OMNI TECHNOLOGIES has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2023 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2023 401k financial data |
|---|
| Total income from all sources | 2023-12-31 | $509,630 |
| Expenses. Total of all expenses incurred | 2023-12-31 | $509,650 |
| Benefits paid (including direct rollovers) | 2023-12-31 | $224,321 |
| Total plan assets at end of year | 2023-12-31 | $10 |
| Total plan assets at beginning of year | 2023-12-31 | $30 |
| Value of fidelity bond covering the plan | 2023-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2023-12-31 | $130,321 |
| Expenses. Other expenses not covered elsewhere | 2023-12-31 | $231,773 |
| Contributions received from other sources (not participants or employers) | 2023-12-31 | $52,677 |
| Net income (gross income less expenses) | 2023-12-31 | $-20 |
| Net plan assets at end of year (total assets less liabilities) | 2023-12-31 | $10 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-12-31 | $30 |
| Total contributions received or receivable from employer(s) | 2023-12-31 | $326,632 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2023-12-31 | $53,556 |
| 2022 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $453,492 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $453,472 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $181,773 |
| Total plan assets at end of year | 2022-12-31 | $30 |
| Total plan assets at beginning of year | 2022-12-31 | $10 |
| Total contributions received or receivable from participants | 2022-12-31 | $131,203 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $230,091 |
| Net income (gross income less expenses) | 2022-12-31 | $20 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $30 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $10 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $322,289 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $41,608 |
| 2021 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $406,179 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $406,169 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $152,188 |
| Total plan assets at end of year | 2021-12-31 | $10 |
| Total plan assets at beginning of year | 2021-12-31 | $0 |
| Total contributions received or receivable from participants | 2021-12-31 | $133,104 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $213,853 |
| Net income (gross income less expenses) | 2021-12-31 | $10 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $10 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $273,075 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $40,128 |
| 2020 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $699,728 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $699,728 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $460,689 |
| Total plan assets at end of year | 2020-12-31 | $0 |
| Total plan assets at beginning of year | 2020-12-31 | $0 |
| Total contributions received or receivable from participants | 2020-12-31 | $119,181 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $198,211 |
| Net income (gross income less expenses) | 2020-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $580,547 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $40,828 |
| 2019 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $273,269 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $273,269 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $59,857 |
| Total plan assets at end of year | 2019-12-31 | $0 |
| Total plan assets at beginning of year | 2019-12-31 | $0 |
| Total contributions received or receivable from participants | 2019-12-31 | $92,744 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $179,505 |
| Net income (gross income less expenses) | 2019-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $180,525 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $33,907 |
| 2018 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $422,411 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $422,411 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $206,331 |
| Total plan assets at end of year | 2018-12-31 | $0 |
| Total plan assets at beginning of year | 2018-12-31 | $0 |
| Total contributions received or receivable from participants | 2018-12-31 | $122,630 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $179,163 |
| Net income (gross income less expenses) | 2018-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $299,781 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $36,917 |
| 2017 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $306,289 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $306,289 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $76,393 |
| Total plan assets at end of year | 2017-12-31 | $0 |
| Total plan assets at beginning of year | 2017-12-31 | $0 |
| Total contributions received or receivable from participants | 2017-12-31 | $154,856 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $185,589 |
| Net income (gross income less expenses) | 2017-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $151,433 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $44,307 |
| 2016 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $492,694 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $492,694 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $244,668 |
| Total plan assets at end of year | 2016-12-31 | $0 |
| Total plan assets at beginning of year | 2016-12-31 | $0 |
| Total contributions received or receivable from participants | 2016-12-31 | $157,144 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $205,325 |
| Net income (gross income less expenses) | 2016-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $335,550 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $42,701 |
| 2015 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $663,480 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $663,480 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $452,160 |
| Total plan assets at end of year | 2015-12-31 | $0 |
| Total plan assets at beginning of year | 2015-12-31 | $0 |
| Total contributions received or receivable from participants | 2015-12-31 | $106,162 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $195,892 |
| Net income (gross income less expenses) | 2015-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $557,318 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $15,428 |
| 2014 : OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $415,905 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $415,905 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $229,495 |
| Total plan assets at end of year | 2014-12-31 | $0 |
| Total plan assets at beginning of year | 2014-12-31 | $0 |
| Total contributions received or receivable from participants | 2014-12-31 | $99,555 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $170,625 |
| Net income (gross income less expenses) | 2014-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $316,350 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $15,785 |
| 2023: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: OMNI TECHNOLOGIES, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | First time form 5500 has been submitted | Yes |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 ) |
| Policy contract number | 14006 |
| Policy instance | 2 |
| Insurance contract or identification number | 14006 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE NORTH RIVER INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 21105 ) |
| Policy contract number | 14006 |
| Policy instance | 1 |
| Insurance contract or identification number | 14006 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $229,279 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 ) |
| Policy contract number | 14006 |
| Policy instance | 2 |
| Insurance contract or identification number | 14006 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $111 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,496 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE NORTH RIVER INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 21105 ) |
| Policy contract number | 14006 |
| Policy instance | 1 |
| Insurance contract or identification number | 14006 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $221,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 ) |
| Policy contract number | 14006 |
| Policy instance | 2 |
| THE NORTH RIVER INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 21105 ) |
| Policy contract number | 14006 |
| Policy instance | 1 |
| THE NORTH RIVER INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 21105 ) |
| Policy contract number | 14006 |
| Policy instance | 2 |
| MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 ) |
| Policy contract number | 14006 |
| Policy instance | 1 |
| MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 ) |
| Policy contract number | 14006 |
| Policy instance | 2 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
| Policy contract number | 14006 |
| Policy instance | 1 |
| MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 ) |
| Policy contract number | 14006 |
| Policy instance | 2 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
| Policy contract number | 14006 |
| Policy instance | 1 |
| MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 ) |
| Policy contract number | 14006 |
| Policy instance | 2 |
| HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 14006 |
| Policy instance | 1 |
