QUAIL VALLEY CLUB LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 72 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 73 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 73 |
| 2021: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 79 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 72 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 72 |
| 2020: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 85 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 79 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 79 |
| 2019: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 80 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 85 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 85 |
| 2018: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 82 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 78 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 80 |
| 2017: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 81 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 82 |
| 2016: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 77 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 84 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 86 |
| 2015: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 78 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 77 |
| Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
| Total of all active and inactive participants | 2015-06-01 | 77 |
| Measure | Date | Value |
|---|
| 2022 : QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2022 401k financial data |
|---|
| Total plan liabilities at end of year | 2022-12-31 | $54,195 |
| Total plan liabilities at beginning of year | 2022-12-31 | $155,337 |
| Total income from all sources | 2022-12-31 | $787,461 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $701,660 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $415,284 |
| Total plan assets at end of year | 2022-12-31 | $8,522 |
| Total plan assets at beginning of year | 2022-12-31 | $23,863 |
| Value of fidelity bond covering the plan | 2022-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $199,667 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $238,941 |
| Contributions received from other sources (not participants or employers) | 2022-12-31 | $0 |
| Other income received | 2022-12-31 | $83 |
| Net income (gross income less expenses) | 2022-12-31 | $85,801 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $-45,673 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $-131,474 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $587,711 |
| Value of corrective distributions | 2022-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $47,435 |
| 2021 : QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-12-31 | $155,337 |
| Total plan liabilities at beginning of year | 2021-12-31 | $369,352 |
| Total income from all sources | 2021-12-31 | $726,115 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $521,418 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $263,418 |
| Total plan assets at end of year | 2021-12-31 | $23,863 |
| Total plan assets at beginning of year | 2021-12-31 | $33,181 |
| Value of fidelity bond covering the plan | 2021-12-31 | $50,000 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $206,949 |
| Other income received | 2021-12-31 | $70 |
| Net income (gross income less expenses) | 2021-12-31 | $204,697 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $-131,474 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $-336,171 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $726,045 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $51,051 |
| 2020 : QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-12-31 | $369,352 |
| Total plan liabilities at beginning of year | 2020-12-31 | $48,809 |
| Total income from all sources | 2020-12-31 | $787,403 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $1,117,854 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $806,147 |
| Total plan assets at end of year | 2020-12-31 | $33,181 |
| Total plan assets at beginning of year | 2020-12-31 | $43,089 |
| Value of fidelity bond covering the plan | 2020-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $235,691 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $216,964 |
| Contributions received from other sources (not participants or employers) | 2020-12-31 | $568 |
| Other income received | 2020-12-31 | $93 |
| Net income (gross income less expenses) | 2020-12-31 | $-330,451 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $-336,171 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $-5,720 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $551,051 |
| Value of corrective distributions | 2020-12-31 | $38,830 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $55,913 |
| 2019 : QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-31 | $48,809 |
| Total plan liabilities at beginning of year | 2019-12-31 | $38,737 |
| Total income from all sources | 2019-12-31 | $729,158 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $784,355 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $473,727 |
| Total plan assets at end of year | 2019-12-31 | $43,089 |
| Total plan assets at beginning of year | 2019-12-31 | $88,214 |
| Value of fidelity bond covering the plan | 2019-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $207,767 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $197,364 |
| Contributions received from other sources (not participants or employers) | 2019-12-31 | $0 |
| Other income received | 2019-12-31 | $238 |
| Net income (gross income less expenses) | 2019-12-31 | $-55,197 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $-5,720 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $49,477 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $521,153 |
| Value of corrective distributions | 2019-12-31 | $61,870 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $51,394 |
| 2018 : QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-12-31 | $38,737 |
| Total plan liabilities at beginning of year | 2018-12-31 | $82,124 |
| Total income from all sources | 2018-12-31 | $703,334 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $571,733 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $370,274 |
| Total plan assets at end of year | 2018-12-31 | $88,214 |
| Total plan assets at beginning of year | 2018-12-31 | $0 |
| Value of fidelity bond covering the plan | 2018-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $193,433 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $135,730 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $22,465 |
| Other income received | 2018-12-31 | $267 |
| Net income (gross income less expenses) | 2018-12-31 | $131,601 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $49,477 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $-82,124 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $487,169 |
| Value of corrective distributions | 2018-12-31 | $17,001 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $48,728 |
| 2017 : QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-12-31 | $82,124 |
| Total plan liabilities at beginning of year | 2017-12-31 | $37,496 |
| Total income from all sources | 2017-12-31 | $685,588 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $785,462 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $480,487 |
| Total plan assets at end of year | 2017-12-31 | $0 |
| Total plan assets at beginning of year | 2017-12-31 | $55,246 |
| Value of fidelity bond covering the plan | 2017-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $190,277 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $246,163 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $9,996 |
| Other income received | 2017-12-31 | $56 |
| Net income (gross income less expenses) | 2017-12-31 | $-99,874 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $-82,124 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $17,750 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $485,259 |
| Value of corrective distributions | 2017-12-31 | $8,998 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $49,814 |
| 2016 : QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-12-31 | $37,496 |
| Total plan liabilities at beginning of year | 2016-12-31 | $0 |
| Total income from all sources | 2016-12-31 | $589,712 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $586,317 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $356,955 |
| Total plan assets at end of year | 2016-12-31 | $55,246 |
| Total plan assets at beginning of year | 2016-12-31 | $14,355 |
| Value of fidelity bond covering the plan | 2016-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $181,628 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $178,709 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $2,256 |
| Other income received | 2016-12-31 | $12 |
| Net income (gross income less expenses) | 2016-12-31 | $3,395 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $17,750 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $14,355 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $405,816 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $50,653 |
| 2015 : QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-12-31 | $0 |
| Total income from all sources | 2015-12-31 | $322,773 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $308,418 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $183,436 |
| Total plan assets at end of year | 2015-12-31 | $14,355 |
| Total plan assets at beginning of year | 2015-12-31 | $0 |
| Value of fidelity bond covering the plan | 2015-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $100,874 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $97,378 |
| Other income received | 2015-12-31 | $30 |
| Net income (gross income less expenses) | 2015-12-31 | $14,355 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $14,355 |
| 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 | $221,869 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $27,604 |
| 2022: QUAIL VALLEY CLUB LLC GROUP 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 – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: QUAIL VALLEY CLUB LLC GROUP 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 – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: QUAIL VALLEY CLUB LLC GROUP 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 – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: QUAIL VALLEY CLUB LLC GROUP 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 – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: QUAIL VALLEY CLUB LLC GROUP 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 – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: QUAIL VALLEY CLUB LLC GROUP 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 – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: QUAIL VALLEY CLUB LLC GROUP 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 – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: QUAIL VALLEY CLUB LLC GROUP BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | First time form 5500 has been submitted | Yes |
| 2015-06-01 | Submission has been amended | No |
| 2015-06-01 | This submission is the final filing | No |
| 2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-06-01 | Plan is a collectively bargained plan | No |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan funding arrangement – Trust | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement - Trust | Yes |
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | 30500124 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500124 | | Number of Individuals Covered | 73 | | 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 $193,284 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500124 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500124 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 $165,418 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 30500124 |
| Policy instance | 1 |
| Insurance contract or identification number | 30500124 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $171,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 85 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 $152,764 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 78 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 $148,853 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 82 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 $147,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 77 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2015-12-31 | | Are there contracts with allocated funds for individual policies? | No | | 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 $74,891 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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