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M-TEK, INC. HEALTH & WELFARE PLAN 401k Plan overview

Plan NameM-TEK, INC. HEALTH & WELFARE PLAN
Plan identification number 501

M-TEK, INC. HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

KASAI NORTH AMERICA, INC. has sponsored the creation of one or more 401k plans.

Company Name:KASAI NORTH AMERICA, INC.
Employer identification number (EIN):621292160
NAIC Classification:336100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan M-TEK, INC. HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01LANA VANHOOSER
5012023-01-01
5012023-01-01LANA VANHOOSER
5012022-01-01
5012022-01-01LANA VANHOOSER
5012021-01-01
5012021-01-01LANA VANHOOSER
5012020-01-01
5012019-01-01
5012017-01-01GREG PINSON GREG PINSON2018-07-31
5012016-01-01GREG PINSON GREG PINSON2017-06-05
5012015-11-01GREG PINSON GREG PINSON2016-07-07
5012014-11-01GREG PINSON
5012013-11-01GREG PINSON
5012012-11-01GREG PINSON
5012011-11-01HOWARD TUCKER
5012010-11-01HOWARD TUCKER
5012009-11-01HOWARD TUCKER HOWARD TUCKER2011-08-10
5012008-11-01
5012006-11-01HOWARD TUCKER HOWARD TUCKER2011-04-11
5012005-11-01HOWARD TUCKER HOWARD TUCKER2011-04-11
5012004-11-01HOWARD TUCKER HOWARD TUCKER2011-04-11
5012003-11-01HOWARD TUCKER HOWARD TUCKER2011-04-11
5012001-11-01HOWARD TUCKER HOWARD TUCKER2011-04-11
5011999-11-01HOWARD TUCKER HOWARD TUCKER2011-04-11
5011998-11-01HOWARD TUCKER HOWARD TUCKER2011-04-11

Plan Statistics for M-TEK, INC. HEALTH & WELFARE PLAN

401k plan membership statisitcs for M-TEK, INC. HEALTH & WELFARE PLAN

Measure Date Value
2023: M-TEK, INC. HEALTH & WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-012,225
Total number of active participants reported on line 7a of the Form 55002023-01-012,076
Number of retired or separated participants receiving benefits2023-01-017
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-012,083
2022: M-TEK, INC. HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-012,487
Total number of active participants reported on line 7a of the Form 55002022-01-012,268
Number of retired or separated participants receiving benefits2022-01-0111
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-012,279
2021: M-TEK, INC. HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-012,627
Total number of active participants reported on line 7a of the Form 55002021-01-011,951
Number of retired or separated participants receiving benefits2021-01-0114
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011,965
2020: M-TEK, INC. HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-012,327
Total number of active participants reported on line 7a of the Form 55002020-01-012,105
Number of other retired or separated participants entitled to future benefits2020-01-0117
Total of all active and inactive participants2020-01-012,122
2019: M-TEK, INC. HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-012,511
Total number of active participants reported on line 7a of the Form 55002019-01-012,317
Number of other retired or separated participants entitled to future benefits2019-01-0110
Total of all active and inactive participants2019-01-012,327
2017: M-TEK, INC. HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-012,472
Total number of active participants reported on line 7a of the Form 55002017-01-012,310
Number of retired or separated participants receiving benefits2017-01-0117
Total of all active and inactive participants2017-01-012,327
2016: M-TEK, INC. HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-012,656
Total number of active participants reported on line 7a of the Form 55002016-01-012,456
Number of retired or separated participants receiving benefits2016-01-0116
Total of all active and inactive participants2016-01-012,472
2015: M-TEK, INC. HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-012,656
Total number of active participants reported on line 7a of the Form 55002015-11-012,638
Number of retired or separated participants receiving benefits2015-11-0118
Number of other retired or separated participants entitled to future benefits2015-11-010
Total of all active and inactive participants2015-11-012,656
2014: M-TEK, INC. HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-012,720
Total number of active participants reported on line 7a of the Form 55002014-11-012,638
Number of retired or separated participants receiving benefits2014-11-0118
Number of other retired or separated participants entitled to future benefits2014-11-010
Total of all active and inactive participants2014-11-012,656
2013: M-TEK, INC. HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-012,378
Total number of active participants reported on line 7a of the Form 55002013-11-012,705
Number of retired or separated participants receiving benefits2013-11-0115
Number of other retired or separated participants entitled to future benefits2013-11-010
Total of all active and inactive participants2013-11-012,720
2012: M-TEK, INC. HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-011,991
Total number of active participants reported on line 7a of the Form 55002012-11-012,278
Number of retired or separated participants receiving benefits2012-11-019
Number of other retired or separated participants entitled to future benefits2012-11-010
Total of all active and inactive participants2012-11-012,287
2011: M-TEK, INC. HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-011,475
Total number of active participants reported on line 7a of the Form 55002011-11-011,916
Number of retired or separated participants receiving benefits2011-11-0110
Number of other retired or separated participants entitled to future benefits2011-11-010
Total of all active and inactive participants2011-11-011,926
2010: M-TEK, INC. HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year2010-11-011,307
Total number of active participants reported on line 7a of the Form 55002010-11-011,435
Number of retired or separated participants receiving benefits2010-11-0111
Number of other retired or separated participants entitled to future benefits2010-11-010
Total of all active and inactive participants2010-11-011,446
2009: M-TEK, INC. HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-011,341
Total number of active participants reported on line 7a of the Form 55002009-11-011,274
Number of retired or separated participants receiving benefits2009-11-0111
Number of other retired or separated participants entitled to future benefits2009-11-010
Total of all active and inactive participants2009-11-011,285
2006: M-TEK, INC. HEALTH & WELFARE PLAN 2006 401k membership
Total participants, beginning-of-year2006-11-011,386
Total number of active participants reported on line 7a of the Form 55002006-11-011,346
Number of retired or separated participants receiving benefits2006-11-0111
Number of other retired or separated participants entitled to future benefits2006-11-010
Total of all active and inactive participants2006-11-011,357
2005: M-TEK, INC. HEALTH & WELFARE PLAN 2005 401k membership
Total participants, beginning-of-year2005-11-011,314
Total number of active participants reported on line 7a of the Form 55002005-11-011,331
Number of retired or separated participants receiving benefits2005-11-015
Number of other retired or separated participants entitled to future benefits2005-11-010
Total of all active and inactive participants2005-11-011,336
2004: M-TEK, INC. HEALTH & WELFARE PLAN 2004 401k membership
Total participants, beginning-of-year2004-11-011,142
Total number of active participants reported on line 7a of the Form 55002004-11-011,305
Number of retired or separated participants receiving benefits2004-11-015
Number of other retired or separated participants entitled to future benefits2004-11-010
Total of all active and inactive participants2004-11-011,310
2003: M-TEK, INC. HEALTH & WELFARE PLAN 2003 401k membership
Total participants, beginning-of-year2003-11-01897
Total number of active participants reported on line 7a of the Form 55002003-11-011,105
Number of retired or separated participants receiving benefits2003-11-016
Number of other retired or separated participants entitled to future benefits2003-11-010
Total of all active and inactive participants2003-11-011,111
2001: M-TEK, INC. HEALTH & WELFARE PLAN 2001 401k membership
Total participants, beginning-of-year2001-11-01640
Total number of active participants reported on line 7a of the Form 55002001-11-01619
Number of retired or separated participants receiving benefits2001-11-017
Number of other retired or separated participants entitled to future benefits2001-11-010
Total of all active and inactive participants2001-11-01626
1999: M-TEK, INC. HEALTH & WELFARE PLAN 1999 401k membership
Total participants, beginning-of-year1999-11-01611
Total number of active participants reported on line 7a of the Form 55001999-11-01632
Number of retired or separated participants receiving benefits1999-11-010
Number of other retired or separated participants entitled to future benefits1999-11-010
Total of all active and inactive participants1999-11-01632
1998: M-TEK, INC. HEALTH & WELFARE PLAN 1998 401k membership
Total participants, beginning-of-year1998-11-01463
Total number of active participants reported on line 7a of the Form 55001998-11-01559
Number of retired or separated participants receiving benefits1998-11-010
Number of other retired or separated participants entitled to future benefits1998-11-010
Total of all active and inactive participants1998-11-01559

Form 5500 Responses for M-TEK, INC. HEALTH & WELFARE PLAN

2023: M-TEK, INC. HEALTH & WELFARE PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: M-TEK, INC. HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: M-TEK, INC. HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: M-TEK, INC. HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: M-TEK, INC. HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: M-TEK, INC. HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: M-TEK, INC. HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: M-TEK, INC. HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan funding arrangement – General assets of the sponsorYes
2015-11-01Plan benefit arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – General assets of the sponsorYes
2014: M-TEK, INC. HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan funding arrangement – General assets of the sponsorYes
2014-11-01Plan benefit arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – General assets of the sponsorYes
2013: M-TEK, INC. HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedNo
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)No
2013-11-01Plan is a collectively bargained planNo
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan funding arrangement – General assets of the sponsorYes
2013-11-01Plan benefit arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – General assets of the sponsorYes
2012: M-TEK, INC. HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan funding arrangement – General assets of the sponsorYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – General assets of the sponsorYes
2011: M-TEK, INC. HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Submission has been amendedNo
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan funding arrangement – General assets of the sponsorYes
2011-11-01Plan benefit arrangement – InsuranceYes
2011-11-01Plan benefit arrangement – General assets of the sponsorYes
2010: M-TEK, INC. HEALTH & WELFARE PLAN 2010 form 5500 responses
2010-11-01Type of plan entitySingle employer plan
2010-11-01Submission has been amendedNo
2010-11-01This submission is the final filingNo
2010-11-01This return/report is a short plan year return/report (less than 12 months)No
2010-11-01Plan is a collectively bargained planNo
2010-11-01Plan funding arrangement – InsuranceYes
2010-11-01Plan funding arrangement – General assets of the sponsorYes
2010-11-01Plan benefit arrangement – InsuranceYes
2010-11-01Plan benefit arrangement – General assets of the sponsorYes
2009: M-TEK, INC. HEALTH & WELFARE PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan funding arrangement – General assets of the sponsorYes
2009-11-01Plan benefit arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – General assets of the sponsorYes
2008: M-TEK, INC. HEALTH & WELFARE PLAN 2008 form 5500 responses
2008-11-01Type of plan entitySingle employer plan
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planNo
2006: M-TEK, INC. HEALTH & WELFARE PLAN 2006 form 5500 responses
2006-11-01Type of plan entitySingle employer plan
2006-11-01Submission has been amendedNo
2006-11-01This submission is the final filingNo
2006-11-01This return/report is a short plan year return/report (less than 12 months)No
2006-11-01Plan is a collectively bargained planNo
2006-11-01Plan funding arrangement – InsuranceYes
2006-11-01Plan funding arrangement – General assets of the sponsorYes
2006-11-01Plan benefit arrangement – InsuranceYes
2006-11-01Plan benefit arrangement – General assets of the sponsorYes
2005: M-TEK, INC. HEALTH & WELFARE PLAN 2005 form 5500 responses
2005-11-01Type of plan entitySingle employer plan
2005-11-01Submission has been amendedNo
2005-11-01This submission is the final filingNo
2005-11-01This return/report is a short plan year return/report (less than 12 months)No
2005-11-01Plan is a collectively bargained planNo
2005-11-01Plan funding arrangement – InsuranceYes
2005-11-01Plan funding arrangement – General assets of the sponsorYes
2005-11-01Plan benefit arrangement – InsuranceYes
2005-11-01Plan benefit arrangement – General assets of the sponsorYes
2004: M-TEK, INC. HEALTH & WELFARE PLAN 2004 form 5500 responses
2004-11-01Type of plan entitySingle employer plan
2004-11-01Submission has been amendedNo
2004-11-01This submission is the final filingNo
2004-11-01This return/report is a short plan year return/report (less than 12 months)No
2004-11-01Plan is a collectively bargained planNo
2004-11-01Plan funding arrangement – InsuranceYes
2004-11-01Plan funding arrangement – General assets of the sponsorYes
2004-11-01Plan benefit arrangement – InsuranceYes
2004-11-01Plan benefit arrangement – General assets of the sponsorYes
2003: M-TEK, INC. HEALTH & WELFARE PLAN 2003 form 5500 responses
2003-11-01Type of plan entitySingle employer plan
2003-11-01Submission has been amendedNo
2003-11-01This submission is the final filingNo
2003-11-01This return/report is a short plan year return/report (less than 12 months)No
2003-11-01Plan is a collectively bargained planNo
2003-11-01Plan funding arrangement – InsuranceYes
2003-11-01Plan funding arrangement – General assets of the sponsorYes
2003-11-01Plan benefit arrangement – InsuranceYes
2003-11-01Plan benefit arrangement – General assets of the sponsorYes
2001: M-TEK, INC. HEALTH & WELFARE PLAN 2001 form 5500 responses
2001-11-01Type of plan entitySingle employer plan
2001-11-01Submission has been amendedNo
2001-11-01This submission is the final filingNo
2001-11-01This return/report is a short plan year return/report (less than 12 months)No
2001-11-01Plan is a collectively bargained planNo
2001-11-01Plan funding arrangement – InsuranceYes
2001-11-01Plan funding arrangement – General assets of the sponsorYes
2001-11-01Plan benefit arrangement – InsuranceYes
2001-11-01Plan benefit arrangement – General assets of the sponsorYes
1999: M-TEK, INC. HEALTH & WELFARE PLAN 1999 form 5500 responses
1999-11-01Type of plan entitySingle employer plan
1999-11-01Submission has been amendedNo
1999-11-01This submission is the final filingNo
1999-11-01This return/report is a short plan year return/report (less than 12 months)No
1999-11-01Plan is a collectively bargained planNo
1999-11-01Plan funding arrangement – InsuranceYes
1999-11-01Plan funding arrangement – General assets of the sponsorYes
1999-11-01Plan benefit arrangement – InsuranceYes
1999-11-01Plan benefit arrangement – General assets of the sponsorYes
1998: M-TEK, INC. HEALTH & WELFARE PLAN 1998 form 5500 responses
1998-11-01Type of plan entitySingle employer plan
1998-11-01First time form 5500 has been submittedYes
1998-11-01Submission has been amendedNo
1998-11-01This submission is the final filingNo
1998-11-01This return/report is a short plan year return/report (less than 12 months)No
1998-11-01Plan is a collectively bargained planNo
1998-11-01Plan funding arrangement – InsuranceYes
1998-11-01Plan funding arrangement – General assets of the sponsorYes
1998-11-01Plan benefit arrangement – InsuranceYes
1998-11-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-014796-000
Policy instance 4
Insurance contract or identification number16-014796-000
Number of Individuals Covered1625
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $68,996
Total amount of fees paid to insurance companyUSD $0
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 $1,379,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number82025
Policy instance 3
Insurance contract or identification number82025
Number of Individuals Covered2898
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $10,070
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI
Policy instance 2
Insurance contract or identification numberMULTI
Number of Individuals Covered2119
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $255,773
Total amount of fees paid to insurance companyUSD $90,370
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, ACCIDENT, CRITICAL ILLNESS
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 $2,198,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30070697
Policy instance 1
Insurance contract or identification number30070697
Number of Individuals Covered1570
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $9,399
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number08335A
Policy instance 4
Insurance contract or identification number08335A
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,323
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $13,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number82025
Policy instance 3
Insurance contract or identification number82025
Number of Individuals Covered3313
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $11,660
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI
Policy instance 2
Insurance contract or identification numberMULTI
Number of Individuals Covered2502
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $205,469
Total amount of fees paid to insurance companyUSD $124,669
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, ACCIDENT, CRITICAL ILLNESS
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 $1,659,973
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30070697
Policy instance 1
Insurance contract or identification number30070697
Number of Individuals Covered1702
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $11,517
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30070697
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI
Policy instance 2
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number82025
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30070697
Policy instance 7
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number910634
Policy instance 6
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number802096
Policy instance 5
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number827315
Policy instance 4
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number328424
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number131350
Policy instance 2
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number161259
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30070697
Policy instance 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number242309
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number910634
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30070697
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number242309
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675023G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675023G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675023G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675023G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675023G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675023G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberOGL GLT 675023
Policy instance 1

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