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SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 401k Plan overview

Plan NameSAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN
Plan identification number 504

SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN Benefits

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

401k Sponsoring company profile

SAFETY NATIONAL CASUALTY CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:SAFETY NATIONAL CASUALTY CORPORATION
Employer identification number (EIN):430727872
NAIC Classification:524150

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042016-06-01ANGELA SCHAEFER ANGELA SCHAEFER2017-07-28
5042015-06-01ANGELA SCHAEFER
5042014-06-01ANGELA SCHAEFER
5042013-06-01ANGELA SCHAEFER ANGELA SCHAEFER2014-12-19
5042012-06-01JEANNE SNYDER
5042011-06-01JEANNE SNYDER
5042010-06-01JEANNE SNYDER
5042009-06-01JEANNE SNYDER

Plan Statistics for SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN

401k plan membership statisitcs for SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN

Measure Date Value
2016: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01428
Total number of active participants reported on line 7a of the Form 55002016-06-010
Number of retired or separated participants receiving benefits2016-06-010
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-010
2015: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01399
Total number of active participants reported on line 7a of the Form 55002015-06-01421
Number of retired or separated participants receiving benefits2015-06-015
Number of other retired or separated participants entitled to future benefits2015-06-012
Total of all active and inactive participants2015-06-01428
2014: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01337
Total number of active participants reported on line 7a of the Form 55002014-06-01392
Number of retired or separated participants receiving benefits2014-06-016
Number of other retired or separated participants entitled to future benefits2014-06-011
Total of all active and inactive participants2014-06-01399
2013: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01273
Total number of active participants reported on line 7a of the Form 55002013-06-01330
Number of retired or separated participants receiving benefits2013-06-017
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-01337
2012: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-01291
Total number of active participants reported on line 7a of the Form 55002012-06-01273
Number of retired or separated participants receiving benefits2012-06-010
Number of other retired or separated participants entitled to future benefits2012-06-010
Total of all active and inactive participants2012-06-01273
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-06-010
Total participants2012-06-01273
2011: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-01278
Total number of active participants reported on line 7a of the Form 55002011-06-01291
Number of retired or separated participants receiving benefits2011-06-010
Number of other retired or separated participants entitled to future benefits2011-06-010
Total of all active and inactive participants2011-06-01291
Total participants2011-06-01291
2010: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-06-01273
Total number of active participants reported on line 7a of the Form 55002010-06-01278
Number of retired or separated participants receiving benefits2010-06-010
Number of other retired or separated participants entitled to future benefits2010-06-010
Total of all active and inactive participants2010-06-01278
Total participants2010-06-01278
2009: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-01245
Total number of active participants reported on line 7a of the Form 55002009-06-01273
Number of retired or separated participants receiving benefits2009-06-010
Number of other retired or separated participants entitled to future benefits2009-06-010
Total of all active and inactive participants2009-06-01273
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-06-010
Total participants2009-06-01273

Form 5500 Responses for SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN

2016: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Submission has been amendedNo
2016-06-01This submission is the final filingYes
2016-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-06-01Plan is a collectively bargained planNo
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Submission has been amendedNo
2015-06-01This submission is the final filingNo
2015-06-01This return/report is a short plan year return/report (less than 12 months)No
2015-06-01Plan is a collectively bargained planNo
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingNo
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Submission has been amendedNo
2012-06-01This submission is the final filingNo
2012-06-01This return/report is a short plan year return/report (less than 12 months)No
2012-06-01Plan is a collectively bargained planNo
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes
2011: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Submission has been amendedNo
2011-06-01This submission is the final filingNo
2011-06-01This return/report is a short plan year return/report (less than 12 months)No
2011-06-01Plan is a collectively bargained planNo
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – InsuranceYes
2010: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2010 form 5500 responses
2010-06-01Type of plan entitySingle employer plan
2010-06-01Submission has been amendedNo
2010-06-01This submission is the final filingNo
2010-06-01This return/report is a short plan year return/report (less than 12 months)No
2010-06-01Plan is a collectively bargained planNo
2010-06-01Plan funding arrangement – InsuranceYes
2010-06-01Plan benefit arrangement – InsuranceYes
2009: SAFETY NATIONAL CASUALTY CORPORATION MEDICAL PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Submission has been amendedNo
2009-06-01This submission is the final filingNo
2009-06-01This return/report is a short plan year return/report (less than 12 months)No
2009-06-01Plan is a collectively bargained planNo
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number705550
Policy instance 1
Insurance contract or identification number705550
Number of Individuals Covered1082
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $15,864
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 $4,249,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees15864
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameTHE CORNERSTONE INSURANCE GROUP LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number705550
Policy instance 1
Insurance contract or identification number705550
Number of Individuals Covered691
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $633
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 $3,864,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees633
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
Insurance broker nameTHE CORNERSTONE INSURANCE GROUP
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number705550
Policy instance 1
Insurance contract or identification number705550
Number of Individuals Covered691
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $336
Total amount of fees paid to insurance companyUSD $152,021
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 $3,050,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $336
Amount paid for insurance broker fees138794
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
Insurance broker nameTHE CORNERSTONE INSURANCE GROUP
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number705550
Policy instance 1
Insurance contract or identification number705550
Number of Individuals Covered273
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $127,909
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,485,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $127,909
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCORNERSTONE INSURANCE GROUP LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0705550
Policy instance 1
Insurance contract or identification number0705550
Number of Individuals Covered291
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $138,516
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,770,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0705550
Policy instance 1
Insurance contract or identification number0705550
Number of Individuals Covered278
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $126,284
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,317,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $126,284
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCORNERSTONE INSURANCE GROUP LLC

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