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STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 401k Plan overview

Plan NameSTEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT
Plan identification number 504

STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT Benefits

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

401k Sponsoring company profile

STEPHENS COLLEGE has sponsored the creation of one or more 401k plans.

Company Name:STEPHENS COLLEGE
Employer identification number (EIN):430670936
NAIC Classification:611000

Additional information about STEPHENS COLLEGE

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1977-08-08
Company Identification Number: 0004126807
Legal Registered Office Address: RR 3 BOX 82BDALTON %DALTON

MANSFIELD
United States of America (USA)
76063

More information about STEPHENS COLLEGE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042021-12-01DANE FUHRMAN2023-08-01
5042020-12-01DANE FUHRMAN2022-06-22
5042019-12-01DANE FUHRMAN2021-09-02
5042018-12-01DANE FUHRMAN2020-05-06
5042017-12-01KIM SCHELLENBERGER2019-05-30
5042016-12-01
5042015-12-01
5042014-12-01KIMBERLY SCHELLENBERGER
5042013-12-01KIMBERLY SCHELLENBERGER
5042012-12-01
5042011-12-01
5042010-12-01
5042009-12-01
5042008-12-01
5042008-07-01
5042007-07-01

Plan Statistics for STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT

401k plan membership statisitcs for STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT

Measure Date Value
2021: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2021 401k membership
Total participants, beginning-of-year2021-12-01131
Total number of active participants reported on line 7a of the Form 55002021-12-01104
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-01104
Number of employers contributing to the scheme2021-12-010
2020: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2020 401k membership
Total participants, beginning-of-year2020-12-01109
Total number of active participants reported on line 7a of the Form 55002020-12-01131
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01131
Number of employers contributing to the scheme2020-12-010
2019: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2019 401k membership
Total participants, beginning-of-year2019-12-01150
Total number of active participants reported on line 7a of the Form 55002019-12-01109
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01109
Number of employers contributing to the scheme2019-12-010
2018: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2018 401k membership
Total participants, beginning-of-year2018-12-01156
Total number of active participants reported on line 7a of the Form 55002018-12-01150
Number of retired or separated participants receiving benefits2018-12-010
Number of other retired or separated participants entitled to future benefits2018-12-010
Total of all active and inactive participants2018-12-01150
Number of employers contributing to the scheme2018-12-010
2017: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2017 401k membership
Total participants, beginning-of-year2017-12-01158
Total number of active participants reported on line 7a of the Form 55002017-12-01150
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-01150
Number of employers contributing to the scheme2017-12-010
2016: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2016 401k membership
Total participants, beginning-of-year2016-12-01175
Total number of active participants reported on line 7a of the Form 55002016-12-01159
Number of retired or separated participants receiving benefits2016-12-010
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-01159
2015: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2015 401k membership
Total participants, beginning-of-year2015-12-01176
Total number of active participants reported on line 7a of the Form 55002015-12-01175
Number of retired or separated participants receiving benefits2015-12-010
Number of other retired or separated participants entitled to future benefits2015-12-010
Total of all active and inactive participants2015-12-01175
2014: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2014 401k membership
Total participants, beginning-of-year2014-12-01161
Total number of active participants reported on line 7a of the Form 55002014-12-01176
Number of retired or separated participants receiving benefits2014-12-010
Number of other retired or separated participants entitled to future benefits2014-12-010
Total of all active and inactive participants2014-12-01176
2013: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2013 401k membership
Total participants, beginning-of-year2013-12-01155
Total number of active participants reported on line 7a of the Form 55002013-12-01161
Number of retired or separated participants receiving benefits2013-12-010
Number of other retired or separated participants entitled to future benefits2013-12-010
Total of all active and inactive participants2013-12-01161
2012: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2012 401k membership
Total participants, beginning-of-year2012-12-01161
Total number of active participants reported on line 7a of the Form 55002012-12-01155
Number of retired or separated participants receiving benefits2012-12-010
Number of other retired or separated participants entitled to future benefits2012-12-010
Total of all active and inactive participants2012-12-01155
2011: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2011 401k membership
Total participants, beginning-of-year2011-12-01161
Total number of active participants reported on line 7a of the Form 55002011-12-01161
Number of retired or separated participants receiving benefits2011-12-010
Number of other retired or separated participants entitled to future benefits2011-12-010
Total of all active and inactive participants2011-12-01161
2010: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2010 401k membership
Total participants, beginning-of-year2010-12-01173
Total number of active participants reported on line 7a of the Form 55002010-12-01161
Number of retired or separated participants receiving benefits2010-12-010
Number of other retired or separated participants entitled to future benefits2010-12-010
Total of all active and inactive participants2010-12-01161
2009: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2009 401k membership
Total participants, beginning-of-year2009-12-01177
Total number of active participants reported on line 7a of the Form 55002009-12-01173
Number of retired or separated participants receiving benefits2009-12-010
Number of other retired or separated participants entitled to future benefits2009-12-010
Total of all active and inactive participants2009-12-01173
2008: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2008 401k membership
Total participants, beginning-of-year2008-12-01122
Total number of active participants reported on line 7a of the Form 55002008-12-01177
Number of retired or separated participants receiving benefits2008-12-010
Number of other retired or separated participants entitled to future benefits2008-12-010
Total of all active and inactive participants2008-12-01177
Total participants, beginning-of-year2008-07-01119
Total number of active participants reported on line 7a of the Form 55002008-07-01122
Number of retired or separated participants receiving benefits2008-07-010
Number of other retired or separated participants entitled to future benefits2008-07-010
Total of all active and inactive participants2008-07-01122
2007: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2007 401k membership
Total participants, beginning-of-year2007-07-01115
Total number of active participants reported on line 7a of the Form 55002007-07-01119
Number of retired or separated participants receiving benefits2007-07-010
Number of other retired or separated participants entitled to future benefits2007-07-010
Total of all active and inactive participants2007-07-01119

Form 5500 Responses for STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT

2021: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – InsuranceYes
2020: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes
2018: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – InsuranceYes
2017: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – InsuranceYes
2016: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan benefit arrangement – InsuranceYes
2015: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Submission has been amendedNo
2015-12-01This submission is the final filingNo
2015-12-01This return/report is a short plan year return/report (less than 12 months)No
2015-12-01Plan is a collectively bargained planNo
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan benefit arrangement – InsuranceYes
2014: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01Submission has been amendedNo
2014-12-01This submission is the final filingNo
2014-12-01This return/report is a short plan year return/report (less than 12 months)No
2014-12-01Plan is a collectively bargained planNo
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan benefit arrangement – InsuranceYes
2013: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2013 form 5500 responses
2013-12-01Type of plan entitySingle employer plan
2013-12-01First time form 5500 has been submittedYes
2013-12-01Submission has been amendedNo
2013-12-01This submission is the final filingNo
2013-12-01This return/report is a short plan year return/report (less than 12 months)No
2013-12-01Plan is a collectively bargained planNo
2013-12-01Plan funding arrangement – InsuranceYes
2013-12-01Plan benefit arrangement – InsuranceYes
2012: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2012 form 5500 responses
2012-12-01Type of plan entitySingle employer plan
2012-12-01Submission has been amendedNo
2012-12-01This submission is the final filingNo
2012-12-01This return/report is a short plan year return/report (less than 12 months)No
2012-12-01Plan is a collectively bargained planNo
2012-12-01Plan funding arrangement – InsuranceYes
2012-12-01Plan benefit arrangement – InsuranceYes
2011: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2011 form 5500 responses
2011-12-01Type of plan entitySingle employer plan
2011-12-01Submission has been amendedNo
2011-12-01This submission is the final filingNo
2011-12-01This return/report is a short plan year return/report (less than 12 months)No
2011-12-01Plan is a collectively bargained planNo
2011-12-01Plan funding arrangement – InsuranceYes
2011-12-01Plan benefit arrangement – InsuranceYes
2010: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2010 form 5500 responses
2010-12-01Type of plan entitySingle employer plan
2010-12-01Submission has been amendedNo
2010-12-01This submission is the final filingNo
2010-12-01This return/report is a short plan year return/report (less than 12 months)No
2010-12-01Plan is a collectively bargained planNo
2010-12-01Plan funding arrangement – InsuranceYes
2010-12-01Plan benefit arrangement – InsuranceYes
2009: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2009 form 5500 responses
2009-12-01Type of plan entitySingle employer plan
2009-12-01Submission has been amendedNo
2009-12-01This submission is the final filingNo
2009-12-01This return/report is a short plan year return/report (less than 12 months)No
2009-12-01Plan is a collectively bargained planNo
2009-12-01Plan funding arrangement – InsuranceYes
2009-12-01Plan benefit arrangement – InsuranceYes
2008: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2008 form 5500 responses
2008-12-01Type of plan entitySingle employer plan
2008-12-01Submission has been amendedNo
2008-12-01This submission is the final filingNo
2008-12-01This return/report is a short plan year return/report (less than 12 months)No
2008-12-01Plan is a collectively bargained planNo
2008-12-01Plan funding arrangement – InsuranceYes
2008-12-01Plan benefit arrangement – InsuranceYes
2008-07-01Type of plan entitySingle employer plan
2008-07-01Submission has been amendedNo
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2008-07-01Plan is a collectively bargained planNo
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan benefit arrangement – InsuranceYes
2007: STEPHENS COLLEGE LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2007 form 5500 responses
2007-07-01Type of plan entitySingle employer plan
2007-07-01Submission has been amendedNo
2007-07-01This submission is the final filingNo
2007-07-01This return/report is a short plan year return/report (less than 12 months)No
2007-07-01Plan is a collectively bargained planNo
2007-07-01Plan funding arrangement – InsuranceYes
2007-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10195751001
Policy instance 3
Insurance contract or identification number10195751001
Number of Individuals Covered119
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $928
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $928
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number1190900
Policy instance 2
Insurance contract or identification number1190900
Number of Individuals Covered145
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,925
Total amount of fees paid to insurance companyUSD $154
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,925
Amount paid for insurance broker fees154
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number246728
Policy instance 1
Insurance contract or identification number246728
Number of Individuals Covered116
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,962
Total amount of fees paid to insurance companyUSD $2,407
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $31,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,962
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10195751001
Policy instance 3
Insurance contract or identification number10195751001
Number of Individuals Covered111
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $766
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $766
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number1190900
Policy instance 2
Insurance contract or identification number1190900
Number of Individuals Covered145
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,925
Total amount of fees paid to insurance companyUSD $154
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,925
Amount paid for insurance broker fees154
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number246728
Policy instance 1
Insurance contract or identification number246728
Number of Individuals Covered131
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,072
Total amount of fees paid to insurance companyUSD $2,380
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $36,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,072
Amount paid for insurance broker fees2380
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10195751001
Policy instance 3
Insurance contract or identification number10195751001
Number of Individuals Covered138
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $827
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number1190900
Policy instance 2
Insurance contract or identification number1190900
Number of Individuals Covered173
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,459
Total amount of fees paid to insurance companyUSD $1,513
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number246728
Policy instance 1
Insurance contract or identification number246728
Number of Individuals Covered109
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,345
Total amount of fees paid to insurance companyUSD $2,565
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $33,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number246728
Policy instance 1
Insurance contract or identification number246728
Number of Individuals Covered122
Insurance policy start date2018-12-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $694
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $694
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number246728
Policy instance 1
Insurance contract or identification number246728
Number of Individuals Covered150
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $11,413
Total amount of fees paid to insurance companyUSD $5,910
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $109,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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