EPPS AIR SERVICE, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2021: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 408 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 197 |
| Total of all active and inactive participants | 2021-10-01 | 197 |
| 2020: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-10-01 | 356 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 408 |
| Total of all active and inactive participants | 2020-10-01 | 408 |
| 2019: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-10-01 | 383 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 356 |
| Total of all active and inactive participants | 2019-10-01 | 356 |
| 2018: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-10-01 | 397 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 383 |
| Total of all active and inactive participants | 2018-10-01 | 383 |
| 2017: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 146 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 397 |
| Total of all active and inactive participants | 2017-10-01 | 397 |
| 2016: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 144 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 146 |
| Total of all active and inactive participants | 2016-10-01 | 146 |
| 2015: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 144 |
| Total of all active and inactive participants | 2015-10-01 | 144 |
| 2014: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 159 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 132 |
| Total of all active and inactive participants | 2014-10-01 | 132 |
| 2013: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 375 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 159 |
| Total of all active and inactive participants | 2013-10-01 | 159 |
| 2012: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 380 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 375 |
| Total of all active and inactive participants | 2012-10-01 | 375 |
| 2011: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 249 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 380 |
| Total of all active and inactive participants | 2011-10-01 | 380 |
| 2010: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-10-01 | 233 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 249 |
| Total of all active and inactive participants | 2010-10-01 | 249 |
| 2009: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 242 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 233 |
| Total of all active and inactive participants | 2009-10-01 | 233 |
| 2021: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2020 form 5500 responses |
|---|
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Submission has been amended | Yes |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2019 form 5500 responses |
|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2018 form 5500 responses |
|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2010 form 5500 responses |
|---|
| 2010-10-01 | Type of plan entity | Single employer plan |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | First time form 5500 has been submitted | Yes |
| 2009-10-01 | Submission has been amended | Yes |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: EPPS AIR SERVICE INC FLEXIBLE BENEFITS PLAN 2008 form 5500 responses |
|---|
| 2008-10-01 | Type of plan entity | Single employer plan |
| 2008-10-01 | Submission has been amended | No |
| 2008-10-01 | This submission is the final filing | No |
| 2008-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-10-01 | Plan is a collectively bargained plan | No |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 925435 |
| Policy instance | 4 |
| Insurance contract or identification number | 925435 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $7,166 | | Total amount of fees paid to insurance company | USD $54,706 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,129,067 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,166 | | Amount paid for insurance broker fees | 54706 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05584655 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05584655 | | Number of Individuals Covered | 197 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $18,998 | | Total amount of fees paid to insurance company | USD $1,858 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $119,660 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,998 | | Amount paid for insurance broker fees | 1858 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL & ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98874721001 |
| Policy instance | 2 |
| Insurance contract or identification number | 98874721001 | | Number of Individuals Covered | 140 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $1,022 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,104 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,022 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 00000162165 |
| Policy instance | 1 |
| Insurance contract or identification number | 00000162165 | | Number of Individuals Covered | 64 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $2,802 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,421 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,308 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 00000162165 |
| Policy instance | 1 |
| Insurance contract or identification number | 00000162165 | | Number of Individuals Covered | 38 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $4,061 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,589 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,267 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98874721001 |
| Policy instance | 2 |
| Insurance contract or identification number | 98874721001 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $1,253 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,253 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05584655 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05584655 | | Number of Individuals Covered | 225 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $19,879 | | Total amount of fees paid to insurance company | USD $2,122 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $123,518 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,879 | | Amount paid for insurance broker fees | 2122 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL & ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | G0386 |
| Policy instance | 4 |
| Insurance contract or identification number | G0386 | | Number of Individuals Covered | 408 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $68,695 | | Total amount of fees paid to insurance company | USD $4,194 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,284,695 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $68,695 | | Amount paid for insurance broker fees | 4194 | | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATION & TRAINING | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GB0502 |
| Policy instance | 4 |
| Insurance contract or identification number | GB0502 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $55,819 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,200,080 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,819 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05584655 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05584655 | | Number of Individuals Covered | 356 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $23,577 | | Total amount of fees paid to insurance company | USD $4,186 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $194,550 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,577 | | Amount paid for insurance broker fees | 64 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION & MARKETING FEES | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98874721001 |
| Policy instance | 2 |
| Insurance contract or identification number | 98874721001 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $1,226 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,190 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,226 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000018021 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000018021 | | Number of Individuals Covered | 89 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $3,524 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,573 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,083 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000018021 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000018021 | | Number of Individuals Covered | 87 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $6,490 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,498 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 98874721001 |
| Policy instance | 2 |
| Insurance contract or identification number | 98874721001 | | Number of Individuals Covered | 179 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $1,211 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $712 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05584655 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05584655 | | Number of Individuals Covered | 383 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $24,009 | | Total amount of fees paid to insurance company | USD $461 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,424 | | Amount paid for insurance broker fees | 27 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 912036 |
| Policy instance | 4 |
| Insurance contract or identification number | 912036 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $62,340 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 62340 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 912036 |
| Policy instance | 4 |
| Insurance contract or identification number | 912036 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $61,625 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,173,538 | | 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 number | TM05584655 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05584655 | | Number of Individuals Covered | 397 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $24,577 | | Total amount of fees paid to insurance company | USD $2,405 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $198,431 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000018021 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000018021 | | Number of Individuals Covered | 81 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $3,780 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,599 | | 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 number | 9887472 |
| Policy instance | 2 |
| Insurance contract or identification number | 9887472 | | Number of Individuals Covered | 168 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $1,071 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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