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PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 401k Plan overview

Plan NamePERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST
Plan identification number 502

PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 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

401k Sponsoring company profile

PERFORMANCE CONTRACTORS, INC. has sponsored the creation of one or more 401k plans.

Company Name:PERFORMANCE CONTRACTORS, INC.
Employer identification number (EIN):720875986
NAIC Classification:237990
NAIC Description:Other Heavy and Civil Engineering Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022019-03-01
5022018-03-01
5022017-03-01ART E. FAVRE
5022016-03-01ART E. FAVRE
5022015-03-01ART E. FAVRE
5022014-03-01ART E. FAVRE
5022011-03-01ART E FAVRE
5022009-03-01ART E FAVRE

Plan Statistics for PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST

401k plan membership statisitcs for PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST

Measure Date Value
2019: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2019 401k membership
Total participants, beginning-of-year2019-03-012,474
Total number of active participants reported on line 7a of the Form 55002019-03-010
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-010
2018: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2018 401k membership
Total participants, beginning-of-year2018-03-012,049
Total number of active participants reported on line 7a of the Form 55002018-03-012,467
Number of retired or separated participants receiving benefits2018-03-017
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-012,474
2017: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2017 401k membership
Total participants, beginning-of-year2017-03-012,502
Total number of active participants reported on line 7a of the Form 55002017-03-012,049
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-012,049
2016: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2016 401k membership
Total participants, beginning-of-year2016-03-012,938
Total number of active participants reported on line 7a of the Form 55002016-03-012,502
Number of retired or separated participants receiving benefits2016-03-010
Number of other retired or separated participants entitled to future benefits2016-03-010
Total of all active and inactive participants2016-03-012,502
2015: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2015 401k membership
Total participants, beginning-of-year2015-03-012,084
Total number of active participants reported on line 7a of the Form 55002015-03-012,938
Number of retired or separated participants receiving benefits2015-03-010
Number of other retired or separated participants entitled to future benefits2015-03-010
Total of all active and inactive participants2015-03-012,938
2014: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2014 401k membership
Total participants, beginning-of-year2014-03-011,657
Total number of active participants reported on line 7a of the Form 55002014-03-012,084
Total of all active and inactive participants2014-03-012,084
Total participants2014-03-010
2011: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2011 401k membership
Total participants, beginning-of-year2011-03-011,091
Total number of active participants reported on line 7a of the Form 55002011-03-01844
Total of all active and inactive participants2011-03-01844
Total participants2011-03-01844
2009: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year2009-03-01755
Total number of active participants reported on line 7a of the Form 55002009-03-01899
Total of all active and inactive participants2009-03-01899
Total participants2009-03-01899

Financial Data on PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST

Measure Date Value
2019 : PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2019 401k financial data
Total transfer of assets from this plan2019-12-31$2,137,771
Total transfer of assets from this plan2019-12-31$2,137,771
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,187,871
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,187,871
Total income from all sources (including contributions)2019-12-31$25,446,679
Total income from all sources (including contributions)2019-12-31$25,446,679
Total of all expenses incurred2019-12-31$23,575,349
Total of all expenses incurred2019-12-31$23,575,349
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$22,591,844
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$25,446,679
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$25,446,679
Value of total assets at beginning of year2019-12-31$2,454,312
Value of total assets at beginning of year2019-12-31$2,454,312
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$983,505
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$983,505
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$3,000,000
Value of fidelity bond cover2019-12-31$3,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$14,327,922
Contributions received from participants2019-12-31$14,327,922
Participant contributions at beginning of year2019-12-31$342,004
Participant contributions at beginning of year2019-12-31$342,004
Administrative expenses (other) incurred2019-12-31$214
Administrative expenses (other) incurred2019-12-31$214
Liabilities. Value of operating payables at beginning of year2019-12-31$198,336
Liabilities. Value of operating payables at beginning of year2019-12-31$198,336
Total non interest bearing cash at beginning of year2019-12-31$737,765
Total non interest bearing cash at beginning of year2019-12-31$737,765
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,871,330
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$266,441
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$3,145,439
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$11,118,757
Contributions received in cash from employer2019-12-31$11,118,757
Employer contributions (assets) at beginning of year2019-12-31$1,374,543
Employer contributions (assets) at beginning of year2019-12-31$1,374,543
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$19,446,405
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$19,446,405
Contract administrator fees2019-12-31$983,291
Contract administrator fees2019-12-31$983,291
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,989,535
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,989,535
Did the plan have assets held for investment2019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31MADDOX & ASSOCIATES APC
Accountancy firm name2019-12-31MADDOX & ASSOCIATES APC
Accountancy firm EIN2019-12-31721314069
Accountancy firm EIN2019-12-31721314069
2018 : PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-02-28$2,828,425
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-02-28$1,970,050
Total income from all sources (including contributions)2018-02-28$26,326,100
Total of all expenses incurred2018-02-28$26,766,636
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-02-28$25,778,442
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-02-28$26,326,100
Value of total assets at end of year2018-02-28$2,972,928
Value of total assets at beginning of year2018-02-28$2,555,089
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-02-28$988,194
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-02-28No
Was this plan covered by a fidelity bond2018-02-28Yes
Value of fidelity bond cover2018-02-28$1,000,000
If this is an individual account plan, was there a blackout period2018-02-28No
Were there any nonexempt tranactions with any party-in-interest2018-02-28No
Contributions received from participants2018-02-28$14,530,145
Participant contributions at end of year2018-02-28$519,980
Participant contributions at beginning of year2018-02-28$589,260
Administrative expenses (other) incurred2018-02-28$58
Liabilities. Value of operating payables at end of year2018-02-28$65,957
Total non interest bearing cash at end of year2018-02-28$2,693
Total non interest bearing cash at beginning of year2018-02-28$182,829
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Value of net income/loss2018-02-28$-440,536
Value of net assets at end of year (total assets less liabilities)2018-02-28$144,503
Value of net assets at beginning of year (total assets less liabilities)2018-02-28$585,039
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2018-02-28No
Were any leases to which the plan was party in default or uncollectible2018-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2018-02-28$1,499,376
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-02-28No
Was there a failure to transmit to the plan any participant contributions2018-02-28No
Has the plan failed to provide any benefit when due under the plan2018-02-28No
Contributions received in cash from employer2018-02-28$11,795,955
Employer contributions (assets) at end of year2018-02-28$2,450,255
Employer contributions (assets) at beginning of year2018-02-28$1,783,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-02-28$24,279,066
Contract administrator fees2018-02-28$988,136
Liabilities. Value of benefit claims payable at end of year2018-02-28$2,762,468
Liabilities. Value of benefit claims payable at beginning of year2018-02-28$1,970,050
Did the plan have assets held for investment2018-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-02-28No
Opinion of an independent qualified public accountant for this plan2018-02-28Unqualified
Accountancy firm name2018-02-28MADDOX & ASSOCIATES APC
Accountancy firm EIN2018-02-28721314069
2017 : PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-02-28$1,970,050
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-02-28$959,185
Total income from all sources (including contributions)2017-02-28$27,561,305
Total of all expenses incurred2017-02-28$27,776,892
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-02-28$26,610,074
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-02-28$27,561,305
Value of total assets at end of year2017-02-28$2,555,089
Value of total assets at beginning of year2017-02-28$1,759,811
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-02-28$1,166,818
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-02-28No
Was this plan covered by a fidelity bond2017-02-28Yes
Value of fidelity bond cover2017-02-28$1,000,000
If this is an individual account plan, was there a blackout period2017-02-28No
Were there any nonexempt tranactions with any party-in-interest2017-02-28No
Contributions received from participants2017-02-28$15,281,305
Participant contributions at end of year2017-02-28$589,260
Participant contributions at beginning of year2017-02-28$351,678
Administrative expenses (other) incurred2017-02-28$75,600
Total non interest bearing cash at end of year2017-02-28$182,829
Total non interest bearing cash at beginning of year2017-02-28$555,133
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Value of net income/loss2017-02-28$-215,587
Value of net assets at end of year (total assets less liabilities)2017-02-28$585,039
Value of net assets at beginning of year (total assets less liabilities)2017-02-28$800,626
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2017-02-28No
Were any leases to which the plan was party in default or uncollectible2017-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2017-02-28$1,886,684
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-02-28No
Was there a failure to transmit to the plan any participant contributions2017-02-28No
Has the plan failed to provide any benefit when due under the plan2017-02-28No
Contributions received in cash from employer2017-02-28$12,280,000
Employer contributions (assets) at end of year2017-02-28$1,783,000
Employer contributions (assets) at beginning of year2017-02-28$853,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-02-28$24,723,390
Contract administrator fees2017-02-28$1,091,218
Liabilities. Value of benefit claims payable at end of year2017-02-28$1,970,050
Liabilities. Value of benefit claims payable at beginning of year2017-02-28$959,185
Did the plan have assets held for investment2017-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-02-28No
Opinion of an independent qualified public accountant for this plan2017-02-28Unqualified
Accountancy firm name2017-02-28MADDOX & ASSOCIATES APC
Accountancy firm EIN2017-02-28721314069
2016 : PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-02-29$959,185
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-02-29$605,060
Total income from all sources (including contributions)2016-02-29$26,029,228
Total of all expenses incurred2016-02-29$26,111,857
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-02-29$24,956,316
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-02-29$26,029,228
Value of total assets at end of year2016-02-29$1,759,811
Value of total assets at beginning of year2016-02-29$1,488,315
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-02-29$1,155,541
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-02-29No
Was this plan covered by a fidelity bond2016-02-29Yes
Value of fidelity bond cover2016-02-29$1,000,000
If this is an individual account plan, was there a blackout period2016-02-29No
Were there any nonexempt tranactions with any party-in-interest2016-02-29No
Contributions received from participants2016-02-29$13,611,628
Participant contributions at end of year2016-02-29$351,678
Participant contributions at beginning of year2016-02-29$51,661
Administrative expenses (other) incurred2016-02-29$168,472
Total non interest bearing cash at end of year2016-02-29$555,133
Total non interest bearing cash at beginning of year2016-02-29$366,654
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-29No
Value of net income/loss2016-02-29$-82,629
Value of net assets at end of year (total assets less liabilities)2016-02-29$800,626
Value of net assets at beginning of year (total assets less liabilities)2016-02-29$883,255
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2016-02-29No
Were any leases to which the plan was party in default or uncollectible2016-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2016-02-29$1,721,895
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-02-29No
Was there a failure to transmit to the plan any participant contributions2016-02-29No
Has the plan failed to provide any benefit when due under the plan2016-02-29No
Contributions received in cash from employer2016-02-29$12,417,600
Employer contributions (assets) at end of year2016-02-29$853,000
Employer contributions (assets) at beginning of year2016-02-29$1,070,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-02-29$23,234,421
Contract administrator fees2016-02-29$987,069
Liabilities. Value of benefit claims payable at end of year2016-02-29$959,185
Liabilities. Value of benefit claims payable at beginning of year2016-02-29$605,060
Did the plan have assets held for investment2016-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-02-29No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-02-29No
Opinion of an independent qualified public accountant for this plan2016-02-29Unqualified
Accountancy firm name2016-02-29MADDOX & ASSOCIATES APC
Accountancy firm EIN2016-02-29721314069
2015 : PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-02-28$605,060
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-02-28$844,061
Total income from all sources (including contributions)2015-02-28$18,959,356
Total of all expenses incurred2015-02-28$18,212,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-02-28$16,943,516
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-02-28$18,959,356
Value of total assets at end of year2015-02-28$1,488,315
Value of total assets at beginning of year2015-02-28$980,226
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-02-28$1,268,750
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-02-28No
Was this plan covered by a fidelity bond2015-02-28Yes
Value of fidelity bond cover2015-02-28$1,000,000
If this is an individual account plan, was there a blackout period2015-02-28No
Were there any nonexempt tranactions with any party-in-interest2015-02-28No
Contributions received from participants2015-02-28$9,246,256
Participant contributions at end of year2015-02-28$51,661
Participant contributions at beginning of year2015-02-28$186,011
Administrative expenses (other) incurred2015-02-28$377,485
Total non interest bearing cash at end of year2015-02-28$366,654
Total non interest bearing cash at beginning of year2015-02-28$3,215
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-02-28No
Value of net income/loss2015-02-28$747,090
Value of net assets at end of year (total assets less liabilities)2015-02-28$883,255
Value of net assets at beginning of year (total assets less liabilities)2015-02-28$136,165
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2015-02-28No
Were any leases to which the plan was party in default or uncollectible2015-02-28No
Value of interest in common/collective trusts at end of year2015-02-28$0
Expenses. Payments to insurance carriers foe the provision of benefits2015-02-28$1,057,220
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-02-28No
Was there a failure to transmit to the plan any participant contributions2015-02-28No
Has the plan failed to provide any benefit when due under the plan2015-02-28No
Contributions received in cash from employer2015-02-28$9,713,100
Employer contributions (assets) at end of year2015-02-28$1,070,000
Employer contributions (assets) at beginning of year2015-02-28$791,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-02-28$15,886,296
Contract administrator fees2015-02-28$891,265
Liabilities. Value of benefit claims payable at end of year2015-02-28$605,060
Liabilities. Value of benefit claims payable at beginning of year2015-02-28$844,061
Did the plan have assets held for investment2015-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-02-28No
Opinion of an independent qualified public accountant for this plan2015-02-28Unqualified
Accountancy firm name2015-02-28MADDOX & ASSOCIATES APC
Accountancy firm EIN2015-02-28721314069
2012 : PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-02-29$466,485
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-02-29$523,202
Total income from all sources (including contributions)2012-02-29$10,268,322
Total of all expenses incurred2012-02-29$10,108,549
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-02-29$9,743,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-02-29$10,268,322
Value of total assets at end of year2012-02-29$819,397
Value of total assets at beginning of year2012-02-29$716,341
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-02-29$365,320
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-02-29No
Was this plan covered by a fidelity bond2012-02-29Yes
Value of fidelity bond cover2012-02-29$1,000,000
Were there any nonexempt tranactions with any party-in-interest2012-02-29No
Contributions received from participants2012-02-29$4,459,622
Participant contributions at end of year2012-02-29$98,136
Participant contributions at beginning of year2012-02-29$201,497
Administrative expenses (other) incurred2012-02-29$59,028
Total non interest bearing cash at end of year2012-02-29$3,261
Total non interest bearing cash at beginning of year2012-02-29$3,344
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-02-29No
Value of net income/loss2012-02-29$159,773
Value of net assets at end of year (total assets less liabilities)2012-02-29$352,912
Value of net assets at beginning of year (total assets less liabilities)2012-02-29$193,139
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2012-02-29No
Were any leases to which the plan was party in default or uncollectible2012-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2012-02-29$849,685
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-02-29No
Was there a failure to transmit to the plan any participant contributions2012-02-29No
Has the plan failed to provide any benefit when due under the plan2012-02-29No
Contributions received in cash from employer2012-02-29$5,808,700
Employer contributions (assets) at end of year2012-02-29$718,000
Employer contributions (assets) at beginning of year2012-02-29$511,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-02-29$8,893,544
Contract administrator fees2012-02-29$306,292
Liabilities. Value of benefit claims payable at end of year2012-02-29$466,485
Liabilities. Value of benefit claims payable at beginning of year2012-02-29$523,202
Did the plan have assets held for investment2012-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-02-29No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-02-29No
Opinion of an independent qualified public accountant for this plan2012-02-29Unqualified
Accountancy firm name2012-02-29DANIEL J. PRITCHARD CPA
Accountancy firm EIN2012-02-29721023586
2011 : PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-02-28$523,202
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-02-28$426,172
Total income from all sources (including contributions)2011-02-28$8,456,113
Total of all expenses incurred2011-02-28$8,341,896
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-02-28$7,973,365
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-02-28$8,456,113
Value of total assets at end of year2011-02-28$716,341
Value of total assets at beginning of year2011-02-28$505,094
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-02-28$368,531
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-02-28No
Was this plan covered by a fidelity bond2011-02-28Yes
Value of fidelity bond cover2011-02-28$1,000,000
Were there any nonexempt tranactions with any party-in-interest2011-02-28No
Contributions received from participants2011-02-28$4,057,950
Participant contributions at end of year2011-02-28$201,497
Participant contributions at beginning of year2011-02-28$118,428
Administrative expenses (other) incurred2011-02-28$55,313
Total non interest bearing cash at end of year2011-02-28$3,344
Total non interest bearing cash at beginning of year2011-02-28$1,409
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Value of net income/loss2011-02-28$114,217
Value of net assets at end of year (total assets less liabilities)2011-02-28$193,139
Value of net assets at beginning of year (total assets less liabilities)2011-02-28$78,922
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2011-02-28No
Were any leases to which the plan was party in default or uncollectible2011-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2011-02-28$797,677
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-02-28No
Was there a failure to transmit to the plan any participant contributions2011-02-28No
Has the plan failed to provide any benefit when due under the plan2011-02-28No
Contributions received in cash from employer2011-02-28$4,398,163
Employer contributions (assets) at end of year2011-02-28$511,500
Employer contributions (assets) at beginning of year2011-02-28$385,257
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-02-28$7,175,688
Contract administrator fees2011-02-28$313,218
Liabilities. Value of benefit claims payable at end of year2011-02-28$523,202
Liabilities. Value of benefit claims payable at beginning of year2011-02-28$426,172
Did the plan have assets held for investment2011-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-02-28No
Opinion of an independent qualified public accountant for this plan2011-02-28Unqualified
Accountancy firm name2011-02-28DANIEL J. PRITCHARD CPA
Accountancy firm EIN2011-02-28721023586

Form 5500 Responses for PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST

2019: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01This submission is the final filingYes
2019-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-03-01Plan funding arrangement – TrustYes
2019-03-01Plan funding arrangement – General assets of the sponsorYes
2019-03-01Plan benefit arrangement – InsuranceYes
2019-03-01Plan benefit arrangement - TrustYes
2019-03-01Plan benefit arrangement – General assets of the sponsorYes
2018: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – TrustYes
2018-03-01Plan funding arrangement – General assets of the sponsorYes
2018-03-01Plan benefit arrangement – InsuranceYes
2018-03-01Plan benefit arrangement - TrustYes
2018-03-01Plan benefit arrangement – General assets of the sponsorYes
2017: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Plan funding arrangement – TrustYes
2017-03-01Plan benefit arrangement – InsuranceYes
2017-03-01Plan benefit arrangement - TrustYes
2017-03-01Plan benefit arrangement – General assets of the sponsorYes
2016: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Plan funding arrangement – TrustYes
2016-03-01Plan benefit arrangement – InsuranceYes
2016-03-01Plan benefit arrangement - TrustYes
2016-03-01Plan benefit arrangement – General assets of the sponsorYes
2015: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01Plan funding arrangement – TrustYes
2015-03-01Plan benefit arrangement – InsuranceYes
2015-03-01Plan benefit arrangement - TrustYes
2015-03-01Plan benefit arrangement – General assets of the sponsorYes
2014: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Plan funding arrangement – TrustYes
2014-03-01Plan benefit arrangement – InsuranceYes
2014-03-01Plan benefit arrangement - TrustYes
2014-03-01Plan benefit arrangement – General assets of the sponsorYes
2011: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Plan funding arrangement – TrustYes
2011-03-01Plan benefit arrangement – InsuranceYes
2011-03-01Plan benefit arrangement - TrustYes
2011-03-01Plan benefit arrangement – General assets of the sponsorYes
2009: PERFORMANCE CONTRACTORS, INC HEALTH BENEFIT TRUST 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Plan funding arrangement – TrustYes
2009-03-01Plan benefit arrangement – InsuranceYes
2009-03-01Plan benefit arrangement - TrustYes
2009-03-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78F59ERC
Policy instance 1
Insurance contract or identification number78F59ERC
Insurance policy start date2019-03-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $160,216
Total amount of fees paid to insurance companyUSD $54,181
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,062,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $160,216
Amount paid for insurance broker fees54181
Additional information about fees paid to insurance brokerBLUE CROSS QUARTERLY BONUS PROGRAM
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0944J
Policy instance 2
Insurance contract or identification numberGLUG0944J
Insurance policy start date2019-03-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $12,399
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,539
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0944J
Policy instance 3
Insurance contract or identification numberGVTL0944J
Insurance policy start date2019-03-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $37,841
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $189,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,165
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number93378
Policy instance 4
Insurance contract or identification number93378
Insurance policy start date2019-03-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,970
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,532
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0200366
Policy instance 5
Insurance contract or identification number0200366
Insurance policy start date2019-03-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $15,891
Total amount of fees paid to insurance companyUSD $1,848
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $178,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,891
Amount paid for insurance broker fees1848
Additional information about fees paid to insurance brokerNON-MONETARY COMP SUPP COMP/MARKETING FEES
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number15472
Policy instance 6
Insurance contract or identification number15472
Insurance policy start date2019-03-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $119,166
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,191,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $119,166
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78F59ERC
Policy instance 1
Insurance contract or identification number78F59ERC
Number of Individuals Covered2474
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $261,190
Total amount of fees paid to insurance companyUSD $54,251
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,654,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $261,190
Amount paid for insurance broker fees54251
Additional information about fees paid to insurance brokerBLUE CROSS QUARTERLY BONUS PROGRAM
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0944J
Policy instance 2
Insurance contract or identification numberGLUG0944J
Number of Individuals Covered3632
Insurance policy start date2017-10-01
Insurance policy end date2018-10-01
Total amount of commissions paid to insurance brokerUSD $39,958
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $195,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,958
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0944J
Policy instance 3
Insurance contract or identification numberGVTL0944J
Number of Individuals Covered226
Insurance policy start date2017-10-01
Insurance policy end date2018-10-01
Total amount of commissions paid to insurance brokerUSD $36,910
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $184,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,910
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0944J
Policy instance 4
Insurance contract or identification numberGLTD0944J
Number of Individuals Covered807
Insurance policy start date2017-10-01
Insurance policy end date2018-10-01
Total amount of commissions paid to insurance brokerUSD $37,537
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $187,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,537
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0200366
Policy instance 5
Insurance contract or identification number0200366
Number of Individuals Covered3099
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $19,449
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $211,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,449
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG944J
Policy instance 2
Insurance contract or identification numberGLUG944J
Number of Individuals Covered2007
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $20,740
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,629
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFIT ADMINISTRATORS IN
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78F59ERC
Policy instance 1
Insurance contract or identification number78F59ERC
Number of Individuals Covered2049
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $250,606
Total amount of fees paid to insurance companyUSD $59,835
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,645,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $250,606
Amount paid for insurance broker fees59835
Additional information about fees paid to insurance brokerBLUE CROSS QUARTERLY BONUS PROGRAM
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78F59ERC
Policy instance 1
Insurance contract or identification number78F59ERC
Number of Individuals Covered2938
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $269,194
Total amount of fees paid to insurance companyUSD $47,072
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,609,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $269,194
Amount paid for insurance broker fees47072
Additional information about fees paid to insurance brokerBLUE CROSS QUARTERLY BONUS PROGRAM
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG944J
Policy instance 2
Insurance contract or identification numberGLUG944J
Number of Individuals Covered2855
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $22,469
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,099
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFIT ADMINISTRATORS IN
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG944J
Policy instance 2
Insurance contract or identification numberGLUG944J
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $16,353
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,956
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFIT ADMINISTRATORS IN
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number402123A
Policy instance 1
Insurance contract or identification number402123A
Number of Individuals Covered2084
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $146,752
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $974,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $130,131
Insurance broker organization code?3
Insurance broker nameRAWLS INSURANCE SERVICES
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract numberIAT-AF0073
Policy instance 1
Insurance contract or identification numberIAT-AF0073
Number of Individuals Covered283
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $54,590
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $362,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG944J AGNZ
Policy instance 2
Insurance contract or identification numberGLUG944J AGNZ
Number of Individuals Covered844
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $12,333
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number402123A
Policy instance 3
Insurance contract or identification number402123A
Number of Individuals Covered561
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $434,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number402123A
Policy instance 3
Insurance contract or identification number402123A
Number of Individuals Covered874
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $411,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberIAT-AF0073
Policy instance 1
Insurance contract or identification numberIAT-AF0073
Number of Individuals Covered217
Insurance policy start date2010-07-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $50,169
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $334,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG944J AGNZ
Policy instance 2
Insurance contract or identification numberGLUG944J AGNZ
Number of Individuals Covered1091
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $12,417
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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