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HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameHVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN
Plan identification number 501

HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

HVPH MOTOR CORP. has sponsored the creation of one or more 401k plans.

Company Name:HVPH MOTOR CORP.
Employer identification number (EIN):660579755
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012023-01-01MYRNA LOPEZ
5012022-01-01
5012022-01-01MYRNA LOPEZ
5012021-01-01
5012021-01-01MYRNA LOPEZ
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01MYRNA LOPEZ MYRNA LOPEZ2018-10-15
5012016-01-01MYRNA LOPEZ MYRNA LOPEZ2018-01-31
5012015-01-01MYRNA LOPEZ MYRNA LOPEZ2016-10-14
5012014-01-01MYRNA LOPEZ MYRNA LOPEZ2015-10-15
5012013-01-01MYRNA LOPEZ MYRNA LOPEZ2014-10-10
5012012-01-01MYRNA LOPEZ MYRNA LOPEZ2013-10-11
5012011-01-01MYRNA LOPEZ MYRNA LOPEZ2012-10-15
5012010-01-01MYRNA LOPEZ MYRNA LOPEZ2011-10-31
5012009-01-01MYRNA LOPEZ MYRNA LOPEZ2010-09-16
5012009-01-01MYRNA LOPEZ MYRNA LOPEZ2010-09-16
5012008-01-01MYRNA LOPEZ MYRNA LOPEZ2012-02-15
5012007-01-01MYRNA LOPEZ MYRNA LOPEZ2010-09-16
5012007-01-01MYRNA LOPEZ MYRNA LOPEZ2010-09-16
5012006-01-01MYRNA LOPEZ MYRNA LOPEZ2010-09-16
5012006-01-01MYRNA LOPEZ MYRNA LOPEZ2010-09-16
5012005-01-01MYRNA LOPEZ MYRNA LOPEZ2010-09-16
5012005-01-01MYRNA LOPEZ MYRNA LOPEZ2010-09-16
5012005-01-01

Plan Statistics for HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN

Measure Date Value
2023: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01235
Total number of active participants reported on line 7a of the Form 55002023-01-01238
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01238
2022: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01397
Total number of active participants reported on line 7a of the Form 55002022-01-01235
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01235
2021: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01397
Total number of active participants reported on line 7a of the Form 55002021-01-01466
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01466
2020: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01377
Total number of active participants reported on line 7a of the Form 55002020-01-01365
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01365
2019: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01403
Total number of active participants reported on line 7a of the Form 55002019-01-01377
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01377
2018: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01415
Total number of active participants reported on line 7a of the Form 55002018-01-01403
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01403
2017: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01421
Total number of active participants reported on line 7a of the Form 55002017-01-01415
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01415
2016: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01348
Total number of active participants reported on line 7a of the Form 55002016-01-01421
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01421
2015: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01323
Total number of active participants reported on line 7a of the Form 55002015-01-01346
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-01348
2014: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01333
Total number of active participants reported on line 7a of the Form 55002014-01-01323
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01323
2013: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01409
Total number of active participants reported on line 7a of the Form 55002013-01-01409
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01409
2012: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01325
Total number of active participants reported on line 7a of the Form 55002012-01-01400
Number of retired or separated participants receiving benefits2012-01-012
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01402
2011: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01360
Total number of active participants reported on line 7a of the Form 55002011-01-01322
Number of retired or separated participants receiving benefits2011-01-014
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01326
2010: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01404
Total number of active participants reported on line 7a of the Form 55002010-01-01420
Number of retired or separated participants receiving benefits2010-01-014
Number of other retired or separated participants entitled to future benefits2010-01-015
Total of all active and inactive participants2010-01-01429
2009: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01443
Total number of active participants reported on line 7a of the Form 55002009-01-01404
Number of retired or separated participants receiving benefits2009-01-0111
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01415
2008: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01413
Total number of active participants reported on line 7a of the Form 55002008-01-01443
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-010
Total of all active and inactive participants2008-01-01443
2007: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01323
Total number of active participants reported on line 7a of the Form 55002007-01-01377
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-01377
2006: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01404
Total number of active participants reported on line 7a of the Form 55002006-01-01323
Number of retired or separated participants receiving benefits2006-01-010
Number of other retired or separated participants entitled to future benefits2006-01-010
Total of all active and inactive participants2006-01-01323
2005: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01357
Total number of active participants reported on line 7a of the Form 55002005-01-01404
Number of retired or separated participants receiving benefits2005-01-010
Number of other retired or separated participants entitled to future benefits2005-01-010
Total of all active and inactive participants2005-01-01404

Form 5500 Responses for HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN

2023: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT 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 benefit arrangement – InsuranceYes
2022: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT 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 benefit arrangement – InsuranceYes
2021: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT 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 benefit arrangement – InsuranceYes
2020: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT 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 benefit arrangement – InsuranceYes
2019: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT 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 benefit arrangement – InsuranceYes
2018: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT 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 benefit arrangement – InsuranceYes
2016: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT 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 benefit arrangement – InsuranceYes
2015: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedYes
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedYes
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1207-0294
Policy instance 4
Insurance contract or identification number1207-0294
Number of Individuals Covered526
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $30,928
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedADD
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 $206,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number0802-0107
Policy instance 3
Insurance contract or identification number0802-0107
Number of Individuals Covered525
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $9,431
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
Other welfare benefits providedCANCER
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 $62,877
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0003754
Policy instance 2
Insurance contract or identification numberSP0003754
Number of Individuals Covered239
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $52,321
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
Other welfare benefits providedMAJOR MEDICAL, ORGAN & TISSUE TRANSPLANT, QUICK HELP AND TELECONSULTATION
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF PUERTO RICO, INC. (National Association of Insurance Commissioners NAIC id number: 47085 )
Policy contract number1280
Policy instance 1
Insurance contract or identification number1280
Number of Individuals Covered239
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,173
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 BenefitYes
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 $64,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF PUERTO RICO, INC. (National Association of Insurance Commissioners NAIC id number: 47085 )
Policy contract number1280
Policy instance 1
Insurance contract or identification number1280
Number of Individuals Covered391
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,764
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 BenefitYes
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 $76,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0003754
Policy instance 2
Insurance contract or identification numberSP0003754
Number of Individuals Covered235
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $58,042
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
Other welfare benefits providedMAJOR MEDICAL, MM SOOA OT, ORGAN AND TISSUE TRANSPLANT, QUICK HELP AND TELECONSULTA
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number0802-0107
Policy instance 3
Insurance contract or identification number0802-0107
Number of Individuals Covered511
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,017
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
Other welfare benefits providedCANCER
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 $60,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1207-0294
Policy instance 4
Insurance contract or identification number1207-0294
Number of Individuals Covered511
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $28,817
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedADD
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 $192,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1207-0294
Policy instance 4
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number0802-0107
Policy instance 3
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0003754
Policy instance 2
DELTA DENTAL OF PUERTO RICO, INC. (National Association of Insurance Commissioners NAIC id number: 47085 )
Policy contract number1280
Policy instance 1
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1207-0294
Policy instance 4
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number0802-0107
Policy instance 3
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0003754
Policy instance 2
DELTA DENTAL OF PUERTO RICO, INC. (National Association of Insurance Commissioners NAIC id number: 47085 )
Policy contract number1280
Policy instance 1
DELTA DENTAL OF PUERTO RICO, INC. (National Association of Insurance Commissioners NAIC id number: 47085 )
Policy contract number1280
Policy instance 1
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0003754
Policy instance 2
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number0802-0107
Policy instance 3
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1207-0294
Policy instance 4
DELTA DENTAL OF PUERTO RICO, INC. (National Association of Insurance Commissioners NAIC id number: 47085 )
Policy contract number1280
Policy instance 1
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0003754
Policy instance 2
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number0802-0107
Policy instance 3
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1207-0294
Policy instance 4
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number1207-0294
Policy instance 4
UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 )
Policy contract number0802-0107
Policy instance 3
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0003754
Policy instance 2
DELTA DENTAL OF PUERTO RICO, INC. (National Association of Insurance Commissioners NAIC id number: 47085 )
Policy contract number1280
Policy instance 1

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