale of assets2019-12-31$5,962,093
Aggregate carrying amount (costs) on sale of assets2019-12-31$5,509,185
Aggregate carrying amount (costs) on sale of assets2019-12-31$5,509,185
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31BDO USA, LLP
Accountancy firm name2019-12-31BDO USA, LLP
Accountancy firm EIN2019-12-31135381590
Accountancy firm EIN2019-12-31135381590
2018 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,500
Total income from all sources (including contributions)2018-12-31$480,182
Total loss/gain on sale of assets2018-12-31$-73,750
Total of all expenses incurred2018-12-31$1,193,406
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$933,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,422,899
Value of total assets at end of year2018-12-31$18,568,844
Value of total assets at beginning of year2018-12-31$19,282,568
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$260,177
Total interest from all sources2018-12-31$130,092
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$369,714
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$185,942
Administrative expenses professional fees incurred2018-12-31$66,315
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,422,865
Participant contributions at end of year2018-12-31$51,161
Participant contributions at beginning of year2018-12-31$52,064
Assets. Other investments not covered elsewhere at end of year2018-12-31$61,710
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$74,051
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$2,566
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$12,061
Other income not declared elsewhere2018-12-31$181
Administrative expenses (other) incurred2018-12-31$13,935
Liabilities. Value of operating payables at end of year2018-12-31$3,000
Liabilities. Value of operating payables at beginning of year2018-12-31$3,500
Total non interest bearing cash at end of year2018-12-31$120,204
Total non interest bearing cash at beginning of year2018-12-31$139,022
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-713,224
Value of net assets at end of year (total assets less liabilities)2018-12-31$18,565,844
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$19,279,068
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$151,268
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$3,969,628
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,892,524
Income. Interest from US Government securities2018-12-31$35,793
Income. Interest from corporate debt instruments2018-12-31$92,679
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$681,009
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$712,470
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$712,470
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$1,620
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$933,229
Asset value of US Government securities at end of year2018-12-31$1,297,263
Asset value of US Government securities at beginning of year2018-12-31$1,343,974
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-1,368,954
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$34
Income. Dividends from common stock2018-12-31$183,772
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$2,285,648
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$2,057,441
Contract administrator fees2018-12-31$28,659
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$10,099,655
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$10,998,961
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$4,664,188
Aggregate carrying amount (costs) on sale of assets2018-12-31$4,737,938
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BDO USA, LLP
Accountancy firm EIN2018-12-31135381590
2017 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$3,500
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$6,508
Total income from all sources (including contributions)2017-12-31$4,154,595
Total loss/gain on sale of assets2017-12-31$154,991
Total of all expenses incurred2017-12-31$1,032,668
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$820,586
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,467,357
Value of total assets at end of year2017-12-31$19,282,568
Value of total assets at beginning of year2017-12-31$16,163,649
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$212,082
Total interest from all sources2017-12-31$174,840
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$270,145
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$95,780
Administrative expenses professional fees incurred2017-12-31$49,803
Assets. Corporate prefeered stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2017-12-31$0
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,465,879
Participant contributions at end of year2017-12-31$52,064
Participant contributions at beginning of year2017-12-31$53,273
Assets. Other investments not covered elsewhere at end of year2017-12-31$74,051
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$53,783
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$12,061
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$10,094
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$3,508
Other income not declared elsewhere2017-12-31$59,382
Administrative expenses (other) incurred2017-12-31$10,326
Liabilities. Value of operating payables at end of year2017-12-31$3,500
Liabilities. Value of operating payables at beginning of year2017-12-31$3,000
Total non interest bearing cash at end of year2017-12-31$139,022
Total non interest bearing cash at beginning of year2017-12-31$215,514
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$3,121,927
Value of net assets at end of year (total assets less liabilities)2017-12-31$19,279,068
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$16,157,141
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$124,217
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$3,892,524
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$1,029,027
Interest earned on other investments2017-12-31$1,014
Income. Interest from US Government securities2017-12-31$49,808
Income. Interest from corporate debt instruments2017-12-31$123,746
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$712,470
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$1,032,021
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$1,032,021
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$272
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$820,586
Asset value of US Government securities at end of year2017-12-31$1,343,974
Asset value of US Government securities at beginning of year2017-12-31$2,028,124
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$2,027,880
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,478
Income. Dividends from common stock2017-12-31$174,365
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$2,057,441
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$2,804,975
Contract administrator fees2017-12-31$27,736
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$10,998,961
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$8,936,838
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$6,633,539
Aggregate carrying amount (costs) on sale of assets2017-12-31$6,478,548
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BDO USA, LLP
Accountancy firm EIN2017-12-31135381590
2016 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$215,198
Total unrealized appreciation/depreciation of assets2016-12-31$215,198
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$6,508
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$3,619
Total income from all sources (including contributions)2016-12-31$2,700,894
Total loss/gain on sale of assets2016-12-31$117,155
Total of all expenses incurred2016-12-31$894,884
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$690,677
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,882,282
Value of total assets at end of year2016-12-31$16,163,649
Value of total assets at beginning of year2016-12-31$14,354,750
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$204,207
Total interest from all sources2016-12-31$176,142
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$219,963
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$44,682
Administrative expenses professional fees incurred2016-12-31$50,835
Assets. Corporate prefeered stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2016-12-31$1,140
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,454,009
Participant contributions at end of year2016-12-31$53,273
Participant contributions at beginning of year2016-12-31$1,246
Assets. Other investments not covered elsewhere at end of year2016-12-31$53,783
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$50,860
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$10,094
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$3,010
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$3,508
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$619
Other income not declared elsewhere2016-12-31$67,817
Administrative expenses (other) incurred2016-12-31$36,707
Liabilities. Value of operating payables at end of year2016-12-31$3,000
Liabilities. Value of operating payables at beginning of year2016-12-31$3,000
Total non interest bearing cash at end of year2016-12-31$215,514
Total non interest bearing cash at beginning of year2016-12-31$157,589
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,806,010
Value of net assets at end of year (total assets less liabilities)2016-12-31$16,157,141
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$14,351,131
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$89,588
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$1,029,027
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$919,158
Income. Interest from US Government securities2016-12-31$57,868
Income. Interest from corporate debt instruments2016-12-31$118,073
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$1,032,021
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$722,018
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$722,018
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$201
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$690,677
Asset value of US Government securities at end of year2016-12-31$2,028,124
Asset value of US Government securities at beginning of year2016-12-31$2,040,200
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$22,337
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$428,273
Income. Dividends from common stock2016-12-31$175,281
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$2,804,975
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$2,502,583
Contract administrator fees2016-12-31$27,077
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$8,936,838
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$7,956,946
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$8,415,310
Aggregate carrying amount (costs) on sale of assets2016-12-31$8,298,155
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BDO USA, LLP
Accountancy firm EIN2016-12-31135381590
2015 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-300,673
Total unrealized appreciation/depreciation of assets2015-12-31$-300,673
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$3,619
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$9,090
Total income from all sources (including contributions)2015-12-31$1,345,775
Total loss/gain on sale of assets2015-12-31$-60,978
Total of all expenses incurred2015-12-31$785,964
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$616,285
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,400,119
Value of total assets at end of year2015-12-31$14,354,750
Value of total assets at beginning of year2015-12-31$13,800,410
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$169,679
Total interest from all sources2015-12-31$151,634
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$180,151
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$46,209
Administrative expenses professional fees incurred2015-12-31$46,636
Assets. Corporate prefeered stocks other than exployer securities at end of year2015-12-31$1,140
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2015-12-31$3,245
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,400,119
Participant contributions at end of year2015-12-31$1,246
Participant contributions at beginning of year2015-12-31$623
Assets. Other investments not covered elsewhere at end of year2015-12-31$50,860
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$47,687
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$3,010
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$6,926
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$619
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$0
Other income not declared elsewhere2015-12-31$2,709
Administrative expenses (other) incurred2015-12-31$29,371
Liabilities. Value of operating payables at end of year2015-12-31$3,000
Liabilities. Value of operating payables at beginning of year2015-12-31$9,090
Total non interest bearing cash at end of year2015-12-31$157,589
Total non interest bearing cash at beginning of year2015-12-31$271,584
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$559,811
Value of net assets at end of year (total assets less liabilities)2015-12-31$14,351,131
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$13,791,320
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$73,546
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$919,158
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$799,757
Interest earned on other investments2015-12-31$2,056
Income. Interest from US Government securities2015-12-31$49,380
Income. Interest from corporate debt instruments2015-12-31$100,004
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$722,018
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$767,313
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$767,313
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$194
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$616,285
Asset value of US Government securities at end of year2015-12-31$2,040,200
Asset value of US Government securities at beginning of year2015-12-31$1,766,768
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-27,187
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Income. Dividends from preferred stock2015-12-31$119
Income. Dividends from common stock2015-12-31$133,823
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$2,502,583
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$2,095,898
Contract administrator fees2015-12-31$20,126
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$7,956,946
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$8,040,609
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$6,182,942
Aggregate carrying amount (costs) on sale of assets2015-12-31$6,243,920
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BDO USA, LLP
Accountancy firm EIN2015-12-31135381590
2014 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$284,594
Total unrealized appreciation/depreciation of assets2014-12-31$284,594
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$9,090
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$11,370
Total income from all sources (including contributions)2014-12-31$1,968,532
Total loss/gain on sale of assets2014-12-31$-52,348
Total of all expenses incurred2014-12-31$685,401
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$516,093
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,392,381
Value of total assets at end of year2014-12-31$13,800,410
Value of total assets at beginning of year2014-12-31$12,519,559
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$169,308
Total interest from all sources2014-12-31$94,849
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$191,652
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$60,796
Administrative expenses professional fees incurred2014-12-31$43,884
Assets. Corporate prefeered stocks other than exployer securities at end of year2014-12-31$3,245
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2014-12-31$6,262
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,391,758
Participant contributions at end of year2014-12-31$623
Participant contributions at beginning of year2014-12-31$8,497
Assets. Other investments not covered elsewhere at end of year2014-12-31$47,687
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$623
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$6,926
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$512
Other income not declared elsewhere2014-12-31$16
Administrative expenses (other) incurred2014-12-31$29,051
Liabilities. Value of operating payables at end of year2014-12-31$9,090
Liabilities. Value of operating payables at beginning of year2014-12-31$10,858
Total non interest bearing cash at end of year2014-12-31$271,584
Total non interest bearing cash at beginning of year2014-12-31$329,422
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,283,131
Value of net assets at end of year (total assets less liabilities)2014-12-31$13,791,320
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$12,508,189
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$68,726
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$799,757
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$1,852,169
Income. Interest from US Government securities2014-12-31$44,542
Income. Interest from corporate debt instruments2014-12-31$49,950
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$767,313
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$650,201
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$650,201
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$357
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$516,093
Asset value of US Government securities at end of year2014-12-31$1,766,768
Asset value of US Government securities at beginning of year2014-12-31$1,667,190
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$57,388
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Income. Dividends from preferred stock2014-12-31$315
Income. Dividends from common stock2014-12-31$130,541
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$2,095,898
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$339,318
Contract administrator fees2014-12-31$27,647
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$8,040,609
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$7,666,500
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$7,478,357
Aggregate carrying amount (costs) on sale of assets2014-12-31$7,530,705
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31BDO USA, LLP
Accountancy firm EIN2014-12-31135381590
2013 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$1,158,619
Total unrealized appreciation/depreciation of assets2013-12-31$1,158,619
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$11,370
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$7,634
Total income from all sources (including contributions)2013-12-31$3,150,778
Total loss/gain on sale of assets2013-12-31$179,626
Total of all expenses incurred2013-12-31$811,847
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$663,068
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,474,485
Value of total assets at end of year2013-12-31$12,519,559
Value of total assets at beginning of year2013-12-31$10,176,892
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$148,779
Total interest from all sources2013-12-31$47,942
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$196,916
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$92,359
Administrative expenses professional fees incurred2013-12-31$48,024
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-12-31$6,262
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,449,823
Participant contributions at end of year2013-12-31$8,497
Participant contributions at beginning of year2013-12-31$20,235
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$24,662
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$55,907
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$512
Other income not declared elsewhere2013-12-31$170,352
Administrative expenses (other) incurred2013-12-31$26,941
Liabilities. Value of operating payables at end of year2013-12-31$10,858
Liabilities. Value of operating payables at beginning of year2013-12-31$7,634
Total non interest bearing cash at end of year2013-12-31$329,422
Total non interest bearing cash at beginning of year2013-12-31$147,487
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$2,338,931
Value of net assets at end of year (total assets less liabilities)2013-12-31$12,508,189
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$10,169,258
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$48,203
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$1,852,169
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,623,264
Income. Interest from US Government securities2013-12-31$40,014
Income. Interest from corporate debt instruments2013-12-31$7,640
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$650,201
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$614,050
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$614,050
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$288
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$663,068
Asset value of US Government securities at end of year2013-12-31$1,667,190
Asset value of US Government securities at beginning of year2013-12-31$1,976,324
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$-77,162
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Income. Dividends from preferred stock2013-12-31$186
Income. Dividends from common stock2013-12-31$104,371
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$339,318
Contract administrator fees2013-12-31$25,611
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$7,666,500
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$5,739,625
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$6,588,992
Aggregate carrying amount (costs) on sale of assets2013-12-31$6,409,366
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31SS&G, INC.
Accountancy firm EIN2013-12-31341945695
2012 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$576,033
Total unrealized appreciation/depreciation of assets2012-12-31$576,033
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$7,634
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$7,309
Total income from all sources (including contributions)2012-12-31$2,693,608
Total loss/gain on sale of assets2012-12-31$104,744
Total of all expenses incurred2012-12-31$688,030
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$544,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,765,433
Value of total assets at end of year2012-12-31$10,176,892
Value of total assets at beginning of year2012-12-31$8,170,989
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$143,789
Total interest from all sources2012-12-31$60,375
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$187,023
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$84,302
Administrative expenses professional fees incurred2012-12-31$42,159
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,417,277
Participant contributions at end of year2012-12-31$20,235
Participant contributions at beginning of year2012-12-31$6,839
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$48,156
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$55,907
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$49,562
Administrative expenses (other) incurred2012-12-31$26,959
Liabilities. Value of operating payables at end of year2012-12-31$7,634
Liabilities. Value of operating payables at beginning of year2012-12-31$7,309
Total non interest bearing cash at end of year2012-12-31$147,487
Total non interest bearing cash at beginning of year2012-12-31$265,905
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$2,005,578
Value of net assets at end of year (total assets less liabilities)2012-12-31$10,169,258
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$8,163,680
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$53,165
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,623,264
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,378,936
Income. Interest from US Government securities2012-12-31$60,286
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$614,050
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$608,500
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$608,500
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$89
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$544,241
Asset value of US Government securities at end of year2012-12-31$1,976,324
Asset value of US Government securities at beginning of year2012-12-31$1,639,124
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$300,000
Income. Dividends from common stock2012-12-31$102,721
Contract administrator fees2012-12-31$21,506
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$5,739,625
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$4,222,123
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$4,671,405
Aggregate carrying amount (costs) on sale of assets2012-12-31$4,566,661
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31SS&G, INC.
Accountancy firm EIN2012-12-31341945695
2011 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-736,660
Total unrealized appreciation/depreciation of assets2011-12-31$-736,660
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$7,309
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$7,944
Total income from all sources (including contributions)2011-12-31$1,346,011
Total loss/gain on sale of assets2011-12-31$382,547
Total of all expenses incurred2011-12-31$527,730
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$403,176
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,482,795
Value of total assets at end of year2011-12-31$8,170,989
Value of total assets at beginning of year2011-12-31$7,353,343
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$124,554
Total interest from all sources2011-12-31$60,030
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$157,299
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$79,207
Administrative expenses professional fees incurred2011-12-31$40,477
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,243,113
Participant contributions at end of year2011-12-31$6,839
Participant contributions at beginning of year2011-12-31$16,676
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$39,682
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$49,562
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$9,245
Administrative expenses (other) incurred2011-12-31$41,237
Liabilities. Value of operating payables at end of year2011-12-31$7,309
Liabilities. Value of operating payables at beginning of year2011-12-31$7,944
Total non interest bearing cash at end of year2011-12-31$265,905
Total non interest bearing cash at beginning of year2011-12-31$46,343
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$818,281
Value of net assets at end of year (total assets less liabilities)2011-12-31$8,163,680
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$7,345,399
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$42,840
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,378,936
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$977,897
Income. Interest from US Government securities2011-12-31$59,725
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$608,500
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$768,328
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$768,328
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$305
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$403,176
Asset value of US Government securities at end of year2011-12-31$1,639,124
Asset value of US Government securities at beginning of year2011-12-31$1,458,002
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$200,000
Income. Dividends from common stock2011-12-31$78,092
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$4,222,123
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$4,076,852
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$4,938,803
Aggregate carrying amount (costs) on sale of assets2011-12-31$4,556,256
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31SS&G, INC.
Accountancy firm EIN2011-12-31341945695
2010 : VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$325,170
Total unrealized appreciation/depreciation of assets2010-12-31$325,170
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$7,944
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$22,950
Total income from all sources (including contributions)2010-12-31$2,195,933
Total loss/gain on sale of assets2010-12-31$257,960
Total of all expenses incurred2010-12-31$419,918
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$322,754
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,383,559
Value of total assets at end of year2010-12-31$7,353,343
Value of total assets at beginning of year2010-12-31$5,592,334
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$97,164
Total interest from all sources2010-12-31$75,778
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$153,466
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$90,473
Administrative expenses professional fees incurred2010-12-31$22,640
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,048,622
Participant contributions at end of year2010-12-31$16,676
Participant contributions at beginning of year2010-12-31$2,780
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$34,937
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$9,245
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$34,122
Administrative expenses (other) incurred2010-12-31$40,685
Liabilities. Value of operating payables at end of year2010-12-31$7,944
Liabilities. Value of operating payables at beginning of year2010-12-31$22,950
Total non interest bearing cash at end of year2010-12-31$46,343
Total non interest bearing cash at beginning of year2010-12-31$6,935
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$1,776,015
Value of net assets at end of year (total assets less liabilities)2010-12-31$7,345,399
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$5,569,384
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$33,839
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$977,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$664,861
Income. Interest from US Government securities2010-12-31$65,944
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$768,328
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$860,289
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$860,289
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$9,834
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$322,754
Asset value of US Government securities at end of year2010-12-31$1,458,002
Asset value of US Government securities at beginning of year2010-12-31$1,066,503
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$300,000
Income. Dividends from common stock2010-12-31$62,993
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$4,076,852
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$2,956,844
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$2,086,906
Aggregate carrying amount (costs) on sale of assets2010-12-31$1,828,946
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31SS&G FINANCIAL SERVICES, INC.
Accountancy firm EIN2010-12-31341945695

Form 5500 Responses for VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN

2022: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: VOLUNTARY LOCAL 4911 RETIREE MEDICAL 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 planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: VOLUNTARY LOCAL 4911 RETIREE MEDICAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number60426-600
Policy instance 1
Insurance contract or identification number60426-600
Number of Individuals Covered208
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 BenefitYes
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 $612,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number60426-600
Policy instance 1
Insurance contract or identification number60426-600
Number of Individuals Covered210
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 BenefitYes
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 $618,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number60426-600
Policy instance 1
Insurance contract or identification number60426-600
Number of Individuals Covered203
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $676,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number60426-600
Policy instance 1
Insurance contract or identification number60426-600
Number of Individuals Covered198
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $791,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number60426-600
Policy instance 1
Insurance contract or identification number60426-600
Number of Individuals Covered182
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $920,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number60426-600
Policy instance 1
Insurance contract or identification number60426-600
Number of Individuals Covered146
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 BenefitYes
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 $844,194
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number60426
Policy instance 1
Insurance contract or identification number60426
Number of Individuals Covered143
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $9,667
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 BenefitYes
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 $619,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,667
Insurance broker organization code?3
Insurance broker nameJOSEPH HANEY
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number69866
Policy instance 1
Insurance contract or identification number69866
Number of Individuals Covered113
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,767
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 BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,767
Insurance broker organization code?3
Insurance broker nameJOSEPH HANEY
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number69866
Policy instance 1
Insurance contract or identification number69866
Number of Individuals Covered111
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
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 BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number69866
Policy instance 1
Insurance contract or identification number69866
Number of Individuals Covered95
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
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 BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number69866
Policy instance 1
Insurance contract or identification number69866
Number of Individuals Covered80
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
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 BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number3761
Policy instance 1
Insurance contract or identification number3761
Number of Individuals Covered64
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
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 BenefitYes
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 $322,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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