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TENCATE USA SERVICES MEDICAL PLAN 401k Plan overview

Plan NameTENCATE USA SERVICES MEDICAL PLAN
Plan identification number 501

TENCATE USA SERVICES MEDICAL PLAN Benefits

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

401k Sponsoring company profile

NICOLON CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:NICOLON CORPORATION
Employer identification number (EIN):570603223
NAIC Classification:314000
NAIC Description: Textile Product Mills

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TENCATE USA SERVICES MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01JONATHAN MCELHANNON2023-10-16
5012021-01-01RANDALL ADAMS2022-10-17
5012020-01-01RANDALL ADAMS2021-10-21
5012019-01-01RANDALL ADAMS
5012018-01-01RANDALL ADAMS2019-10-28
5012018-01-01RANDALL ADAMS2019-10-15

Plan Statistics for TENCATE USA SERVICES MEDICAL PLAN

401k plan membership statisitcs for TENCATE USA SERVICES MEDICAL PLAN

Measure Date Value
2022: TENCATE USA SERVICES MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01770
Total number of active participants reported on line 7a of the Form 55002022-01-01770
Total of all active and inactive participants2022-01-01770
2021: TENCATE USA SERVICES MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01392
Total number of active participants reported on line 7a of the Form 55002021-01-01770
Total of all active and inactive participants2021-01-01770
2020: TENCATE USA SERVICES MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01390
Total number of active participants reported on line 7a of the Form 55002020-01-01392
Total of all active and inactive participants2020-01-01392
2019: TENCATE USA SERVICES MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01385
Total number of active participants reported on line 7a of the Form 55002019-01-01390
Total of all active and inactive participants2019-01-01390
2018: TENCATE USA SERVICES MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01378
Total number of active participants reported on line 7a of the Form 55002018-01-01385
Total of all active and inactive participants2018-01-01385

Financial Data on TENCATE USA SERVICES MEDICAL PLAN

Measure Date Value
2022 : TENCATE USA SERVICES MEDICAL PLAN 2022 401k financial data
Total income from all sources (including contributions)2022-12-31$7,303,371
Total of all expenses incurred2022-12-31$7,110,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$6,888,002
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$7,300,597
Value of total assets at end of year2022-12-31$538,583
Value of total assets at beginning of year2022-12-31$345,228
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$222,014
Total interest from all sources2022-12-31$2,774
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$2,042,873
Total non interest bearing cash at end of year2022-12-31$403
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$193,355
Value of net assets at end of year (total assets less liabilities)2022-12-31$538,583
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$345,228
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$538,180
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$345,228
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$345,228
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$2,774
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$823,327
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$5,257,724
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$6,064,675
Contract administrator fees2022-12-31$222,014
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MERSEREAU, LAZENBY & ROCKAS, LLC
Accountancy firm EIN2022-12-31582115374
2021 : TENCATE USA SERVICES MEDICAL PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-12-31$10,603,322
Total of all expenses incurred2021-12-31$10,583,928
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$10,155,221
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$10,603,291
Value of total assets at end of year2021-12-31$345,228
Value of total assets at beginning of year2021-12-31$325,834
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$428,707
Total interest from all sources2021-12-31$31
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,859,551
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$19,394
Value of net assets at end of year (total assets less liabilities)2021-12-31$345,228
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$325,834
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$345,228
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$325,832
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$325,832
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$31
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,067,475
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$7,743,740
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$9,087,746
Contract administrator fees2021-12-31$428,707
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31MERSEREAU, LAZENBY & ROCKAS LLC
Accountancy firm EIN2021-12-31582115374
2020 : TENCATE USA SERVICES MEDICAL PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$49,541
Total income from all sources (including contributions)2020-12-31$9,457,307
Total of all expenses incurred2020-12-31$9,213,086
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$8,920,379
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$9,456,946
Value of total assets at end of year2020-12-31$325,834
Value of total assets at beginning of year2020-12-31$131,154
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$292,707
Total interest from all sources2020-12-31$361
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,918,262
Total non interest bearing cash at end of year2020-12-31$2
Total non interest bearing cash at beginning of year2020-12-31$97
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$244,221
Value of net assets at end of year (total assets less liabilities)2020-12-31$325,834
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$81,613
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$325,832
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$131,057
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$131,057
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$361
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,496,906
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$7,538,684
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$7,423,473
Contract administrator fees2020-12-31$292,707
Liabilities. Value of benefit claims payable at end of year2020-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$49,541
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31MERSEREAU, LAZENBY & ROCKAS LLC
Accountancy firm EIN2020-12-31582115374
2019 : TENCATE USA SERVICES MEDICAL PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$49,541
Total income from all sources (including contributions)2019-12-31$10,185,348
Total of all expenses incurred2019-12-31$10,538,657
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$10,227,419
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$10,181,197
Value of total assets at end of year2019-12-31$131,154
Value of total assets at beginning of year2019-12-31$434,922
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$311,238
Total interest from all sources2019-12-31$4,151
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$2,665,117
Total non interest bearing cash at end of year2019-12-31$97
Total non interest bearing cash at beginning of year2019-12-31$102,736
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-353,309
Value of net assets at end of year (total assets less liabilities)2019-12-31$81,613
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$434,922
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$131,057
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$332,186
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$332,186
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$4,151
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$791,227
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$7,516,080
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$9,436,192
Contract administrator fees2019-12-31$311,238
Liabilities. Value of benefit claims payable at end of year2019-12-31$49,541
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MERSEREAU, LAZENBY & ROCKAS LLC
Accountancy firm EIN2019-12-31582115374
2018 : TENCATE USA SERVICES MEDICAL PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$9,410,863
Total of all expenses incurred2018-12-31$9,309,650
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$8,995,690
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$9,408,184
Value of total assets at end of year2018-12-31$434,922
Value of total assets at beginning of year2018-12-31$333,709
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$313,960
Total interest from all sources2018-12-31$2,679
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$2,474,818
Total non interest bearing cash at end of year2018-12-31$102,736
Total non interest bearing cash at beginning of year2018-12-31$75,176
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$101,213
Value of net assets at end of year (total assets less liabilities)2018-12-31$434,922
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$333,709
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$332,186
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$258,533
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$258,533
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$2,679
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$588,483
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$6,933,366
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$8,407,207
Contract administrator fees2018-12-31$313,960
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31MERSEREAU, LAZENBY & ROCKAS LLC
Accountancy firm EIN2018-12-31582115374

Form 5500 Responses for TENCATE USA SERVICES MEDICAL PLAN

2022: TENCATE USA SERVICES MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: TENCATE USA SERVICES MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: TENCATE USA SERVICES MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: TENCATE USA SERVICES MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: TENCATE USA SERVICES MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGB0558
Policy instance 1
Insurance contract or identification numberGB0558
Number of Individuals Covered1673
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Other welfare benefits providedHEALTH IDEMNITY
Welfare Benefit Premiums Paid to CarrierUSD $1,488,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGB0558
Policy instance 1
Insurance contract or identification numberGB0558
Number of Individuals Covered1697
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Other welfare benefits providedHEALTH IDEMNITY
Welfare Benefit Premiums Paid to CarrierUSD $1,496,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9679705
Policy instance 1
Insurance contract or identification number9679705
Number of Individuals Covered954
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,877
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number813580
Policy instance 2
Insurance contract or identification number813580
Number of Individuals Covered1563
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $791,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9679705
Policy instance 1
Insurance contract or identification number9679705
Number of Individuals Covered1506
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,266
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number813580
Policy instance 2
Insurance contract or identification number813580
Number of Individuals Covered1538
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $606,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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