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Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 401k Plan overview

Plan NameZ & M SHEET METAL, INC. GROUP MEDICAL PLAN
Plan identification number 503

Z & M SHEET METAL, INC. GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

Z & M SHEET METAL, INC. has sponsored the creation of one or more 401k plans.

Company Name:Z & M SHEET METAL, INC.
Employer identification number (EIN):540808788
NAIC Classification:332900

Additional information about Z & M SHEET METAL, INC.

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1986-12-02
Company Identification Number: F052804
Legal Registered Office Address: 3931 AVION PARK CT C102

CHANTILLY
United States of America (USA)
20151-2950

More information about Z & M SHEET METAL, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan Z & M SHEET METAL, INC. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-09-01
5032021-09-01
5032020-09-01
5032019-09-01
5032018-09-01

Plan Statistics for Z & M SHEET METAL, INC. GROUP MEDICAL PLAN

401k plan membership statisitcs for Z & M SHEET METAL, INC. GROUP MEDICAL PLAN

Measure Date Value
2022: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-09-01100
Total number of active participants reported on line 7a of the Form 55002022-09-0198
Number of retired or separated participants receiving benefits2022-09-010
Number of other retired or separated participants entitled to future benefits2022-09-010
Total of all active and inactive participants2022-09-0198
2021: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-0194
Total number of active participants reported on line 7a of the Form 55002021-09-0198
Number of retired or separated participants receiving benefits2021-09-012
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01100
2020: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-0192
Total number of active participants reported on line 7a of the Form 55002020-09-0192
Number of retired or separated participants receiving benefits2020-09-012
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-0194
2019: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-0195
Total number of active participants reported on line 7a of the Form 55002019-09-0191
Number of retired or separated participants receiving benefits2019-09-011
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-0192
2018: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01100
Total number of active participants reported on line 7a of the Form 55002018-09-0194
Number of retired or separated participants receiving benefits2018-09-011
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-0195

Financial Data on Z & M SHEET METAL, INC. GROUP MEDICAL PLAN

Measure Date Value
2023 : Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2023 401k financial data
Total plan liabilities at end of year2023-08-31$853,999
Total plan liabilities at beginning of year2023-08-31$191,612
Total income from all sources2023-08-31$1,481,883
Expenses. Total of all expenses incurred2023-08-31$2,113,902
Benefits paid (including direct rollovers)2023-08-31$1,574,965
Total plan assets at end of year2023-08-31$174,716
Total plan assets at beginning of year2023-08-31$144,348
Value of fidelity bond covering the plan2023-08-31$500,000
Total contributions received or receivable from participants2023-08-31$393,806
Expenses. Other expenses not covered elsewhere2023-08-31$412,417
Contributions received from other sources (not participants or employers)2023-08-31$10,195
Other income received2023-08-31$1,051
Net income (gross income less expenses)2023-08-31$-632,019
Net plan assets at end of year (total assets less liabilities)2023-08-31$-679,283
Net plan assets at beginning of year (total assets less liabilities)2023-08-31$-47,264
Total contributions received or receivable from employer(s)2023-08-31$1,076,831
Value of corrective distributions2023-08-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2023-08-31$126,520
2022 : Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2022 401k financial data
Total plan liabilities at end of year2022-08-31$191,612
Total plan liabilities at beginning of year2022-08-31$103,647
Total income from all sources2022-08-31$1,244,487
Expenses. Total of all expenses incurred2022-08-31$1,203,690
Benefits paid (including direct rollovers)2022-08-31$786,973
Total plan assets at end of year2022-08-31$144,348
Total plan assets at beginning of year2022-08-31$15,586
Value of fidelity bond covering the plan2022-08-31$500,000
Total contributions received or receivable from participants2022-08-31$352,395
Expenses. Other expenses not covered elsewhere2022-08-31$343,670
Contributions received from other sources (not participants or employers)2022-08-31$12,828
Other income received2022-08-31$258
Net income (gross income less expenses)2022-08-31$40,797
Net plan assets at end of year (total assets less liabilities)2022-08-31$-47,264
Net plan assets at beginning of year (total assets less liabilities)2022-08-31$-88,061
Total contributions received or receivable from employer(s)2022-08-31$879,006
Value of corrective distributions2022-08-31$45,654
Expenses. Administrative service providers (salaries,fees and commissions)2022-08-31$27,393
2021 : Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2021 401k financial data
Total plan liabilities at end of year2021-08-31$103,647
Total plan liabilities at beginning of year2021-08-31$70,891
Total income from all sources2021-08-31$1,100,693
Expenses. Total of all expenses incurred2021-08-31$1,324,558
Benefits paid (including direct rollovers)2021-08-31$850,310
Total plan assets at end of year2021-08-31$15,586
Total plan assets at beginning of year2021-08-31$206,695
Value of fidelity bond covering the plan2021-08-31$500,000
Total contributions received or receivable from participants2021-08-31$289,470
Expenses. Other expenses not covered elsewhere2021-08-31$294,339
Contributions received from other sources (not participants or employers)2021-08-31$10,633
Other income received2021-08-31$297
Net income (gross income less expenses)2021-08-31$-223,865
Net plan assets at end of year (total assets less liabilities)2021-08-31$-88,061
Net plan assets at beginning of year (total assets less liabilities)2021-08-31$135,804
Total contributions received or receivable from employer(s)2021-08-31$800,293
Value of corrective distributions2021-08-31$150,903
Expenses. Administrative service providers (salaries,fees and commissions)2021-08-31$29,006
2020 : Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-08-31$70,891
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-08-31$915
Total income from all sources (including contributions)2020-08-31$949,095
Total loss/gain on sale of assets2020-08-31$0
Total of all expenses incurred2020-08-31$1,108,606
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-08-31$777,596
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-08-31$948,338
Value of total assets at end of year2020-08-31$206,695
Value of total assets at beginning of year2020-08-31$296,230
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-08-31$331,010
Total interest from all sources2020-08-31$757
Total dividends received (eg from common stock, registered investment company shares)2020-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-08-31No
Was this plan covered by a fidelity bond2020-08-31Yes
Value of fidelity bond cover2020-08-31$500,000
If this is an individual account plan, was there a blackout period2020-08-31No
Were there any nonexempt tranactions with any party-in-interest2020-08-31No
Contributions received from participants2020-08-31$249,101
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-08-31$6,813
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-08-31$8,751
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-08-31$69,204
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-08-31$0
Administrative expenses (other) incurred2020-08-31$229,726
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-08-31No
Value of net income/loss2020-08-31$-159,511
Value of net assets at end of year (total assets less liabilities)2020-08-31$135,804
Value of net assets at beginning of year (total assets less liabilities)2020-08-31$295,315
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-08-31No
Were any leases to which the plan was party in default or uncollectible2020-08-31No
Investment advisory and management fees2020-08-31$23,244
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-08-31$199,882
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-08-31$287,479
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-08-31$287,479
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-08-31$757
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-08-31No
Was there a failure to transmit to the plan any participant contributions2020-08-31No
Has the plan failed to provide any benefit when due under the plan2020-08-31No
Assets. Invements in employer securities at end of year2020-08-31$0
Assets. Invements in employer securities at beginning of year2020-08-31$0
Contributions received in cash from employer2020-08-31$699,237
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-08-31$777,596
Contract administrator fees2020-08-31$78,040
Liabilities. Value of benefit claims payable at end of year2020-08-31$1,687
Liabilities. Value of benefit claims payable at beginning of year2020-08-31$915
Did the plan have assets held for investment2020-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-08-31No
Opinion of an independent qualified public accountant for this plan2020-08-31Unqualified
Accountancy firm name2020-08-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2020-08-31251589048
2019 : Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-08-31$915
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-08-31$0
Total income from all sources (including contributions)2019-08-31$1,098,154
Total loss/gain on sale of assets2019-08-31$0
Total of all expenses incurred2019-08-31$802,839
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-08-31$431,854
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-08-31$1,097,748
Value of total assets at end of year2019-08-31$296,230
Value of total assets at beginning of year2019-08-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-08-31$370,985
Total interest from all sources2019-08-31$406
Total dividends received (eg from common stock, registered investment company shares)2019-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-08-31No
Was this plan covered by a fidelity bond2019-08-31Yes
Value of fidelity bond cover2019-08-31$500,000
If this is an individual account plan, was there a blackout period2019-08-31No
Were there any nonexempt tranactions with any party-in-interest2019-08-31No
Contributions received from participants2019-08-31$255,302
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-08-31$8,751
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-08-31$0
Administrative expenses (other) incurred2019-08-31$211,153
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-08-31No
Value of net income/loss2019-08-31$295,315
Value of net assets at end of year (total assets less liabilities)2019-08-31$295,315
Value of net assets at beginning of year (total assets less liabilities)2019-08-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-08-31No
Were any leases to which the plan was party in default or uncollectible2019-08-31No
Investment advisory and management fees2019-08-31$28,517
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-08-31$287,479
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-08-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-08-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-08-31$406
Expenses. Payments to insurance carriers foe the provision of benefits2019-08-31$431,854
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-08-31No
Was there a failure to transmit to the plan any participant contributions2019-08-31No
Has the plan failed to provide any benefit when due under the plan2019-08-31No
Assets. Invements in employer securities at end of year2019-08-31$0
Assets. Invements in employer securities at beginning of year2019-08-31$0
Contributions received in cash from employer2019-08-31$842,446
Contract administrator fees2019-08-31$131,315
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-08-31No
Liabilities. Value of benefit claims payable at end of year2019-08-31$915
Liabilities. Value of benefit claims payable at beginning of year2019-08-31$0
Did the plan have assets held for investment2019-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-08-31No
Opinion of an independent qualified public accountant for this plan2019-08-31Unqualified
Accountancy firm name2019-08-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2019-08-31251589048

Form 5500 Responses for Z & M SHEET METAL, INC. GROUP MEDICAL PLAN

2022: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Submission has been amendedNo
2022-09-01This submission is the final filingNo
2022-09-01This return/report is a short plan year return/report (less than 12 months)No
2022-09-01Plan is a collectively bargained planNo
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan funding arrangement – TrustYes
2022-09-01Plan funding arrangement – General assets of the sponsorYes
2022-09-01Plan benefit arrangement – InsuranceYes
2022-09-01Plan benefit arrangement - TrustYes
2022-09-01Plan benefit arrangement – General assets of the sponsorYes
2021: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan funding arrangement – TrustYes
2021-09-01Plan benefit arrangement – InsuranceYes
2021-09-01Plan benefit arrangement - TrustYes
2020: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan funding arrangement – TrustYes
2020-09-01Plan benefit arrangement – InsuranceYes
2020-09-01Plan benefit arrangement - TrustYes
2019: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan funding arrangement – TrustYes
2019-09-01Plan benefit arrangement – InsuranceYes
2019-09-01Plan benefit arrangement - TrustYes
2018: Z & M SHEET METAL, INC. GROUP MEDICAL PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01First time form 5500 has been submittedYes
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan funding arrangement – TrustYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number3100038
Policy instance 1
Insurance contract or identification number3100038
Number of Individuals Covered98
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $272,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number000000
Policy instance 2
Insurance contract or identification number000000
Number of Individuals Covered98
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $67,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number3100038
Policy instance 1
Insurance contract or identification number3100038
Number of Individuals Covered100
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $282,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number3100038
Policy instance 1
Insurance contract or identification number3100038
Number of Individuals Covered92
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $232,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS_JULY
Policy instance 1
Insurance contract or identification numberVERIS_JULY
Number of Individuals Covered91
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $229,726
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS_JULY
Policy instance 1
Insurance contract or identification numberVERIS_JULY
Number of Individuals Covered94
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $138,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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