RUVILLA SOLUTIONS, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023 : RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN 2023 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2023-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $137,070 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $237,712 |
| Total income from all sources (including contributions) | 2023-12-31 | $1,341,818 |
| Total loss/gain on sale of assets | 2023-12-31 | $0 |
| Total of all expenses incurred | 2023-12-31 | $934,438 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-12-31 | $640,708 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-12-31 | $1,333,787 |
| Value of total assets at end of year | 2023-12-31 | $1,194,709 |
| Value of total assets at beginning of year | 2023-12-31 | $887,971 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-12-31 | $293,730 |
| Total interest from all sources | 2023-12-31 | $8,031 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-12-31 | No |
| Was this plan covered by a fidelity bond | 2023-12-31 | Yes |
| Value of fidelity bond cover | 2023-12-31 | $100,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2023-12-31 | No |
| Contributions received from participants | 2023-12-31 | $38,936 |
| Participant contributions at end of year | 2023-12-31 | $4,110 |
| Participant contributions at beginning of year | 2023-12-31 | $0 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2023-12-31 | $38,225 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-12-31 | $12,799 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-12-31 | $19 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-12-31 | $9,662 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-12-31 | $9,662 |
| Administrative expenses (other) incurred | 2023-12-31 | $14,178 |
| Liabilities. Value of operating payables at end of year | 2023-12-31 | $4,821 |
| Liabilities. Value of operating payables at beginning of year | 2023-12-31 | $74,525 |
| Total non interest bearing cash at end of year | 2023-12-31 | $563,577 |
| Total non interest bearing cash at beginning of year | 2023-12-31 | $786,593 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-12-31 | No |
| Value of net income/loss | 2023-12-31 | $407,380 |
| Value of net assets at end of year (total assets less liabilities) | 2023-12-31 | $1,057,639 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-12-31 | $650,259 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-12-31 | $508,031 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-12-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-12-31 | $0 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-12-31 | $8,031 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-12-31 | $602,483 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-12-31 | No |
| Contributions received in cash from employer | 2023-12-31 | $1,294,851 |
| Employer contributions (assets) at end of year | 2023-12-31 | $106,192 |
| Employer contributions (assets) at beginning of year | 2023-12-31 | $101,359 |
| Liabilities. Value of benefit claims payable at end of year | 2023-12-31 | $122,587 |
| Liabilities. Value of benefit claims payable at beginning of year | 2023-12-31 | $153,525 |
| Did the plan have assets held for investment | 2023-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-12-31 | Unqualified |
| Accountancy firm name | 2023-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2023-12-31 | 410746749 |
| Total unrealized appreciation/depreciation of assets | 2023-01-01 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-01-01 | $137,070 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-01-01 | $237,712 |
| Total income from all sources (including contributions) | 2023-01-01 | $1,341,818 |
| Total loss/gain on sale of assets | 2023-01-01 | $0 |
| Total of all expenses incurred | 2023-01-01 | $934,438 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-01-01 | $640,708 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-01-01 | $1,333,787 |
| Value of total assets at end of year | 2023-01-01 | $1,194,709 |
| Value of total assets at beginning of year | 2023-01-01 | $887,971 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-01-01 | $293,730 |
| Total interest from all sources | 2023-01-01 | $8,031 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-01-01 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-01-01 | No |
| Was this plan covered by a fidelity bond | 2023-01-01 | Yes |
| Value of fidelity bond cover | 2023-01-01 | $100,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2023-01-01 | No |
| Contributions received from participants | 2023-01-01 | $38,936 |
| Participant contributions at end of year | 2023-01-01 | $4,110 |
| Participant contributions at beginning of year | 2023-01-01 | $0 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2023-01-01 | $38,225 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-01-01 | $12,799 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-01-01 | $19 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-01-01 | $9,662 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-01-01 | $9,662 |
| Administrative expenses (other) incurred | 2023-01-01 | $14,178 |
| Liabilities. Value of operating payables at end of year | 2023-01-01 | $4,821 |
| Liabilities. Value of operating payables at beginning of year | 2023-01-01 | $74,525 |
| Total non interest bearing cash at end of year | 2023-01-01 | $563,577 |
| Total non interest bearing cash at beginning of year | 2023-01-01 | $786,593 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-01-01 | No |
| Value of net income/loss | 2023-01-01 | $407,380 |
| Value of net assets at end of year (total assets less liabilities) | 2023-01-01 | $1,057,639 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-01-01 | $650,259 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-01-01 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-01-01 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-01-01 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-01-01 | $508,031 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-01-01 | $8,031 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-01-01 | $602,483 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-01-01 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-01-01 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-01-01 | No |
| Contributions received in cash from employer | 2023-01-01 | $1,294,851 |
| Employer contributions (assets) at end of year | 2023-01-01 | $106,192 |
| Employer contributions (assets) at beginning of year | 2023-01-01 | $101,359 |
| Liabilities. Value of benefit claims payable at end of year | 2023-01-01 | $122,587 |
| Liabilities. Value of benefit claims payable at beginning of year | 2023-01-01 | $153,525 |
| Did the plan have assets held for investment | 2023-01-01 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-01-01 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-01-01 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-01-01 | 1 |
| Accountancy firm name | 2023-01-01 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2023-01-01 | 410746749 |
| 2022 : RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN 2022 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $237,712 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $303,759 |
| Total income from all sources (including contributions) | 2022-12-31 | $1,310,220 |
| Total loss/gain on sale of assets | 2022-12-31 | $0 |
| Total of all expenses incurred | 2022-12-31 | $1,021,464 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $751,659 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $1,310,220 |
| Value of total assets at end of year | 2022-12-31 | $887,971 |
| Value of total assets at beginning of year | 2022-12-31 | $665,262 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $269,805 |
| Total interest from all sources | 2022-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Administrative expenses professional fees incurred | 2022-12-31 | $21,630 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $100,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $13,791 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-12-31 | $49,412 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $19 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $9,662 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $9,662 |
| Administrative expenses (other) incurred | 2022-12-31 | $5,998 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $74,525 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $47,083 |
| Total non interest bearing cash at end of year | 2022-12-31 | $786,593 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $566,779 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $288,756 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $650,259 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $361,503 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $17,323 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $702,247 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $1,296,429 |
| Employer contributions (assets) at end of year | 2022-12-31 | $101,359 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $98,483 |
| Contract administrator fees | 2022-12-31 | $224,854 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $153,525 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $247,014 |
| Did the plan have assets held for investment | 2022-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2022-12-31 | 410746749 |
| Total unrealized appreciation/depreciation of assets | 2022-01-01 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-01-01 | $237,712 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-01-01 | $303,759 |
| Total income from all sources (including contributions) | 2022-01-01 | $1,310,220 |
| Total loss/gain on sale of assets | 2022-01-01 | $0 |
| Total of all expenses incurred | 2022-01-01 | $1,021,464 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-01-01 | $751,659 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-01-01 | $1,310,220 |
| Value of total assets at end of year | 2022-01-01 | $887,971 |
| Value of total assets at beginning of year | 2022-01-01 | $665,262 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-01-01 | $269,805 |
| Total interest from all sources | 2022-01-01 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-01-01 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-01-01 | No |
| Administrative expenses professional fees incurred | 2022-01-01 | $21,630 |
| Was this plan covered by a fidelity bond | 2022-01-01 | Yes |
| Value of fidelity bond cover | 2022-01-01 | $100,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-01-01 | No |
| Contributions received from participants | 2022-01-01 | $13,791 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-01-01 | $49,412 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-01-01 | $19 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-01-01 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-01-01 | $9,662 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-01-01 | $9,662 |
| Administrative expenses (other) incurred | 2022-01-01 | $5,998 |
| Liabilities. Value of operating payables at end of year | 2022-01-01 | $74,525 |
| Liabilities. Value of operating payables at beginning of year | 2022-01-01 | $47,083 |
| Total non interest bearing cash at end of year | 2022-01-01 | $786,593 |
| Total non interest bearing cash at beginning of year | 2022-01-01 | $566,779 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-01-01 | No |
| Value of net income/loss | 2022-01-01 | $288,756 |
| Value of net assets at end of year (total assets less liabilities) | 2022-01-01 | $650,259 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-01-01 | $361,503 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-01-01 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-01-01 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-01-01 | No |
| Investment advisory and management fees | 2022-01-01 | $17,323 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-01-01 | $702,247 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-01-01 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-01-01 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-01-01 | No |
| Contributions received in cash from employer | 2022-01-01 | $1,296,429 |
| Employer contributions (assets) at end of year | 2022-01-01 | $101,359 |
| Employer contributions (assets) at beginning of year | 2022-01-01 | $98,483 |
| Contract administrator fees | 2022-01-01 | $224,854 |
| Liabilities. Value of benefit claims payable at end of year | 2022-01-01 | $153,525 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-01-01 | $247,014 |
| Did the plan have assets held for investment | 2022-01-01 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-01-01 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-01-01 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-01-01 | 1 |
| Accountancy firm name | 2022-01-01 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2022-01-01 | 410746749 |
| 2021 : RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN 2021 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $303,759 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $237,080 |
| Total income from all sources (including contributions) | 2021-12-31 | $1,275,353 |
| Total loss/gain on sale of assets | 2021-12-31 | $0 |
| Total of all expenses incurred | 2021-12-31 | $1,279,547 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $1,001,861 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $1,275,353 |
| Value of total assets at end of year | 2021-12-31 | $665,262 |
| Value of total assets at beginning of year | 2021-12-31 | $602,777 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $277,686 |
| Total interest from all sources | 2021-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Administrative expenses professional fees incurred | 2021-12-31 | $20,055 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $100,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-12-31 | $171,094 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $9,662 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $9,662 |
| Administrative expenses (other) incurred | 2021-12-31 | $4,566 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $47,083 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $39,199 |
| Total non interest bearing cash at end of year | 2021-12-31 | $566,779 |
| Total non interest bearing cash at beginning of year | 2021-12-31 | $492,639 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $-4,194 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $361,503 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $365,697 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Investment advisory and management fees | 2021-12-31 | $17,953 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $830,767 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $1,275,353 |
| Employer contributions (assets) at end of year | 2021-12-31 | $98,483 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $110,138 |
| Contract administrator fees | 2021-12-31 | $235,112 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $247,014 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $188,219 |
| Did the plan have assets held for investment | 2021-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2021-12-31 | 410746749 |
| 2020 : RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN 2020 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $237,080 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $455,206 |
| Total income from all sources (including contributions) | 2020-12-31 | $1,224,497 |
| Total loss/gain on sale of assets | 2020-12-31 | $0 |
| Total of all expenses incurred | 2020-12-31 | $1,046,703 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $827,310 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $1,224,497 |
| Value of total assets at end of year | 2020-12-31 | $602,777 |
| Value of total assets at beginning of year | 2020-12-31 | $643,109 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $219,393 |
| Total interest from all sources | 2020-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Administrative expenses professional fees incurred | 2020-12-31 | $18,375 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $60,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-12-31 | $93,217 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $5,695 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $9,662 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $67,579 |
| Administrative expenses (other) incurred | 2020-12-31 | $58,204 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $39,199 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $62,975 |
| Total non interest bearing cash at end of year | 2020-12-31 | $492,639 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $523,562 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $177,794 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $365,697 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $187,903 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $734,093 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $1,224,497 |
| Employer contributions (assets) at end of year | 2020-12-31 | $110,138 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $113,852 |
| Contract administrator fees | 2020-12-31 | $142,814 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $188,219 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $324,652 |
| Did the plan have assets held for investment | 2020-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2020-12-31 | 410746749 |
| 2019 : RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN 2019 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $455,206 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $361,545 |
| Total income from all sources (including contributions) | 2019-12-31 | $1,240,313 |
| Total loss/gain on sale of assets | 2019-12-31 | $0 |
| Total of all expenses incurred | 2019-12-31 | $1,244,286 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $998,306 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $1,240,313 |
| Value of total assets at end of year | 2019-12-31 | $643,109 |
| Value of total assets at beginning of year | 2019-12-31 | $553,421 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $245,980 |
| Total interest from all sources | 2019-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Administrative expenses professional fees incurred | 2019-12-31 | $15,000 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $60,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-12-31 | $218,611 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $5,695 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $335,231 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $255,605 |
| Administrative expenses (other) incurred | 2019-12-31 | $69,756 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $62,975 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $48,940 |
| Total non interest bearing cash at end of year | 2019-12-31 | $523,562 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $443,333 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $-3,973 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $187,903 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $191,876 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $779,695 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $1,240,313 |
| Employer contributions (assets) at end of year | 2019-12-31 | $113,852 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $110,088 |
| Contract administrator fees | 2019-12-31 | $161,224 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $57,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $57,000 |
| Did the plan have assets held for investment | 2019-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2019-12-31 | 410746749 |
| 2018 : RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN 2018 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $361,545 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $74,084 |
| Total income from all sources (including contributions) | 2018-12-31 | $836,352 |
| Total loss/gain on sale of assets | 2018-12-31 | $0 |
| Total of all expenses incurred | 2018-12-31 | $850,660 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $695,827 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $836,352 |
| Value of total assets at end of year | 2018-12-31 | $553,421 |
| Value of total assets at beginning of year | 2018-12-31 | $280,268 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $154,833 |
| Total interest from all sources | 2018-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Administrative expenses professional fees incurred | 2018-12-31 | $15,450 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $70,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-12-31 | $237,098 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-12-31 | $255,605 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-12-31 | $6,833 |
| Administrative expenses (other) incurred | 2018-12-31 | $42,497 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $48,940 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $10,251 |
| Total non interest bearing cash at end of year | 2018-12-31 | $443,333 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $219,159 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $-14,308 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $191,876 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $206,184 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $458,729 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $836,352 |
| Employer contributions (assets) at end of year | 2018-12-31 | $110,088 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $61,109 |
| Contract administrator fees | 2018-12-31 | $96,886 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $57,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $57,000 |
| Did the plan have assets held for investment | 2018-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2018-12-31 | 410746749 |
| 2017 : RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN 2017 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $74,084 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $136,283 |
| Total income from all sources (including contributions) | 2017-12-31 | $737,304 |
| Total loss/gain on sale of assets | 2017-12-31 | $0 |
| Total of all expenses incurred | 2017-12-31 | $677,156 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $566,230 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $737,304 |
| Value of total assets at end of year | 2017-12-31 | $280,268 |
| Value of total assets at beginning of year | 2017-12-31 | $282,319 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $110,926 |
| Total interest from all sources | 2017-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Administrative expenses professional fees incurred | 2017-12-31 | $15,050 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $70,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-12-31 | $31,316 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $146 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-12-31 | $6,833 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-12-31 | $54,050 |
| Administrative expenses (other) incurred | 2017-12-31 | $33,614 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $10,251 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $25,233 |
| Total non interest bearing cash at end of year | 2017-12-31 | $219,159 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $229,025 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $60,148 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $206,184 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $146,036 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $534,914 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $737,304 |
| Employer contributions (assets) at end of year | 2017-12-31 | $61,109 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $53,148 |
| Contract administrator fees | 2017-12-31 | $62,262 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $57,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $57,000 |
| Did the plan have assets held for investment | 2017-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2017-12-31 | 410746749 |
| 2016 : RUVILLA SOLUTIONS, LLC HEALTH & WELFARE PLAN 2016 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $136,283 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $94,606 |
| Total income from all sources (including contributions) | 2016-12-31 | $724,057 |
| Total loss/gain on sale of assets | 2016-12-31 | $0 |
| Total of all expenses incurred | 2016-12-31 | $656,742 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $560,524 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $724,057 |
| Value of total assets at end of year | 2016-12-31 | $282,319 |
| Value of total assets at beginning of year | 2016-12-31 | $173,327 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $96,218 |
| Total interest from all sources | 2016-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $70,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $146 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-12-31 | $54,050 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-12-31 | $13,849 |
| Administrative expenses (other) incurred | 2016-12-31 | $32,528 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $25,233 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $23,757 |
| Total non interest bearing cash at end of year | 2016-12-31 | $229,025 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $119,636 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $67,315 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $146,036 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $78,721 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $560,524 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $724,057 |
| Employer contributions (assets) at end of year | 2016-12-31 | $53,148 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $53,691 |
| Contract administrator fees | 2016-12-31 | $63,690 |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $57,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $57,000 |
| Did the plan have assets held for investment | 2016-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2016-12-31 | 410746749 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 70-85687 |
| Policy instance | 11 |
| Insurance contract or identification number | 70-85687 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,440 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | LM-169 |
| Policy instance | 1 |
| Insurance contract or identification number | LM-169 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $8,496 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $115,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 70-85687 |
| Policy instance | 2 |
| Insurance contract or identification number | 70-85687 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $11,188 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $281,309 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TELADOC HEALTH MEDICAL GROUP, P.A. (National Association of Insurance Commissioners NAIC id number: 62161 ) |
| Policy contract number | 238204 |
| Policy instance | 3 |
| Insurance contract or identification number | 238204 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | TELEMEDICINE | | 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 Carrier | USD $192 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154824 |
| Policy instance | 4 |
| Insurance contract or identification number | GL 154824 | | Number of Individuals Covered | 201 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $1,289 | | Total amount of fees paid to insurance company | USD $1,473 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $11,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR 206757 |
| Policy instance | 5 |
| Insurance contract or identification number | VAR 206757 | | Number of Individuals Covered | 201 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $275 | | Total amount of fees paid to insurance company | USD $315 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 Carrier | USD $2,504 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | EL 117-13528 |
| Policy instance | 6 |
| Insurance contract or identification number | EL 117-13528 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $5,235 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $118,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10311771001 |
| Policy instance | 7 |
| Insurance contract or identification number | 10311771001 | | Number of Individuals Covered | 210 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $968 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $10,246 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 11273-42 |
| Policy instance | 8 |
| Insurance contract or identification number | 11273-42 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,230 | | Total amount of fees paid to insurance company | USD $14,499 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $44,613 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED WORKER WELLNESS (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | RVSUW |
| Policy instance | 9 |
| Insurance contract or identification number | RVSUW | | Number of Individuals Covered | 207 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | 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 Carrier | USD $7,260 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 70-85687 |
| Policy instance | 10 |
| Insurance contract or identification number | 70-85687 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $1,577 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $15,872 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154824 |
| Policy instance | 4 |
| Insurance contract or identification number | GL 154824 | | Number of Individuals Covered | 203 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,657 | | Total amount of fees paid to insurance company | USD $1,705 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $15,061 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TELADOC HEALTH MEDICAL GROUP, P.A. (National Association of Insurance Commissioners NAIC id number: 62161 ) |
| Policy contract number | 238204 |
| Policy instance | 3 |
| Insurance contract or identification number | 238204 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | TELEMEDICINE | | 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 Carrier | USD $2,594 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 70-85687 |
| Policy instance | 2 |
| Insurance contract or identification number | 70-85687 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $12,827 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $304,063 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | LM-169 |
| Policy instance | 1 |
| Insurance contract or identification number | LM-169 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $9,458 | | Total amount of fees paid to insurance company | USD $36,376 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $145,502 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR 206757 |
| Policy instance | 5 |
| Insurance contract or identification number | VAR 206757 | | Number of Individuals Covered | 203 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $354 | | Total amount of fees paid to insurance company | USD $364 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 Carrier | USD $3,218 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | EL 117-13528 |
| Policy instance | 6 |
| Insurance contract or identification number | EL 117-13528 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $7,303 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $142,113 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10311771001 |
| Policy instance | 7 |
| Insurance contract or identification number | 10311771001 | | Number of Individuals Covered | 441 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,228 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $10,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 11273-42 |
| Policy instance | 8 |
| Insurance contract or identification number | 11273-42 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $21,303 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $65,547 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 54199 ) |
| Policy contract number | FCE0-001 |
| Policy instance | 9 |
| Insurance contract or identification number | FCE0-001 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | 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 Carrier | USD $2,761 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 70-85687 |
| Policy instance | 10 |
| Insurance contract or identification number | 70-85687 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,810 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $17,170 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 70-85687 |
| Policy instance | 11 |
| Insurance contract or identification number | 70-85687 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,440 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85687 |
| Policy instance | 2 |
| TELADOC HEALTH MEDICAL GROUP, P.A. (National Association of Insurance Commissioners NAIC id number: 62161 ) |
| Policy contract number | 238204 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154824 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR 206757 |
| Policy instance | 5 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | EL 117-13528 |
| Policy instance | 6 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10311771001 |
| Policy instance | 7 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 11273-42 |
| Policy instance | 8 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85687-00 |
| Policy instance | 10 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85687-00 |
| Policy instance | 11 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | LM-169 |
| Policy instance | 1 |
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 54199 ) |
| Policy contract number | FCE0-001 |
| Policy instance | 9 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85687-00 |
| Policy instance | 11 |
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | CLLMBRUV10 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85687-00 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154824 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR 206757 |
| Policy instance | 5 |
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 09211 |
| Policy instance | 6 |
| EYE MED VISION CARE (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | CL VIS RSL 2 |
| Policy instance | 7 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 11273-42 |
| Policy instance | 8 |
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 54199 ) |
| Policy contract number | FCE0-001 |
| Policy instance | 9 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85687-00 |
| Policy instance | 10 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 11273-42 |
| Policy instance | 8 |
| EYE MED VISION CARE (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | CL VIS RSL 2 |
| Policy instance | 7 |
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 08909 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR 206757 |
| Policy instance | 5 |
| UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 1395871 |
| Policy instance | 3 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 743756 |
| Policy instance | 2 |
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | CLLMB RSL 2 |
| Policy instance | 1 |
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 54199 ) |
| Policy contract number | FCE0-001 |
| Policy instance | 9 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154824 |
| Policy instance | 4 |
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | CLLMBUV |
| Policy instance | 1 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 11273-42 |
| Policy instance | 8 |
| EYE MED VISION CARE (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | CLLMBUV |
| Policy instance | 7 |
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 08724 |
| Policy instance | 6 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 743756 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR 206757 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154824 |
| Policy instance | 4 |
| UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 360261 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR 206757 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 154824 |
| Policy instance | 4 |
| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 54199 ) |
| Policy contract number | FCE0-001 |
| Policy instance | 3 |
| UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 359974 |
| Policy instance | 2 |
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | CLL MBR UV4 |
| Policy instance | 1 |
