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PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan NamePETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN
Plan identification number 501

PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN Benefits

401k Plan TypeWelfare 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

PETERSON PROPERTIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:PETERSON PROPERTIES, INC.
Employer identification number (EIN):480919120
NAIC Classification:531110
NAIC Description:Lessors of Residential Buildings and Dwellings

Additional information about PETERSON PROPERTIES, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1963-01-02
Company Identification Number: 153326
Legal Registered Office Address: 9 EAST MAIN ST
PO BOX 148
CORFU
United States of America (USA)
14036

More information about PETERSON PROPERTIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-02-01
5012021-02-01
5012020-02-01
5012019-02-01
5012018-02-01
5012017-02-01JOHN KORNHAUS
5012016-02-01JOHN KORNHAUS JOHN KORNHAUS2017-09-07
5012015-02-01JOHN KORNHAUS

Plan Statistics for PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN

Measure Date Value
2022: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-02-01270
Total number of active participants reported on line 7a of the Form 55002022-02-01240
Number of retired or separated participants receiving benefits2022-02-010
Number of other retired or separated participants entitled to future benefits2022-02-010
Total of all active and inactive participants2022-02-01240
Total participants2022-02-01240
2021: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-02-01207
Total number of active participants reported on line 7a of the Form 55002021-02-01270
Number of retired or separated participants receiving benefits2021-02-010
Number of other retired or separated participants entitled to future benefits2021-02-010
Total of all active and inactive participants2021-02-01270
Total participants2021-02-01270
2020: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-02-01221
Total number of active participants reported on line 7a of the Form 55002020-02-01207
Number of retired or separated participants receiving benefits2020-02-010
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-01207
Total participants2020-02-01207
2019: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-02-01229
Total number of active participants reported on line 7a of the Form 55002019-02-01221
Number of retired or separated participants receiving benefits2019-02-010
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-01221
Total participants2019-02-01221
2018: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-02-01156
Total number of active participants reported on line 7a of the Form 55002018-02-01229
Number of retired or separated participants receiving benefits2018-02-010
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-01229
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-02-010
Total participants2018-02-01229
2017: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-02-01154
Total number of active participants reported on line 7a of the Form 55002017-02-01156
Number of retired or separated participants receiving benefits2017-02-010
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-02-010
Total participants2017-02-01156
2016: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-02-01170
Total number of active participants reported on line 7a of the Form 55002016-02-01153
Number of retired or separated participants receiving benefits2016-02-011
Number of other retired or separated participants entitled to future benefits2016-02-010
Total of all active and inactive participants2016-02-01154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-02-010
Total participants2016-02-01154
2015: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-02-01152
Total number of active participants reported on line 7a of the Form 55002015-02-01169
Number of retired or separated participants receiving benefits2015-02-011
Number of other retired or separated participants entitled to future benefits2015-02-010
Total of all active and inactive participants2015-02-01170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-02-010
Total participants2015-02-01170

Financial Data on PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN

Measure Date Value
2023 : PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-31$0
Total income from all sources (including contributions)2023-01-31$1,160,193
Total loss/gain on sale of assets2023-01-31$0
Total of all expenses incurred2023-01-31$1,164,857
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-31$1,057,500
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-31$1,160,193
Value of total assets at end of year2023-01-31$3,264
Value of total assets at beginning of year2023-01-31$7,928
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-31$107,357
Total interest from all sources2023-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2023-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-31No
Was this plan covered by a fidelity bond2023-01-31No
If this is an individual account plan, was there a blackout period2023-01-31No
Were there any nonexempt tranactions with any party-in-interest2023-01-31No
Contributions received from participants2023-01-31$527,837
Income. Received or receivable in cash from other sources (including rollovers)2023-01-31$22,376
Total non interest bearing cash at end of year2023-01-31$3,264
Total non interest bearing cash at beginning of year2023-01-31$7,928
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Value of net income/loss2023-01-31$-4,664
Value of net assets at end of year (total assets less liabilities)2023-01-31$3,264
Value of net assets at beginning of year (total assets less liabilities)2023-01-31$7,928
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-31No
Were any leases to which the plan was party in default or uncollectible2023-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2023-01-31$272,973
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-31No
Was there a failure to transmit to the plan any participant contributions2023-01-31No
Has the plan failed to provide any benefit when due under the plan2023-01-31No
Contributions received in cash from employer2023-01-31$609,980
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-31$784,527
Contract administrator fees2023-01-31$107,357
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-01-31No
Did the plan have assets held for investment2023-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-31No
Opinion of an independent qualified public accountant for this plan2023-01-31Unqualified
Accountancy firm name2023-01-31KELLER & OWENS, LLC
Accountancy firm EIN2023-01-31481195228
2022 : PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-31$0
Total income from all sources (including contributions)2022-01-31$1,197,376
Total loss/gain on sale of assets2022-01-31$0
Total of all expenses incurred2022-01-31$1,219,183
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-31$1,152,809
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-31$1,197,376
Value of total assets at end of year2022-01-31$7,928
Value of total assets at beginning of year2022-01-31$29,735
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-31$66,374
Total interest from all sources2022-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-31No
Was this plan covered by a fidelity bond2022-01-31No
If this is an individual account plan, was there a blackout period2022-01-31No
Were there any nonexempt tranactions with any party-in-interest2022-01-31No
Contributions received from participants2022-01-31$527,877
Income. Received or receivable in cash from other sources (including rollovers)2022-01-31$78,269
Total non interest bearing cash at end of year2022-01-31$7,928
Total non interest bearing cash at beginning of year2022-01-31$29,735
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-31No
Value of net income/loss2022-01-31$-21,807
Value of net assets at end of year (total assets less liabilities)2022-01-31$7,928
Value of net assets at beginning of year (total assets less liabilities)2022-01-31$29,735
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-31No
Were any leases to which the plan was party in default or uncollectible2022-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2022-01-31$292,215
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-31No
Was there a failure to transmit to the plan any participant contributions2022-01-31No
Has the plan failed to provide any benefit when due under the plan2022-01-31No
Contributions received in cash from employer2022-01-31$591,230
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-31$860,594
Contract administrator fees2022-01-31$66,374
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-01-31No
Did the plan have assets held for investment2022-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-31No
Opinion of an independent qualified public accountant for this plan2022-01-31Unqualified
Accountancy firm name2022-01-31KELLER & OWENS, LLC
Accountancy firm EIN2022-01-31481195228
2021 : PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-01-31$0
Total income from all sources (including contributions)2021-01-31$1,954,971
Total loss/gain on sale of assets2021-01-31$0
Total of all expenses incurred2021-01-31$1,959,577
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-01-31$1,896,111
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-01-31$1,954,971
Value of total assets at end of year2021-01-31$29,735
Value of total assets at beginning of year2021-01-31$34,341
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-01-31$63,466
Total interest from all sources2021-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-01-31No
Was this plan covered by a fidelity bond2021-01-31No
If this is an individual account plan, was there a blackout period2021-01-31No
Were there any nonexempt tranactions with any party-in-interest2021-01-31No
Contributions received from participants2021-01-31$548,092
Income. Received or receivable in cash from other sources (including rollovers)2021-01-31$385,336
Total non interest bearing cash at end of year2021-01-31$29,735
Total non interest bearing cash at beginning of year2021-01-31$34,341
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-01-31No
Value of net income/loss2021-01-31$-4,606
Value of net assets at end of year (total assets less liabilities)2021-01-31$29,735
Value of net assets at beginning of year (total assets less liabilities)2021-01-31$34,341
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-01-31No
Were any leases to which the plan was party in default or uncollectible2021-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-01-31$309,749
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-01-31No
Was there a failure to transmit to the plan any participant contributions2021-01-31No
Has the plan failed to provide any benefit when due under the plan2021-01-31No
Contributions received in cash from employer2021-01-31$1,021,543
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-01-31$1,586,362
Contract administrator fees2021-01-31$63,466
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-01-31No
Did the plan have assets held for investment2021-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-01-31No
Opinion of an independent qualified public accountant for this plan2021-01-31Unqualified
Accountancy firm name2021-01-31KELLER & OWENS, LLC
Accountancy firm EIN2021-01-31481195228
2020 : PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-01-31$0
Total income from all sources (including contributions)2020-01-31$1,869,120
Total loss/gain on sale of assets2020-01-31$0
Total of all expenses incurred2020-01-31$1,836,658
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-01-31$1,769,952
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-01-31$1,869,120
Value of total assets at end of year2020-01-31$34,341
Value of total assets at beginning of year2020-01-31$1,879
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-01-31$66,706
Total interest from all sources2020-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-01-31No
Was this plan covered by a fidelity bond2020-01-31No
If this is an individual account plan, was there a blackout period2020-01-31No
Were there any nonexempt tranactions with any party-in-interest2020-01-31No
Contributions received from participants2020-01-31$551,627
Income. Received or receivable in cash from other sources (including rollovers)2020-01-31$143,390
Total non interest bearing cash at end of year2020-01-31$34,341
Total non interest bearing cash at beginning of year2020-01-31$1,879
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-01-31No
Value of net income/loss2020-01-31$32,462
Value of net assets at end of year (total assets less liabilities)2020-01-31$34,341
Value of net assets at beginning of year (total assets less liabilities)2020-01-31$1,879
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-01-31No
Were any leases to which the plan was party in default or uncollectible2020-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-01-31$308,248
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-01-31No
Was there a failure to transmit to the plan any participant contributions2020-01-31No
Has the plan failed to provide any benefit when due under the plan2020-01-31No
Contributions received in cash from employer2020-01-31$1,174,103
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-01-31$1,461,704
Contract administrator fees2020-01-31$66,706
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-01-31No
Did the plan have assets held for investment2020-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-01-31No
Opinion of an independent qualified public accountant for this plan2020-01-31Unqualified
Accountancy firm name2020-01-31KELLER & OWENS, LLC
Accountancy firm EIN2020-01-31481195228
2019 : PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-01-31$0
Total income from all sources (including contributions)2019-01-31$1,592,312
Total loss/gain on sale of assets2019-01-31$0
Total of all expenses incurred2019-01-31$1,682,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-01-31$1,599,872
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-01-31$1,429,417
Value of total assets at end of year2019-01-31$1,879
Value of total assets at beginning of year2019-01-31$92,542
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-01-31$83,103
Total interest from all sources2019-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-01-31No
Was this plan covered by a fidelity bond2019-01-31No
If this is an individual account plan, was there a blackout period2019-01-31No
Were there any nonexempt tranactions with any party-in-interest2019-01-31No
Contributions received from participants2019-01-31$550,855
Other income not declared elsewhere2019-01-31$162,895
Total non interest bearing cash at end of year2019-01-31$1,879
Total non interest bearing cash at beginning of year2019-01-31$92,542
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-01-31No
Value of net income/loss2019-01-31$-90,663
Value of net assets at end of year (total assets less liabilities)2019-01-31$1,879
Value of net assets at beginning of year (total assets less liabilities)2019-01-31$92,542
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-01-31No
Were any leases to which the plan was party in default or uncollectible2019-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-01-31$284,590
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-01-31No
Was there a failure to transmit to the plan any participant contributions2019-01-31No
Has the plan failed to provide any benefit when due under the plan2019-01-31No
Contributions received in cash from employer2019-01-31$878,562
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-01-31$1,315,282
Contract administrator fees2019-01-31$83,103
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-01-31No
Did the plan have assets held for investment2019-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-01-31No
Opinion of an independent qualified public accountant for this plan2019-01-31Unqualified
Accountancy firm name2019-01-31KELLER & OWENS, LLC
Accountancy firm EIN2019-01-31481195228
2018 : PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-01-31$0
Total income from all sources (including contributions)2018-01-31$1,778,547
Total loss/gain on sale of assets2018-01-31$0
Total of all expenses incurred2018-01-31$1,732,360
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-01-31$1,615,934
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-01-31$1,333,363
Value of total assets at end of year2018-01-31$92,542
Value of total assets at beginning of year2018-01-31$46,355
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-01-31$116,426
Total interest from all sources2018-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-01-31No
Was this plan covered by a fidelity bond2018-01-31No
If this is an individual account plan, was there a blackout period2018-01-31No
Were there any nonexempt tranactions with any party-in-interest2018-01-31No
Contributions received from participants2018-01-31$601,292
Other income not declared elsewhere2018-01-31$445,184
Administrative expenses (other) incurred2018-01-31$102,712
Total non interest bearing cash at end of year2018-01-31$92,542
Total non interest bearing cash at beginning of year2018-01-31$46,355
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-01-31No
Value of net income/loss2018-01-31$46,187
Value of net assets at end of year (total assets less liabilities)2018-01-31$92,542
Value of net assets at beginning of year (total assets less liabilities)2018-01-31$46,355
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-01-31No
Were any leases to which the plan was party in default or uncollectible2018-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-01-31$252,654
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-01-31No
Was there a failure to transmit to the plan any participant contributions2018-01-31No
Has the plan failed to provide any benefit when due under the plan2018-01-31No
Contributions received in cash from employer2018-01-31$732,071
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-01-31$1,363,280
Contract administrator fees2018-01-31$13,714
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-01-31No
Did the plan have assets held for investment2018-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-01-31No
Opinion of an independent qualified public accountant for this plan2018-01-31Unqualified
Accountancy firm name2018-01-31KELLER & OWENS, LLC
Accountancy firm EIN2018-01-31481195228
2017 : PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-01-31$0
Total income from all sources (including contributions)2017-01-31$2,618,246
Total loss/gain on sale of assets2017-01-31$0
Total of all expenses incurred2017-01-31$2,599,177
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-01-31$2,469,966
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-01-31$1,778,242
Value of total assets at end of year2017-01-31$46,355
Value of total assets at beginning of year2017-01-31$27,286
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-01-31$129,211
Total interest from all sources2017-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-01-31No
Was this plan covered by a fidelity bond2017-01-31No
If this is an individual account plan, was there a blackout period2017-01-31No
Were there any nonexempt tranactions with any party-in-interest2017-01-31No
Contributions received from participants2017-01-31$671,696
Other income not declared elsewhere2017-01-31$840,004
Administrative expenses (other) incurred2017-01-31$37,772
Total non interest bearing cash at end of year2017-01-31$46,355
Total non interest bearing cash at beginning of year2017-01-31$27,286
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-01-31No
Value of net income/loss2017-01-31$19,069
Value of net assets at end of year (total assets less liabilities)2017-01-31$46,355
Value of net assets at beginning of year (total assets less liabilities)2017-01-31$27,286
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-01-31No
Were any leases to which the plan was party in default or uncollectible2017-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-01-31$249,740
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-01-31No
Was there a failure to transmit to the plan any participant contributions2017-01-31No
Has the plan failed to provide any benefit when due under the plan2017-01-31No
Contributions received in cash from employer2017-01-31$1,106,546
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-01-31$2,220,226
Contract administrator fees2017-01-31$91,439
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-01-31No
Did the plan have assets held for investment2017-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-01-31No
Opinion of an independent qualified public accountant for this plan2017-01-31Unqualified
Accountancy firm name2017-01-31KELLER & OWENS, LLC
Accountancy firm EIN2017-01-31481195228
2016 : PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-01-31$0
Total income from all sources (including contributions)2016-01-31$2,922,401
Total loss/gain on sale of assets2016-01-31$0
Total of all expenses incurred2016-01-31$2,907,497
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-01-31$2,800,705
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-01-31$2,036,775
Value of total assets at end of year2016-01-31$27,286
Value of total assets at beginning of year2016-01-31$12,382
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-01-31$106,792
Total interest from all sources2016-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-01-31No
Was this plan covered by a fidelity bond2016-01-31Yes
Value of fidelity bond cover2016-01-31$500,000
If this is an individual account plan, was there a blackout period2016-01-31No
Were there any nonexempt tranactions with any party-in-interest2016-01-31No
Contributions received from participants2016-01-31$493,155
Other income not declared elsewhere2016-01-31$885,626
Administrative expenses (other) incurred2016-01-31$38,407
Total non interest bearing cash at end of year2016-01-31$27,286
Total non interest bearing cash at beginning of year2016-01-31$12,382
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-01-31No
Value of net income/loss2016-01-31$14,904
Value of net assets at end of year (total assets less liabilities)2016-01-31$27,286
Value of net assets at beginning of year (total assets less liabilities)2016-01-31$12,382
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-01-31No
Were any leases to which the plan was party in default or uncollectible2016-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-01-31$227,002
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-01-31No
Was there a failure to transmit to the plan any participant contributions2016-01-31No
Has the plan failed to provide any benefit when due under the plan2016-01-31No
Contributions received in cash from employer2016-01-31$1,543,620
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-01-31$2,573,703
Contract administrator fees2016-01-31$68,385
Did the plan have assets held for investment2016-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-01-31No
Opinion of an independent qualified public accountant for this plan2016-01-31Unqualified
Accountancy firm name2016-01-31KELLER & OWENS, LLC
Accountancy firm EIN2016-01-31481195228

Form 5500 Responses for PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN

2022: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Submission has been amendedNo
2022-02-01This submission is the final filingNo
2022-02-01This return/report is a short plan year return/report (less than 12 months)No
2022-02-01Plan is a collectively bargained planNo
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan funding arrangement – TrustYes
2022-02-01Plan benefit arrangement – InsuranceYes
2022-02-01Plan benefit arrangement - TrustYes
2021: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-02-01Type of plan entitySingle employer plan
2021-02-01Submission has been amendedNo
2021-02-01This submission is the final filingNo
2021-02-01This return/report is a short plan year return/report (less than 12 months)No
2021-02-01Plan is a collectively bargained planNo
2021-02-01Plan funding arrangement – InsuranceYes
2021-02-01Plan funding arrangement – TrustYes
2021-02-01Plan benefit arrangement – InsuranceYes
2021-02-01Plan benefit arrangement - TrustYes
2020: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Submission has been amendedNo
2020-02-01This submission is the final filingNo
2020-02-01This return/report is a short plan year return/report (less than 12 months)No
2020-02-01Plan is a collectively bargained planNo
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan funding arrangement – TrustYes
2020-02-01Plan benefit arrangement – InsuranceYes
2020-02-01Plan benefit arrangement - TrustYes
2019: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Submission has been amendedNo
2019-02-01This submission is the final filingNo
2019-02-01This return/report is a short plan year return/report (less than 12 months)No
2019-02-01Plan is a collectively bargained planNo
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan funding arrangement – TrustYes
2019-02-01Plan benefit arrangement – InsuranceYes
2019-02-01Plan benefit arrangement - TrustYes
2018: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Submission has been amendedNo
2018-02-01This submission is the final filingNo
2018-02-01This return/report is a short plan year return/report (less than 12 months)No
2018-02-01Plan is a collectively bargained planNo
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan funding arrangement – TrustYes
2018-02-01Plan benefit arrangement – InsuranceYes
2018-02-01Plan benefit arrangement - TrustYes
2017: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan funding arrangement – TrustYes
2017-02-01Plan benefit arrangement – InsuranceYes
2017-02-01Plan benefit arrangement - TrustYes
2016: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)No
2016-02-01Plan is a collectively bargained planNo
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan funding arrangement – TrustYes
2016-02-01Plan benefit arrangement – InsuranceYes
2016-02-01Plan benefit arrangement - TrustYes
2015: PETERSON PROPERTIES, INC. EMPLOYEE BENEFITS PLAN 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)No
2015-02-01Plan is a collectively bargained planNo
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan funding arrangement – TrustYes
2015-02-01Plan benefit arrangement – InsuranceYes
2015-02-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract number417003412809
Policy instance 2
Insurance contract or identification number417003412809
Number of Individuals Covered113
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
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
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 $272,890
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 number5968669
Policy instance 1
Insurance contract or identification number5968669
Number of Individuals Covered240
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $21,746
Total amount of fees paid to insurance companyUSD $6,426
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $153,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,746
Amount paid for insurance broker fees6426
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract number417003412809
Policy instance 2
Insurance contract or identification number417003412809
Number of Individuals Covered112
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
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
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 $291,398
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 number5968669
Policy instance 1
Insurance contract or identification number5968669
Number of Individuals Covered270
Insurance policy start date2021-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $18,569
Total amount of fees paid to insurance companyUSD $8,274
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 BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $149,555
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,569
Amount paid for insurance broker fees8274
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number247853
Policy instance 2
Insurance contract or identification number247853
Number of Individuals Covered131
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $9,756
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
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 $309,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees7679
Additional information about fees paid to insurance brokerOVERRIDES
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5968669
Policy instance 1
Insurance contract or identification number5968669
Number of Individuals Covered207
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $17,803
Total amount of fees paid to insurance companyUSD $3,325
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 BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $145,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,803
Amount paid for insurance broker fees3325
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number1889-000-1, 2
Policy instance 3
Insurance contract or identification number1889-000-1, 2
Number of Individuals Covered121
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $64,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number247853
Policy instance 2
Insurance contract or identification number247853
Number of Individuals Covered143
Insurance policy start date2019-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $8,911
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
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 $308,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,995
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number905815
Policy instance 1
Insurance contract or identification number905815
Number of Individuals Covered221
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $17,498
Total amount of fees paid to insurance companyUSD $4,972
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $106,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,498
Amount paid for insurance broker fees5972
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136921,110744
Policy instance 3
Insurance contract or identification number136921,110744
Number of Individuals Covered237
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $13,636
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $83,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,636
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBUKATY COMPANIES
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number01889-000-00001
Policy instance 2
Insurance contract or identification number01889-000-00001
Number of Individuals Covered132
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $72,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number247853
Policy instance 1
Insurance contract or identification number247853
Number of Individuals Covered156
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
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
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 $252,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136921 / 110744
Policy instance 4
Insurance contract or identification number136921 / 110744
Number of Individuals Covered238
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $11,902
Total amount of fees paid to insurance companyUSD $1,952
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $71,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,632
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerAGENT
Insurance broker organization code?3
Insurance broker nameHALLIER REED LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0839484
Policy instance 3
Insurance contract or identification number0839484
Number of Individuals Covered170
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $21,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number0655828
Policy instance 2
Insurance contract or identification number0655828
Number of Individuals Covered170
Insurance policy start date2015-02-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $29,284
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $195,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,284
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerTPA
Insurance broker organization code?5
Insurance broker nameFMH CORESOURCE
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number01889-00001
Policy instance 1
Insurance contract or identification number01889-00001
Number of Individuals Covered138
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $69,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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