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PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NamePHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN
Plan identification number 503

PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

PHYSICIANS MUTUAL INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:PHYSICIANS MUTUAL INSURANCE COMPANY
Employer identification number (EIN):470270450
NAIC Classification:524140

Additional information about PHYSICIANS MUTUAL INSURANCE COMPANY

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 572616

More information about PHYSICIANS MUTUAL INSURANCE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-01-01SHERI HOWARD2024-05-09
5032022-01-01
5032022-01-01CHERYL FRANKO
5032021-01-01
5032021-01-01CHERYL FRANKO
5032020-01-01
5032019-01-01
5032018-01-01
5032017-01-01LORI KIEFER
5032016-01-01LORI KIEFER
5032015-01-01LORI KIEFER
5032014-01-01LORI KIEFER
5032013-01-01LORI KIEFER
5032012-01-01LORI KIEFER
5032011-01-01HOWARD DAUBERT HOWARD DAUBERT2012-10-08
5032009-01-01LARRY BELDIN LARRY BELDIN2010-10-14
5032009-01-01HOWARD DAUBERT HOWARD DAUBERT2012-10-25

Financial Data on PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN

Measure Date Value
2019 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$132,343
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$132,343
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$52,524
Total income from all sources (including contributions)2019-12-31$8,466,994
Total income from all sources (including contributions)2019-12-31$8,466,994
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$9,789,121
Total of all expenses incurred2019-12-31$9,789,121
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$9,443,146
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$9,443,146
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$8,466,994
Value of total assets at end of year2019-12-31$132,343
Value of total assets at end of year2019-12-31$132,343
Value of total assets at beginning of year2019-12-31$1,374,651
Value of total assets at beginning of year2019-12-31$1,374,651
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$345,975
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$345,975
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)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 year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$57,972
Administrative expenses professional fees incurred2019-12-31$57,972
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$2,000,000
Value of fidelity bond cover2019-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$2,935,665
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$36,895
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$36,895
Liabilities. Value of operating payables at end of year2019-12-31$132,343
Liabilities. Value of operating payables at end of year2019-12-31$132,343
Liabilities. Value of operating payables at beginning of year2019-12-31$52,524
Liabilities. Value of operating payables at beginning of year2019-12-31$52,524
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-1,322,127
Value of net income/loss2019-12-31$-1,322,127
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,322,127
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,322,127
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,337,756
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,337,756
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,337,756
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,337,756
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,064,853
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,064,853
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$5,531,329
Employer contributions (assets) at end of year2019-12-31$132,343
Employer contributions (assets) at end of year2019-12-31$132,343
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$8,378,293
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$8,378,293
Contract administrator fees2019-12-31$288,003
Contract administrator fees2019-12-31$288,003
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31LUTZ & COMPANY, PC
Accountancy firm name2019-12-31LUTZ & COMPANY, PC
Accountancy firm EIN2019-12-31470625816
2018 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$52,524
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$54,020
Total income from all sources (including contributions)2018-12-31$10,148,309
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$8,983,940
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$8,645,564
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$10,148,309
Value of total assets at end of year2018-12-31$1,374,651
Value of total assets at beginning of year2018-12-31$211,778
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$338,376
Total interest from all sources2018-12-31$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 year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$50,933
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$2,956,656
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$36,895
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$92,022
Liabilities. Value of operating payables at end of year2018-12-31$52,524
Liabilities. Value of operating payables at beginning of year2018-12-31$54,020
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$1,164,369
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,322,127
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$157,758
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$1,337,756
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$119,756
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$119,756
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$1,109,338
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$7,191,653
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$7,536,226
Contract administrator fees2018-12-31$287,443
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31LUTZ & COMPANY, PC
Accountancy firm EIN2018-12-31470625816
2017 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$54,020
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$86,284
Total income from all sources (including contributions)2017-12-31$10,255,832
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$10,493,082
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$10,218,659
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$10,255,832
Value of total assets at end of year2017-12-31$211,778
Value of total assets at beginning of year2017-12-31$481,292
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$274,423
Total interest from all sources2017-12-31$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 year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$52,768
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$2,982,496
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$92,022
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$32,450
Administrative expenses (other) incurred2017-12-31$0
Liabilities. Value of operating payables at end of year2017-12-31$54,020
Liabilities. Value of operating payables at beginning of year2017-12-31$86,284
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-237,250
Value of net assets at end of year (total assets less liabilities)2017-12-31$157,758
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$395,008
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$119,756
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$448,842
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$448,842
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$1,029,907
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$7,273,336
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$9,188,752
Contract administrator fees2017-12-31$221,655
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31LUTZ & COMPANY
Accountancy firm EIN2017-12-31470625816
2016 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$86,284
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$268,529
Total income from all sources (including contributions)2016-12-31$9,988,313
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$9,556,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$9,249,820
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$9,988,313
Value of total assets at end of year2016-12-31$481,292
Value of total assets at beginning of year2016-12-31$231,614
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$306,570
Total interest from all sources2016-12-31$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 year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$59,687
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,984,742
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$32,450
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$110,424
Administrative expenses (other) incurred2016-12-31$35,762
Liabilities. Value of operating payables at end of year2016-12-31$86,284
Liabilities. Value of operating payables at beginning of year2016-12-31$268,529
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$431,923
Value of net assets at end of year (total assets less liabilities)2016-12-31$395,008
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-36,915
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$448,842
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$121,190
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$121,190
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$1,008,401
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$7,003,571
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$8,241,419
Contract administrator fees2016-12-31$211,121
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31LUTZ & COMPANY
Accountancy firm EIN2016-12-31470625816
2015 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$268,529
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$217,807
Total income from all sources (including contributions)2015-12-31$9,618,991
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$10,064,945
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$9,735,036
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$9,618,991
Value of total assets at end of year2015-12-31$231,614
Value of total assets at beginning of year2015-12-31$626,846
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$329,909
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$49,169
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$2,992,270
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$110,424
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$62,166
Administrative expenses (other) incurred2015-12-31$60,192
Liabilities. Value of operating payables at end of year2015-12-31$268,529
Liabilities. Value of operating payables at beginning of year2015-12-31$217,807
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-445,954
Value of net assets at end of year (total assets less liabilities)2015-12-31$-36,915
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$409,039
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$121,190
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$564,680
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$564,680
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$1,101,326
Asset value of US Government securities at beginning of year2015-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$6,626,721
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$8,633,710
Contract administrator fees2015-12-31$220,548
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31LUTZ & COMPANY
Accountancy firm EIN2015-12-31470625816
2014 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$217,807
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$230,788
Total income from all sources (including contributions)2014-12-31$7,779,879
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$7,647,851
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$7,341,113
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$7,779,879
Value of total assets at end of year2014-12-31$626,846
Value of total assets at beginning of year2014-12-31$507,799
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$306,738
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$12,334
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$2,311,203
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$62,166
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$108,534
Administrative expenses (other) incurred2014-12-31$87,046
Liabilities. Value of operating payables at end of year2014-12-31$217,807
Liabilities. Value of operating payables at beginning of year2014-12-31$230,788
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$132,028
Value of net assets at end of year (total assets less liabilities)2014-12-31$409,039
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$277,011
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$564,680
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$399,265
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$399,265
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$471,814
Asset value of US Government securities at end of year2014-12-31$0
Asset value of US Government securities at beginning of year2014-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$5,468,676
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$6,869,299
Contract administrator fees2014-12-31$207,358
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31LUTZ & COMPANY, PC
Accountancy firm EIN2014-12-31470625816
2013 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$-2,429
Total unrealized appreciation/depreciation of assets2013-12-31$-2,429
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$230,788
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$142,091
Total income from all sources (including contributions)2013-12-31$8,387,926
Total loss/gain on sale of assets2013-12-31$817
Total of all expenses incurred2013-12-31$8,527,406
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$8,310,812
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$8,387,650
Value of total assets at end of year2013-12-31$507,799
Value of total assets at beginning of year2013-12-31$558,582
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$216,594
Total interest from all sources2013-12-31$1,888
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$10,460
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$2,336,680
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$108,534
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$91,599
Liabilities. Value of operating payables at end of year2013-12-31$230,788
Liabilities. Value of operating payables at beginning of year2013-12-31$142,091
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-139,480
Value of net assets at end of year (total assets less liabilities)2013-12-31$277,011
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$416,491
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$399,265
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$215,228
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$215,228
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$1,888
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$473,153
Asset value of US Government securities at end of year2013-12-31$0
Asset value of US Government securities at beginning of year2013-12-31$251,755
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$6,050,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$7,837,659
Contract administrator fees2013-12-31$206,134
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$250,962
Aggregate carrying amount (costs) on sale of assets2013-12-31$250,145
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31LUTZ & COMPANY, PC
Accountancy firm EIN2013-12-31470625816
2012 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$142,091
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$199,482
Total income from all sources (including contributions)2012-12-31$7,515,743
Total loss/gain on sale of assets2012-12-31$914
Total of all expenses incurred2012-12-31$8,127,778
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$7,899,720
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$7,512,534
Value of total assets at end of year2012-12-31$558,582
Value of total assets at beginning of year2012-12-31$1,228,008
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$228,058
Total interest from all sources2012-12-31$2,295
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$10,000
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$2,293,363
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$91,599
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$19,612
Liabilities. Value of operating payables at end of year2012-12-31$142,091
Liabilities. Value of operating payables at beginning of year2012-12-31$199,482
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-612,035
Value of net assets at end of year (total assets less liabilities)2012-12-31$416,491
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,028,526
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$215,228
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$442,319
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$442,319
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$2,295
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$482,237
Asset value of US Government securities at end of year2012-12-31$251,755
Asset value of US Government securities at beginning of year2012-12-31$766,077
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$5,219,171
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$7,417,483
Contract administrator fees2012-12-31$218,058
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$251,970
Aggregate carrying amount (costs) on sale of assets2012-12-31$251,056
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31LUTZ & COMPANY, PC
Accountancy firm EIN2012-12-31470625816
2011 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$0
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$199,482
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$202,830
Total income from all sources (including contributions)2011-12-31$7,544,047
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$7,831,261
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$7,620,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$7,528,614
Value of total assets at end of year2011-12-31$1,228,008
Value of total assets at beginning of year2011-12-31$1,518,570
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$210,418
Total interest from all sources2011-12-31$15,433
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$9,700
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$2,316,657
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$19,612
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$47,824
Liabilities. Value of operating payables at end of year2011-12-31$199,482
Liabilities. Value of operating payables at beginning of year2011-12-31$202,830
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-287,214
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,028,526
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,315,740
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$442,319
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$703,305
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$703,305
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$15,433
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$491,278
Asset value of US Government securities at end of year2011-12-31$766,077
Asset value of US Government securities at beginning of year2011-12-31$767,441
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$5,211,957
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$7,129,565
Contract administrator fees2011-12-31$200,718
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31LUTZ & COMPANY, PC
Accountancy firm EIN2011-12-31470625816
2010 : PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$-6,238
Total unrealized appreciation/depreciation of assets2010-12-31$-6,238
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$202,830
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$190,387
Total income from all sources (including contributions)2010-12-31$7,096,772
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$7,396,497
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$7,190,970
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$7,077,005
Value of total assets at end of year2010-12-31$1,518,570
Value of total assets at beginning of year2010-12-31$1,805,852
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$205,527
Total interest from all sources2010-12-31$26,005
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$9,400
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$2,246,998
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$47,824
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$57,594
Liabilities. Value of operating payables at end of year2010-12-31$202,830
Liabilities. Value of operating payables at beginning of year2010-12-31$190,387
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-299,725
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,315,740
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,615,465
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Income. Interest from US Government securities2010-12-31$26,005
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$703,305
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$466,703
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$466,703
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$422,872
Asset value of US Government securities at end of year2010-12-31$767,441
Asset value of US Government securities at beginning of year2010-12-31$1,281,555
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$4,830,007
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$6,768,098
Contract administrator fees2010-12-31$196,127
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31LUTZ & COMPANY, PC
Accountancy firm EIN2010-12-31470625816

Form 5500 Responses for PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN

2023: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: PHYSICIANS MUTUAL EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number677938G
Policy instance 2
Insurance contract or identification number677938G
Number of Individuals Covered931
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $36,794
Total amount of fees paid to insurance companyUSD $23,170
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $613,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number96875181001
Policy instance 1
Insurance contract or identification number96875181001
Number of Individuals Covered924
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,197
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,289
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 number96875181001
Policy instance 3
Insurance contract or identification number96875181001
Number of Individuals Covered866
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,970
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $56,806
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 numberETB-155040
Policy instance 2
Insurance contract or identification numberETB-155040
Number of Individuals Covered1004
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
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 number677938G
Policy instance 1
Insurance contract or identification number677938G
Number of Individuals Covered1430
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $38,619
Total amount of fees paid to insurance companyUSD $12,600
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, VOLUNTARY LIFE, DEPENDENT LIFE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $643,657
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 number677938G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB-155040
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number96875181001
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number96875181001
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB155040
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number677938G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number677938G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB155040
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number96875181001
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9687518
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB155040
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number677938G
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9687518
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB155040
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number677938G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number677938G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB155040
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9687518
Policy instance 3
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number8300440000
Policy instance 1
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number8300440000
Policy instance 1
COVENTRY HEALTH CARE OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number8300440000
Policy instance 1
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number8300440000
Policy instance 1
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number8300440000
Policy instance 1

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