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401k Plan overview

Plan NameCHRISTIAN BROADCASTING NETWORK, INC. SECTION 125 PLAN
Plan identification number 502

CHRISTIAN BROADCASTING NETWORK, INC. SECTION 125 PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    THE CHRISTIAN BROADCASTING NETWORK, INC. has sponsored the creation of one or more 401k plans.

    Company Name:THE CHRISTIAN BROADCASTING NETWORK, INC.
    Employer identification number (EIN):540678752
    NAIC Classification:813000
    NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

    Additional information about THE CHRISTIAN BROADCASTING NETWORK, INC.

    Jurisdiction of Incorporation: Virginia Secretary of State
    Incorporation Date: 1960-01-11
    Company Identification Number: 0085781
    Legal Registered Office Address: 977 CENTERVILLE TURNPIKE

    VIRGINIA BEACH
    United States of America (USA)
    23463

    More information about THE CHRISTIAN BROADCASTING NETWORK, INC.

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan CHRISTIAN BROADCASTING NETWORK, INC. SECTION 125 PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5022020-04-01BARBARA RITTER2021-08-25
    5022019-04-01BARBARA RITTER2020-08-20
    5022018-04-01BARBARA RITTER2019-11-19
    5022017-04-01
    5022016-04-01BARBARA RITTER
    5022015-04-01BARBARA RITTER BARBARA RITTER2017-01-16
    5022014-04-01BARBARA RITTER BARBARA RITTER2016-01-14
    5022013-04-01BARBARA RITTER BARBARA RITTER2015-01-15
    5022012-04-01BARBARA RITTER BARBARA RITTER2014-01-15
    5022011-04-01BARBARA RITTER BARBARA RITTER2013-03-06
    5022010-04-01BARBARA RITTER BARBARA RITTER2013-03-06
    5022009-04-01BARBARA RITTER BARBARA RITTER2013-03-06

    Plan Statistics for CHRISTIAN BROADCASTING NETWORK, INC. SECTION 125 PLAN

    401k plan membership statisitcs for CHRISTIAN BROADCASTING NETWORK, INC. SECTION 125 PLAN

    Measure Date Value
    2020
    Total participants, beginning-of-year2020-04-011,029
    Total number of active participants reported on line 7a of the Form 55002020-04-01996
    Number of retired or separated participants receiving benefits2020-04-010
    Number of other retired or separated participants entitled to future benefits2020-04-010
    Total of all active and inactive participants2020-04-01996
    Number of employers contributing to the scheme2020-04-010
    2019
    Total participants, beginning-of-year2019-04-011,089
    Total number of active participants reported on line 7a of the Form 55002019-04-011,029
    Number of retired or separated participants receiving benefits2019-04-010
    Number of other retired or separated participants entitled to future benefits2019-04-010
    Total of all active and inactive participants2019-04-011,029
    Number of employers contributing to the scheme2019-04-010
    2018
    Total participants, beginning-of-year2018-04-011,131
    Total number of active participants reported on line 7a of the Form 55002018-04-011,089
    Number of retired or separated participants receiving benefits2018-04-010
    Number of other retired or separated participants entitled to future benefits2018-04-010
    Total of all active and inactive participants2018-04-011,089
    Number of employers contributing to the scheme2018-04-010
    2017
    Total participants, beginning-of-year2017-04-011,080
    Total number of active participants reported on line 7a of the Form 55002017-04-011,131
    Number of retired or separated participants receiving benefits2017-04-010
    Number of other retired or separated participants entitled to future benefits2017-04-010
    Total of all active and inactive participants2017-04-011,131
    2016
    Total participants, beginning-of-year2016-04-01921
    Total number of active participants reported on line 7a of the Form 55002016-04-01907
    Number of retired or separated participants receiving benefits2016-04-010
    Number of other retired or separated participants entitled to future benefits2016-04-010
    Total of all active and inactive participants2016-04-01907
    2015
    Total participants, beginning-of-year2015-04-01955
    Total number of active participants reported on line 7a of the Form 55002015-04-01907
    Number of retired or separated participants receiving benefits2015-04-0114
    Total of all active and inactive participants2015-04-01921
    Total participants2015-04-01921
    2014
    Total participants, beginning-of-year2014-04-01955
    Total number of active participants reported on line 7a of the Form 55002014-04-01924
    Number of retired or separated participants receiving benefits2014-04-016
    Total of all active and inactive participants2014-04-01930
    Total participants2014-04-01930
    2013
    Total participants, beginning-of-year2013-04-01907
    Total number of active participants reported on line 7a of the Form 55002013-04-01943
    Number of retired or separated participants receiving benefits2013-04-0112
    Total of all active and inactive participants2013-04-01955
    Total participants2013-04-01955
    2012
    Total participants, beginning-of-year2012-04-01937
    Total number of active participants reported on line 7a of the Form 55002012-04-01893
    Number of retired or separated participants receiving benefits2012-04-0114
    Total of all active and inactive participants2012-04-01907
    Total participants2012-04-01907
    2011
    Total participants, beginning-of-year2011-04-01965
    Total number of active participants reported on line 7a of the Form 55002011-04-01923
    Number of retired or separated participants receiving benefits2011-04-0114
    Total of all active and inactive participants2011-04-01937
    Total participants2011-04-01937
    2010
    Total participants, beginning-of-year2010-04-01994
    Total number of active participants reported on line 7a of the Form 55002010-04-01940
    Number of retired or separated participants receiving benefits2010-04-0125
    Total of all active and inactive participants2010-04-01965
    Total participants2010-04-01965
    2009
    Total participants, beginning-of-year2009-04-011,011
    Total number of active participants reported on line 7a of the Form 55002009-04-01961
    Number of retired or separated participants receiving benefits2009-04-0133
    Total of all active and inactive participants2009-04-01994
    Total participants2009-04-01994

    Form 5500 Responses

    2020
    2020-04-01Type of plan entitySingle employer plan
    2020-04-01Plan funding arrangement – InsuranceYes
    2020-04-01Plan funding arrangement – General assets of the sponsorYes
    2020-04-01Plan benefit arrangement – InsuranceYes
    2020-04-01Plan benefit arrangement – General assets of the sponsorYes
    2019
    2019-04-01Type of plan entitySingle employer plan
    2019-04-01Plan funding arrangement – InsuranceYes
    2019-04-01Plan funding arrangement – General assets of the sponsorYes
    2019-04-01Plan benefit arrangement – InsuranceYes
    2019-04-01Plan benefit arrangement – General assets of the sponsorYes
    2018
    2018-04-01Type of plan entitySingle employer plan
    2018-04-01Plan funding arrangement – InsuranceYes
    2018-04-01Plan funding arrangement – General assets of the sponsorYes
    2018-04-01Plan benefit arrangement – InsuranceYes
    2018-04-01Plan benefit arrangement – General assets of the sponsorYes
    2017
    2017-04-01Type of plan entitySingle employer plan
    2017-04-01Plan funding arrangement – InsuranceYes
    2017-04-01Plan funding arrangement – General assets of the sponsorYes
    2017-04-01Plan benefit arrangement – InsuranceYes
    2017-04-01Plan benefit arrangement – General assets of the sponsorYes
    2016
    2016-04-01Type of plan entitySingle employer plan
    2016-04-01Submission has been amendedNo
    2016-04-01This submission is the final filingNo
    2016-04-01This return/report is a short plan year return/report (less than 12 months)No
    2016-04-01Plan is a collectively bargained planNo
    2016-04-01Plan funding arrangement – General assets of the sponsorYes
    2016-04-01Plan benefit arrangement – General assets of the sponsorYes
    2015
    2015-04-01Type of plan entitySingle employer plan
    2015-04-01Submission has been amendedNo
    2015-04-01This submission is the final filingNo
    2015-04-01This return/report is a short plan year return/report (less than 12 months)No
    2015-04-01Plan is a collectively bargained planNo
    2015-04-01Plan funding arrangement – InsuranceYes
    2015-04-01Plan funding arrangement – General assets of the sponsorYes
    2015-04-01Plan benefit arrangement – InsuranceYes
    2014
    2014-04-01Type of plan entitySingle employer plan
    2014-04-01Submission has been amendedNo
    2014-04-01This submission is the final filingNo
    2014-04-01This return/report is a short plan year return/report (less than 12 months)No
    2014-04-01Plan is a collectively bargained planNo
    2014-04-01Plan funding arrangement – InsuranceYes
    2014-04-01Plan funding arrangement – General assets of the sponsorYes
    2014-04-01Plan benefit arrangement – InsuranceYes
    2013
    2013-04-01Type of plan entitySingle employer plan
    2013-04-01Submission has been amendedNo
    2013-04-01This submission is the final filingNo
    2013-04-01This return/report is a short plan year return/report (less than 12 months)No
    2013-04-01Plan is a collectively bargained planNo
    2013-04-01Plan funding arrangement – InsuranceYes
    2013-04-01Plan funding arrangement – General assets of the sponsorYes
    2013-04-01Plan benefit arrangement – InsuranceYes
    2012
    2012-04-01Type of plan entitySingle employer plan
    2012-04-01Submission has been amendedNo
    2012-04-01This submission is the final filingNo
    2012-04-01This return/report is a short plan year return/report (less than 12 months)No
    2012-04-01Plan is a collectively bargained planNo
    2012-04-01Plan funding arrangement – InsuranceYes
    2012-04-01Plan funding arrangement – General assets of the sponsorYes
    2012-04-01Plan benefit arrangement – InsuranceYes
    2011
    2011-04-01Type of plan entitySingle employer plan
    2011-04-01Submission has been amendedNo
    2011-04-01This submission is the final filingNo
    2011-04-01This return/report is a short plan year return/report (less than 12 months)No
    2011-04-01Plan is a collectively bargained planNo
    2011-04-01Plan funding arrangement – InsuranceYes
    2011-04-01Plan funding arrangement – General assets of the sponsorYes
    2011-04-01Plan benefit arrangement – InsuranceYes
    2010
    2010-04-01Type of plan entitySingle employer plan
    2010-04-01Submission has been amendedNo
    2010-04-01This submission is the final filingNo
    2010-04-01This return/report is a short plan year return/report (less than 12 months)No
    2010-04-01Plan is a collectively bargained planNo
    2010-04-01Plan funding arrangement – InsuranceYes
    2010-04-01Plan funding arrangement – General assets of the sponsorYes
    2010-04-01Plan benefit arrangement – InsuranceYes
    2009
    2009-04-01Type of plan entitySingle employer plan
    2009-04-01Submission has been amendedNo
    2009-04-01This submission is the final filingNo
    2009-04-01This return/report is a short plan year return/report (less than 12 months)No
    2009-04-01Plan is a collectively bargained planNo
    2009-04-01Plan funding arrangement – General assets of the sponsorYes
    2009-04-01Plan benefit arrangement – InsuranceYes

    Insurance Providers Used on plan

    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX963099
    Policy instance 1
    Insurance contract or identification numberFLX963099
    Number of Individuals Covered1029
    Insurance policy start date2020-04-01
    Insurance policy end date2021-03-31
    Total amount of commissions paid to insurance brokerUSD $24,677
    Total amount of fees paid to insurance companyUSD $5,349
    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
    Welfare Benefit Premiums Paid to CarrierUSD $507,469
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $24,677
    Amount paid for insurance broker fees5349
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker organization code?3
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX963099
    Policy instance 1
    Insurance contract or identification numberFLX963099
    Number of Individuals Covered1089
    Insurance policy start date2019-04-01
    Insurance policy end date2020-03-31
    Total amount of commissions paid to insurance brokerUSD $27,024
    Total amount of fees paid to insurance companyUSD $14,374
    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
    Welfare Benefit Premiums Paid to CarrierUSD $567,674
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $27,024
    Amount paid for insurance broker fees14374
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker organization code?3
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX963099
    Policy instance 1
    Insurance contract or identification numberFLX963099
    Number of Individuals Covered1131
    Insurance policy start date2018-04-01
    Insurance policy end date2019-03-31
    Total amount of commissions paid to insurance brokerUSD $33,272
    Total amount of fees paid to insurance companyUSD $8,737
    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
    Welfare Benefit Premiums Paid to CarrierUSD $735,974
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $33,272
    Amount paid for insurance broker fees8737
    Additional information about fees paid to insurance brokerOVERRIDE
    Insurance broker organization code?3
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX963099
    Policy instance 1
    Insurance contract or identification numberFLX963099
    Number of Individuals Covered1080
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $36,434
    Total amount of fees paid to insurance companyUSD $0
    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
    Welfare Benefit Premiums Paid to CarrierUSD $834,327
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $36,434
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameUSI INSURANCE SERVICES, LLC
    ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
    Policy contract numberV05306
    Policy instance 1
    Insurance contract or identification numberV05306
    Number of Individuals Covered1024
    Insurance policy start date2015-04-01
    Insurance policy end date2016-03-31
    Total amount of commissions paid to insurance brokerUSD $55,414
    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 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 $497,423
    Commission paid to Insurance BrokerUSD $41,248
    Insurance broker nameUSI INSURANCE SERVICES, LLC
    HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
    Policy contract number05306
    Policy instance 2
    Insurance contract or identification number05306
    Number of Individuals Covered1062
    Insurance policy start date2015-04-01
    Insurance policy end date2016-03-31
    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 $514,432
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
    Policy contract number05306
    Policy instance 1
    Insurance contract or identification number05306
    Number of Individuals Covered1052
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-01
    Total amount of commissions paid to insurance brokerUSD $11,911
    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 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 $452,219
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $11,911
    Insurance broker organization code?7
    Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
    HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
    Policy contract number05306
    Policy instance 2
    Insurance contract or identification number05306
    Number of Individuals Covered1114
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Total amount of commissions paid to insurance brokerUSD $11,441
    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 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 $420,736
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $11,441
    Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
    ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
    Policy contract number05306
    Policy instance 1
    Insurance contract or identification number05306
    Number of Individuals Covered980
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $35,000
    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 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 $482,087
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $-17,499
    Insurance broker nameWELLS FARGO INSURANCE SERVICES
    HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
    Policy contract number05306
    Policy instance 2
    Insurance contract or identification number05306
    Number of Individuals Covered1062
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    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 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 $498,729
    Commission paid to Insurance BrokerUSD $-17,499
    Insurance broker nameWELLS FARGO INSURANCE SERVICES
    ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
    Policy contract number05306
    Policy instance 2
    Insurance contract or identification number05306
    Number of Individuals Covered928
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    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 $408,563
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
    Policy contract number05306
    Policy instance 1
    Insurance contract or identification number05306
    Number of Individuals Covered1055
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $70,000
    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 $463,030
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $70,000
    Insurance broker organization code?3
    Insurance broker nameWELLS FARGO INSURANCE SERVICES
    HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
    Policy contract number05306
    Policy instance 1
    Insurance contract or identification number05306
    Number of Individuals Covered1108
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $477,382
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
    Policy contract number05306
    Policy instance 2
    Insurance contract or identification number05306
    Number of Individuals Covered948
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $289,933
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
    Policy contract numberG1608
    Policy instance 2
    Insurance contract or identification numberG1608
    Number of Individuals Covered1184
    Insurance policy start date2010-04-01
    Insurance policy end date2011-03-31
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $396,590
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
    Policy contract number05306
    Policy instance 1
    Insurance contract or identification number05306
    Number of Individuals Covered986
    Insurance policy start date2010-04-01
    Insurance policy end date2011-03-31
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $329,992
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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