ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST
401k plan membership statisitcs for ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST
| Measure | Date | Value |
|---|
| 2016 : ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST 2016 401k financial data |
|---|
| Transfers to/from the plan | 2016-09-30 | $-126,625 |
| Total plan liabilities at beginning of year | 2016-09-30 | $3,695 |
| Total plan assets at end of year | 2016-09-30 | $0 |
| Total plan assets at beginning of year | 2016-09-30 | $130,320 |
| Net plan assets at end of year (total assets less liabilities) | 2016-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-09-30 | $126,625 |
| 2015 : ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-09-30 | $3,695 |
| Total plan liabilities at beginning of year | 2015-09-30 | $41,316 |
| Total income from all sources | 2015-09-30 | $305,616 |
| Expenses. Total of all expenses incurred | 2015-09-30 | $351,953 |
| Benefits paid (including direct rollovers) | 2015-09-30 | $327,164 |
| Total plan assets at end of year | 2015-09-30 | $130,320 |
| Total plan assets at beginning of year | 2015-09-30 | $214,278 |
| Expenses. Other expenses not covered elsewhere | 2015-09-30 | $4,276 |
| Net income (gross income less expenses) | 2015-09-30 | $-46,337 |
| Net plan assets at end of year (total assets less liabilities) | 2015-09-30 | $126,625 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-09-30 | $172,962 |
| Total contributions received or receivable from employer(s) | 2015-09-30 | $305,616 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-09-30 | $20,513 |
| 2014 : ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-09-30 | $41,316 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-09-30 | $21,900 |
| Total income from all sources (including contributions) | 2014-09-30 | $2,833,379 |
| Total of all expenses incurred | 2014-09-30 | $2,925,063 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-09-30 | $2,696,842 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-09-30 | $2,750,632 |
| Value of total assets at end of year | 2014-09-30 | $214,278 |
| Value of total assets at beginning of year | 2014-09-30 | $286,546 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-09-30 | $228,221 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-09-30 | No |
| Was this plan covered by a fidelity bond | 2014-09-30 | Yes |
| Value of fidelity bond cover | 2014-09-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2014-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-09-30 | No |
| Contributions received from participants | 2014-09-30 | $1,375,249 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-09-30 | $51,798 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-09-30 | $286,546 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-09-30 | $2,997 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-09-30 | $67 |
| Other income not declared elsewhere | 2014-09-30 | $82,747 |
| Administrative expenses (other) incurred | 2014-09-30 | $80,425 |
| Total non interest bearing cash at end of year | 2014-09-30 | $162,480 |
| Total non interest bearing cash at beginning of year | 2014-09-30 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-09-30 | No |
| Value of net income/loss | 2014-09-30 | $-91,684 |
| Value of net assets at end of year (total assets less liabilities) | 2014-09-30 | $172,962 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-09-30 | $264,646 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-09-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-09-30 | $819,207 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-09-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-09-30 | No |
| Contributions received in cash from employer | 2014-09-30 | $1,375,383 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-09-30 | $1,877,635 |
| Contract administrator fees | 2014-09-30 | $147,796 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-09-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2014-09-30 | $38,319 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-09-30 | $21,833 |
| Did the plan have assets held for investment | 2014-09-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-09-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-09-30 | Unqualified |
| Accountancy firm name | 2014-09-30 | BROUSSARD & COMPANY CPA'S, LLC |
| Accountancy firm EIN | 2014-09-30 | 721447940 |
| 2013 : ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-09-30 | $21,900 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-09-30 | $46,966 |
| Total income from all sources (including contributions) | 2013-09-30 | $3,359,740 |
| Total of all expenses incurred | 2013-09-30 | $3,622,667 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-09-30 | $3,440,802 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-09-30 | $2,813,289 |
| Value of total assets at end of year | 2013-09-30 | $286,546 |
| Value of total assets at beginning of year | 2013-09-30 | $574,539 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-09-30 | $181,865 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-09-30 | No |
| Was this plan covered by a fidelity bond | 2013-09-30 | Yes |
| Value of fidelity bond cover | 2013-09-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2013-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-09-30 | No |
| Contributions received from participants | 2013-09-30 | $1,265,604 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-09-30 | $286,546 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-09-30 | $16,922 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-09-30 | $67 |
| Other income not declared elsewhere | 2013-09-30 | $546,451 |
| Administrative expenses (other) incurred | 2013-09-30 | $16,942 |
| Total non interest bearing cash at end of year | 2013-09-30 | $0 |
| Total non interest bearing cash at beginning of year | 2013-09-30 | $557,617 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-09-30 | No |
| Value of net income/loss | 2013-09-30 | $-262,927 |
| Value of net assets at end of year (total assets less liabilities) | 2013-09-30 | $264,646 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-09-30 | $527,573 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-09-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-09-30 | $599,211 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-09-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-09-30 | No |
| Contributions received in cash from employer | 2013-09-30 | $1,547,685 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-09-30 | $2,841,591 |
| Contract administrator fees | 2013-09-30 | $164,923 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-09-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2013-09-30 | $21,833 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-09-30 | $46,966 |
| Did the plan have assets held for investment | 2013-09-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-09-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-09-30 | Unqualified |
| Accountancy firm name | 2013-09-30 | BROUSSARD & COMPANY CPA'S, LLC |
| Accountancy firm EIN | 2013-09-30 | 721447940 |
| 2012 : ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-09-30 | $46,966 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-09-30 | $37,087 |
| Total income from all sources (including contributions) | 2012-09-30 | $2,623,257 |
| Total of all expenses incurred | 2012-09-30 | $2,647,330 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-09-30 | $2,489,777 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-09-30 | $2,230,303 |
| Value of total assets at end of year | 2012-09-30 | $574,539 |
| Value of total assets at beginning of year | 2012-09-30 | $588,733 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-09-30 | $157,553 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-09-30 | No |
| Was this plan covered by a fidelity bond | 2012-09-30 | Yes |
| Value of fidelity bond cover | 2012-09-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-09-30 | No |
| Contributions received from participants | 2012-09-30 | $861,087 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-09-30 | $16,922 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-09-30 | $40 |
| Other income not declared elsewhere | 2012-09-30 | $392,954 |
| Administrative expenses (other) incurred | 2012-09-30 | $12,189 |
| Total non interest bearing cash at end of year | 2012-09-30 | $557,617 |
| Total non interest bearing cash at beginning of year | 2012-09-30 | $588,693 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-09-30 | No |
| Value of net income/loss | 2012-09-30 | $-24,073 |
| Value of net assets at end of year (total assets less liabilities) | 2012-09-30 | $527,573 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-09-30 | $551,646 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-09-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-09-30 | $415,131 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-09-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-09-30 | No |
| Contributions received in cash from employer | 2012-09-30 | $1,369,216 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-09-30 | $2,074,646 |
| Contract administrator fees | 2012-09-30 | $145,364 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-09-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2012-09-30 | $46,966 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-09-30 | $37,087 |
| Did the plan have assets held for investment | 2012-09-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-09-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-09-30 | Unqualified |
| Accountancy firm name | 2012-09-30 | BROUSSARD & COMPANY CPA'S, LLC |
| Accountancy firm EIN | 2012-09-30 | 721447940 |
| 2011 : ALL STAR DEALERSHIPS EMPLOYEE BENEFIT PLAN & TRUST 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-09-30 | $37,087 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-09-30 | $41,490 |
| Total income from all sources (including contributions) | 2011-09-30 | $2,176,435 |
| Total of all expenses incurred | 2011-09-30 | $1,998,775 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-09-30 | $1,854,986 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-09-30 | $2,176,435 |
| Value of total assets at end of year | 2011-09-30 | $588,733 |
| Value of total assets at beginning of year | 2011-09-30 | $415,476 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-09-30 | $143,789 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-09-30 | No |
| Was this plan covered by a fidelity bond | 2011-09-30 | Yes |
| Value of fidelity bond cover | 2011-09-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-09-30 | No |
| Contributions received from participants | 2011-09-30 | $960,815 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-09-30 | $40 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-09-30 | $5,532 |
| Administrative expenses (other) incurred | 2011-09-30 | $11,700 |
| Total non interest bearing cash at end of year | 2011-09-30 | $588,693 |
| Total non interest bearing cash at beginning of year | 2011-09-30 | $409,944 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-09-30 | No |
| Value of net income/loss | 2011-09-30 | $177,660 |
| Value of net assets at end of year (total assets less liabilities) | 2011-09-30 | $551,646 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-09-30 | $373,986 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-09-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-09-30 | $398,396 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-09-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-09-30 | No |
| Contributions received in cash from employer | 2011-09-30 | $1,215,620 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-09-30 | $1,456,590 |
| Contract administrator fees | 2011-09-30 | $132,089 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-09-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2011-09-30 | $37,087 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-09-30 | $41,490 |
| Did the plan have assets held for investment | 2011-09-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-09-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-09-30 | Unqualified |
| Accountancy firm name | 2011-09-30 | BROUSSARD AND COMPANY CPAS, LLC |
| Accountancy firm EIN | 2011-09-30 | 721447940 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 8 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $30,396 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SPOUSE LIFE, DEP LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $258,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,396 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $13,300 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $66,443 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,300 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| IPROCERT (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $1,669 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | PRECERTIFICATION | | Welfare Benefit Premiums Paid to Carrier | USD $8,896 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,669 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| IHEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 4 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $6,613 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | HEALTH CARE SUPPORT SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $18,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,613 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| WORLDDOC, INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 5 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $1,199 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | HEALTH DECISION SUPPORT SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $2,998 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,199 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 6 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $4,400 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $29,685 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,400 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| ACTIVENET (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 7 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $1,190 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $2,210 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,190 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 9 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $11,751 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | CANCER & GAP COVERAGE | | Welfare Benefit Premiums Paid to Carrier | USD $41,911 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,751 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| VERITY HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 10 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $2,210 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $22,095 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,210 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 339 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $54,740 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | COMPLIANCE | | Welfare Benefit Premiums Paid to Carrier | USD $364,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $54,740 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $15,876 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D, SPOUSE LIFE, DEP LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $79,305 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,876 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 9 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $3,808 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | CANCER & GAP COVERAGE | | Welfare Benefit Premiums Paid to Carrier | USD $21,717 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,808 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $47,805 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | COMPLIANCE | | Welfare Benefit Premiums Paid to Carrier | USD $318,858 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,805 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| IPROCERT (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $2,497 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | PRECERTIFICATION | | Welfare Benefit Premiums Paid to Carrier | USD $12,031 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,497 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| IHEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 4 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $6,810 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | HEALTH CARE SUPPORT SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $24,970 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,810 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| WORLDDOC, INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 5 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $1,816 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | HEALTH DECISION SUPPORT SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $4,540 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,816 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 6 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $4,540 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $27,239 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,540 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 8 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $8,501 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $108,237 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,501 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| ACTIVENET (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 7 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 368 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $1,246 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $2,314 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,246 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 6 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 340 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $4,257 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $24,479 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WORLDDOC, INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 5 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 340 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $1,703 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | HEALTH DECISION SUPPORT SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $4,257 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| IHEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 4 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 340 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $6,386 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | HEALTH CARE SUPPORT SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $23,414 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| IPROCERT (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 340 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $2,341 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | PRECERTIFICATION | | Welfare Benefit Premiums Paid to Carrier | USD $11,281 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 340 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $15,240 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD AND D | | Welfare Benefit Premiums Paid to Carrier | USD $76,214 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 340 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $41,264 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | COMPLIANCE | | Welfare Benefit Premiums Paid to Carrier | USD $274,927 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ACTIVENET (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 7 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 340 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $301 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $559 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 6 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 333 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $4,067 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $21,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WORLDDOC, INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 5 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 333 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $1,627 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | HEALTH DECISION SUPPORT SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $4,067 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| IHEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 4 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 333 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $6,101 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | HEALTH CARE SUPPORT SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $22,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 333 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $14,964 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD AND D | | Welfare Benefit Premiums Paid to Carrier | USD $74,820 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 ) |
| Policy contract number | PX00729 |
| Policy instance | 1 |
| Insurance contract or identification number | PX00729 | | Number of Individuals Covered | 333 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $39,749 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | COMPLIANCE | | Welfare Benefit Premiums Paid to Carrier | USD $265,011 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| IPROCERT (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 333 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $2,237 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | PRECERTIFICATION | | Welfare Benefit Premiums Paid to Carrier | USD $10,778 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
