401k Plan data: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN plan

WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number	513

WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

WASHINGTON PRIME GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: WASHINGTON PRIME GROUP, INC.

Employer identification number (EIN): 464323686

NAIC Classification: 531390
NAIC Description: Other Activities Related to Real Estate

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
513 2021-01-01 PAGLE HELTERBRAND 2022-07-11
513 2020-01-01 PAGLE HELTERBRAND 2021-07-15
513 2019-01-01 PAGLE HELTERBRAND 2020-07-22
513 2018-01-01
513 2017-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
513	2021-01-01	PAGLE HELTERBRAND	2022-07-11
513	2020-01-01	PAGLE HELTERBRAND	2021-07-15
513	2019-01-01	PAGLE HELTERBRAND	2020-07-22
513	2018-01-01
513	2017-01-01

Plan Statistics for WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN

401k plan membership statisitcs for WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2021: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 719
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 662
Number of retired or separated participants receiving benefits 2021-01-01 16
Total of all active and inactive participants 2021-01-01 678
2020: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 724
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 702
Number of retired or separated participants receiving benefits 2020-01-01 17
Total of all active and inactive participants 2020-01-01 719
2019: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 709
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 708
Number of retired or separated participants receiving benefits 2019-01-01 16
Total of all active and inactive participants 2019-01-01 724
2018: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 695
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 695
Number of retired or separated participants receiving benefits 2018-01-01 14
Total of all active and inactive participants 2018-01-01 709
2017: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 692
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 574
Number of retired or separated participants receiving benefits 2017-01-01 14
Total of all active and inactive participants 2017-01-01 588
Total participants 2017-01-01 588

Measure	Date	Value
2021: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	719
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	662
Number of retired or separated participants receiving benefits	2021-01-01	16
Total of all active and inactive participants	2021-01-01	678
2020: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	724
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	702
Number of retired or separated participants receiving benefits	2020-01-01	17
Total of all active and inactive participants	2020-01-01	719
2019: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	709
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	708
Number of retired or separated participants receiving benefits	2019-01-01	16
Total of all active and inactive participants	2019-01-01	724
2018: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	695
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	695
Number of retired or separated participants receiving benefits	2018-01-01	14
Total of all active and inactive participants	2018-01-01	709
2017: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	692
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	574
Number of retired or separated participants receiving benefits	2017-01-01	14
Total of all active and inactive participants	2017-01-01	588
Total participants	2017-01-01	588

Form 5500 Responses for WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN

2021: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: WASHINGTON PRIME GROUP EMPLOYEE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

GENWORTH LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70025 )

Policy contract number

18728

Policy instance

Insurance contract or identification number	18728
Number of Individuals Covered	6
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $2,677
Other welfare benefits provided	LONG TERM CARE
Welfare Benefit Premiums Paid to Carrier	USD $17,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,104
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

189329

Policy instance

Insurance contract or identification number	189329
Number of Individuals Covered	1049
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	FSA
Welfare Benefit Premiums Paid to Carrier	USD $889,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )

Policy contract number

10017

Policy instance

Insurance contract or identification number	10017
Number of Individuals Covered	1190
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of fees paid to insurance company	USD $10,096
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	10096
Additional information about fees paid to insurance broker	NEW BUSINESS BONUS
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98578301001

Policy instance

Insurance contract or identification number	98578301001
Number of Individuals Covered	992
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $5,634
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $62,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,634
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

307011

Policy instance

Insurance contract or identification number	307011
Number of Individuals Covered	977
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, VOLUNTARY LIFE
Welfare Benefit Premiums Paid to Carrier	USD $776,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

21480 1

Policy instance

Insurance contract or identification number	21480 1
Number of Individuals Covered	28
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $197,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

3F9338

Policy instance

Insurance contract or identification number	3F9338
Number of Individuals Covered	9
Insurance policy start date	2021-01-01
Insurance policy end date	2021-11-30
Total amount of commissions paid to insurance broker	USD $1,440
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,440
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

189329

Policy instance

Insurance contract or identification number	189329
Number of Individuals Covered	1166
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	FSA
Welfare Benefit Premiums Paid to Carrier	USD $942,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )

Policy contract number

10017

Policy instance

Insurance contract or identification number	10017
Number of Individuals Covered	1349
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Dental Insurance Welfare Benefit	Yes
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

98578301001

Policy instance

Insurance contract or identification number	98578301001
Number of Individuals Covered	1099
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $6,629
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $67,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,629
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

307011

Policy instance

Insurance contract or identification number	307011
Number of Individuals Covered	1035
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, VOLUNTARY LIFE
Welfare Benefit Premiums Paid to Carrier	USD $766,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

21480 1

Policy instance

Insurance contract or identification number	21480 1
Number of Individuals Covered	34
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $172,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

3F9338

Policy instance

Insurance contract or identification number	3F9338
Number of Individuals Covered	6
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $250
Total amount of fees paid to insurance company	USD $278
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $37,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $250
Amount paid for insurance broker fees	278
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3

GENWORTH LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70025 )

Policy contract number

18728

Policy instance

Insurance contract or identification number	18728
Number of Individuals Covered	9
Total amount of commissions paid to insurance broker	USD $3,469
Other welfare benefits provided	LONG TERM CARE
Welfare Benefit Premiums Paid to Carrier	USD $18,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,775
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

3F9338

Policy instance

Insurance contract or identification number	3F9338
Number of Individuals Covered	4
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $230
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $230

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

21480 1

Policy instance

Insurance contract or identification number	21480 1
Number of Individuals Covered	34
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $159,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

298532P 725966D

Policy instance

Insurance contract or identification number	298532P 725966D
Number of Individuals Covered	35
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $757
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,397
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $757
Insurance broker organization code?	3

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

000301

Policy instance

Insurance contract or identification number	000301
Number of Individuals Covered	708
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $435,144
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

98578301001

Policy instance

Insurance contract or identification number	98578301001
Number of Individuals Covered	1123
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $6,637
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $67,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,637
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5940135

Policy instance

Insurance contract or identification number	5940135
Number of Individuals Covered	1341
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $441,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

189329

Policy instance

Insurance contract or identification number	189329
Number of Individuals Covered	576
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	FSA
Welfare Benefit Premiums Paid to Carrier	USD $790,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

189329

Policy instance

Insurance contract or identification number	189329
Number of Individuals Covered	565
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Other welfare benefits provided	TELADOC, FSA
Welfare Benefit Premiums Paid to Carrier	USD $732,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5940135

Policy instance

Insurance contract or identification number	5940135
Number of Individuals Covered	1315
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of fees paid to insurance company	USD $61
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $407,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	61
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98578301001-02

Policy instance

Insurance contract or identification number	98578301001-02
Number of Individuals Covered	1114
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $7,173
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $66,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,173
Insurance broker organization code?	3

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

000301

Policy instance

Insurance contract or identification number	000301
Number of Individuals Covered	732
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $789,023
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

298532P 725966D

Policy instance

Insurance contract or identification number	298532P 725966D
Number of Individuals Covered	36
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,216
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,216
Insurance broker organization code?	3

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

21480 1

Policy instance

Insurance contract or identification number	21480 1
Number of Individuals Covered	26
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $137,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

21480 1

Policy instance

Insurance contract or identification number	21480 1
Number of Individuals Covered	33
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $183,877
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

298532P 725966D

Policy instance

Insurance contract or identification number	298532P 725966D
Number of Individuals Covered	31
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $657
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $657
Insurance broker organization code?	3
Insurance broker name	LANG FINANCIAL GROUP, INC.

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

000301

Policy instance

Insurance contract or identification number	000301
Number of Individuals Covered	695
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	VOLUNTARY LIFE, VOLUNTARY AD&D
Welfare Benefit Premiums Paid to Carrier	USD $698,019
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

98578301001-02

Policy instance

Insurance contract or identification number	98578301001-02
Number of Individuals Covered	1188
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,967
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $74,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,867
Insurance broker organization code?	3
Insurance broker name	USI INSURANCE SERVICES, LLC

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5940135

Policy instance

Insurance contract or identification number	5940135
Number of Individuals Covered	1330
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $394,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

189329

Policy instance

Insurance contract or identification number	189329
Number of Individuals Covered	574
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Other welfare benefits provided	TELADOC, FSA
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	WASHINGTON PRIME GROUP, INC.
Employer identification number (EIN):	464323686
NAIC Classification:	531390
NAIC Description:	Other Activities Related to Real Estate