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MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 401k Plan overview

Plan NameMCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN
Plan identification number 501

MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

MCELROY MANUFACTURING, INC. has sponsored the creation of one or more 401k plans.

Company Name:MCELROY MANUFACTURING, INC.
Employer identification number (EIN):730722906
NAIC Classification:333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-09-01DONNA M. DUTTON2023-04-04 DONNA M. DUTTON2023-04-04
5012020-09-01
5012019-09-01
5012018-09-01
5012018-08-01HOGANTAYLOR LLP PREPARER
5012017-08-01HOGANTAYLOR LLP PREPARER
5012016-08-01HOGANTAYLOR LLP PREPARER
5012015-08-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2017-01-30
5012014-08-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2016-02-26
5012013-08-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2015-03-02
5012012-08-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2014-02-28
5012011-08-01JACK LAUBACH
5012010-08-01JACK LAUBACH
5012009-08-01JACK LAUBACH

Plan Statistics for MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN

401k plan membership statisitcs for MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN

Measure Date Value
2021: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01334
Total number of active participants reported on line 7a of the Form 55002021-09-01403
Number of retired or separated participants receiving benefits2021-09-012
Total of all active and inactive participants2021-09-01405
2020: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01339
Total number of active participants reported on line 7a of the Form 55002020-09-01324
Number of retired or separated participants receiving benefits2020-09-011
Total of all active and inactive participants2020-09-01325
2019: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01382
Total number of active participants reported on line 7a of the Form 55002019-09-01337
Number of retired or separated participants receiving benefits2019-09-011
Total of all active and inactive participants2019-09-01338
2018: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01315
Total number of active participants reported on line 7a of the Form 55002018-09-01380
Number of retired or separated participants receiving benefits2018-09-012
Total of all active and inactive participants2018-09-01382
Total participants, beginning-of-year2018-08-01309
Total number of active participants reported on line 7a of the Form 55002018-08-01307
Number of retired or separated participants receiving benefits2018-08-012
Total of all active and inactive participants2018-08-01309
2017: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01302
Total number of active participants reported on line 7a of the Form 55002017-08-01307
Number of retired or separated participants receiving benefits2017-08-012
Total of all active and inactive participants2017-08-01309
Total participants2017-08-01309
2016: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01345
Total number of active participants reported on line 7a of the Form 55002016-08-01293
Number of retired or separated participants receiving benefits2016-08-016
Total of all active and inactive participants2016-08-01299
Total participants2016-08-01299
2015: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01360
Total number of active participants reported on line 7a of the Form 55002015-08-01342
Number of retired or separated participants receiving benefits2015-08-015
Total of all active and inactive participants2015-08-01347
Total participants2015-08-01347
2014: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01378
Total number of active participants reported on line 7a of the Form 55002014-08-01358
Number of retired or separated participants receiving benefits2014-08-012
Total of all active and inactive participants2014-08-01360
Total participants2014-08-01360
2013: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01362
Total number of active participants reported on line 7a of the Form 55002013-08-01396
Number of retired or separated participants receiving benefits2013-08-014
Total of all active and inactive participants2013-08-01400
Total participants2013-08-01400
2012: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01322
Total number of active participants reported on line 7a of the Form 55002012-08-01362
Total of all active and inactive participants2012-08-01362
Total participants2012-08-01362
2011: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01256
Total number of active participants reported on line 7a of the Form 55002011-08-01322
Total of all active and inactive participants2011-08-01322
Total participants2011-08-01322
2010: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01171
Total number of active participants reported on line 7a of the Form 55002010-08-01255
Number of retired or separated participants receiving benefits2010-08-011
Total of all active and inactive participants2010-08-01256
Total participants2010-08-01256
2009: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01246
Total number of active participants reported on line 7a of the Form 55002009-08-01156
Number of retired or separated participants receiving benefits2009-08-0110
Number of other retired or separated participants entitled to future benefits2009-08-015
Total of all active and inactive participants2009-08-01171
Total participants2009-08-01171

Financial Data on MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN

Measure Date Value
2014 : MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-07-31$8,408
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-07-31$13,514
Total income from all sources (including contributions)2014-07-31$2,305,822
Total of all expenses incurred2014-07-31$2,321,121
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-07-31$2,308,901
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-07-31$2,305,822
Value of total assets at end of year2014-07-31$28,379
Value of total assets at beginning of year2014-07-31$48,784
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-07-31$12,220
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-07-31No
Was this plan covered by a fidelity bond2014-07-31Yes
Value of fidelity bond cover2014-07-31$1,000,000
If this is an individual account plan, was there a blackout period2014-07-31No
Were there any nonexempt tranactions with any party-in-interest2014-07-31No
Contributions received from participants2014-07-31$924,475
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-07-31$22,626
Liabilities. Value of operating payables at end of year2014-07-31$1,303
Liabilities. Value of operating payables at beginning of year2014-07-31$8,098
Total non interest bearing cash at end of year2014-07-31$28,379
Total non interest bearing cash at beginning of year2014-07-31$26,158
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-07-31No
Value of net income/loss2014-07-31$-15,299
Value of net assets at end of year (total assets less liabilities)2014-07-31$19,971
Value of net assets at beginning of year (total assets less liabilities)2014-07-31$35,270
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-07-31No
Were any leases to which the plan was party in default or uncollectible2014-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-07-31$2,187,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-07-31No
Was there a failure to transmit to the plan any participant contributions2014-07-31No
Has the plan failed to provide any benefit when due under the plan2014-07-31No
Contributions received in cash from employer2014-07-31$1,381,347
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-07-31$121,070
Contract administrator fees2014-07-31$12,220
Liabilities. Value of benefit claims payable at end of year2014-07-31$7,105
Liabilities. Value of benefit claims payable at beginning of year2014-07-31$5,416
Did the plan have assets held for investment2014-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-07-31No
Opinion of an independent qualified public accountant for this plan2014-07-31Unqualified
Accountancy firm name2014-07-31HOGANTAYLOR LLP
Accountancy firm EIN2014-07-31731413977
2013 : MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-07-31$13,514
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-07-31$11,962
Total income from all sources (including contributions)2013-07-31$2,343,240
Total of all expenses incurred2013-07-31$2,339,367
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-07-31$2,323,882
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-07-31$2,343,240
Value of total assets at end of year2013-07-31$48,784
Value of total assets at beginning of year2013-07-31$43,359
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-07-31$15,485
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-07-31No
Was this plan covered by a fidelity bond2013-07-31Yes
Value of fidelity bond cover2013-07-31$1,000,000
If this is an individual account plan, was there a blackout period2013-07-31No
Were there any nonexempt tranactions with any party-in-interest2013-07-31No
Contributions received from participants2013-07-31$881,673
Participant contributions at beginning of year2013-07-31$11,603
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-07-31$22,626
Liabilities. Value of operating payables at end of year2013-07-31$8,098
Liabilities. Value of operating payables at beginning of year2013-07-31$11,962
Total non interest bearing cash at end of year2013-07-31$26,158
Total non interest bearing cash at beginning of year2013-07-31$10,296
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-07-31No
Value of net income/loss2013-07-31$3,873
Value of net assets at end of year (total assets less liabilities)2013-07-31$35,270
Value of net assets at beginning of year (total assets less liabilities)2013-07-31$31,397
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-07-31No
Were any leases to which the plan was party in default or uncollectible2013-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-07-31$2,191,246
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-07-31No
Was there a failure to transmit to the plan any participant contributions2013-07-31No
Has the plan failed to provide any benefit when due under the plan2013-07-31No
Contributions received in cash from employer2013-07-31$1,461,567
Employer contributions (assets) at beginning of year2013-07-31$21,460
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-07-31$132,636
Contract administrator fees2013-07-31$15,485
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-07-31No
Liabilities. Value of benefit claims payable at end of year2013-07-31$5,416
Did the plan have assets held for investment2013-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-07-31No
Opinion of an independent qualified public accountant for this plan2013-07-31Unqualified
Accountancy firm name2013-07-31HOGANTAYLOR LLP
Accountancy firm EIN2013-07-31731413977
2012 : MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-07-31$11,962
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-07-31$13,746
Total income from all sources (including contributions)2012-07-31$2,214,321
Total of all expenses incurred2012-07-31$2,192,055
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-07-31$2,172,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-07-31$2,214,321
Value of total assets at end of year2012-07-31$43,359
Value of total assets at beginning of year2012-07-31$22,877
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-07-31$19,748
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-07-31No
Was this plan covered by a fidelity bond2012-07-31No
Were there any nonexempt tranactions with any party-in-interest2012-07-31No
Contributions received from participants2012-07-31$896,996
Participant contributions at end of year2012-07-31$11,603
Participant contributions at beginning of year2012-07-31$9,523
Income. Received or receivable in cash from other sources (including rollovers)2012-07-31$6,150
Administrative expenses (other) incurred2012-07-31$19,748
Liabilities. Value of operating payables at end of year2012-07-31$11,962
Liabilities. Value of operating payables at beginning of year2012-07-31$9,994
Total non interest bearing cash at end of year2012-07-31$10,296
Total non interest bearing cash at beginning of year2012-07-31$3,733
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-07-31No
Value of net income/loss2012-07-31$22,266
Value of net assets at end of year (total assets less liabilities)2012-07-31$31,397
Value of net assets at beginning of year (total assets less liabilities)2012-07-31$9,131
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-07-31No
Were any leases to which the plan was party in default or uncollectible2012-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-07-31$1,747,358
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-07-31No
Was there a failure to transmit to the plan any participant contributions2012-07-31No
Has the plan failed to provide any benefit when due under the plan2012-07-31No
Contributions received in cash from employer2012-07-31$1,311,175
Employer contributions (assets) at end of year2012-07-31$21,460
Employer contributions (assets) at beginning of year2012-07-31$9,621
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-07-31$424,949
Liabilities. Value of benefit claims payable at end of year2012-07-31$0
Liabilities. Value of benefit claims payable at beginning of year2012-07-31$3,752
Did the plan have assets held for investment2012-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-07-31No
Opinion of an independent qualified public accountant for this plan2012-07-31Unqualified
Accountancy firm name2012-07-31GRANT THORNTON, LLP
Accountancy firm EIN2012-07-31366055558
2011 : MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-07-31$13,746
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-07-31$40,640
Total income from all sources (including contributions)2011-07-31$1,956,378
Total of all expenses incurred2011-07-31$1,954,991
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-07-31$1,937,535
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-07-31$1,956,378
Value of total assets at end of year2011-07-31$22,877
Value of total assets at beginning of year2011-07-31$48,384
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-07-31$17,456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-07-31No
Was this plan covered by a fidelity bond2011-07-31No
Were there any nonexempt tranactions with any party-in-interest2011-07-31No
Contributions received from participants2011-07-31$804,428
Participant contributions at end of year2011-07-31$9,523
Participant contributions at beginning of year2011-07-31$17,375
Income. Received or receivable in cash from other sources (including rollovers)2011-07-31$37,320
Administrative expenses (other) incurred2011-07-31$17,456
Liabilities. Value of operating payables at end of year2011-07-31$9,994
Liabilities. Value of operating payables at beginning of year2011-07-31$33,513
Total non interest bearing cash at end of year2011-07-31$3,733
Total non interest bearing cash at beginning of year2011-07-31$26,711
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-07-31No
Value of net income/loss2011-07-31$1,387
Value of net assets at end of year (total assets less liabilities)2011-07-31$9,131
Value of net assets at beginning of year (total assets less liabilities)2011-07-31$7,744
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-07-31No
Were any leases to which the plan was party in default or uncollectible2011-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-07-31$1,570,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-07-31No
Was there a failure to transmit to the plan any participant contributions2011-07-31No
Has the plan failed to provide any benefit when due under the plan2011-07-31No
Contributions received in cash from employer2011-07-31$1,114,630
Employer contributions (assets) at end of year2011-07-31$9,621
Employer contributions (assets) at beginning of year2011-07-31$4,298
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-07-31$367,347
Liabilities. Value of benefit claims payable at end of year2011-07-31$3,752
Liabilities. Value of benefit claims payable at beginning of year2011-07-31$7,127
Did the plan have assets held for investment2011-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-07-31No
Opinion of an independent qualified public accountant for this plan2011-07-31Unqualified
Accountancy firm name2011-07-31GRANT THORNTON, LLP
Accountancy firm EIN2011-07-31366055558

Form 5500 Responses for MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN

2021: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-08-01Type of plan entitySingle employer plan
2018-08-01Submission has been amendedNo
2018-08-01This submission is the final filingNo
2018-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-08-01Plan is a collectively bargained planNo
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – InsuranceYes
2017: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Submission has been amendedNo
2017-08-01This submission is the final filingNo
2017-08-01This return/report is a short plan year return/report (less than 12 months)No
2017-08-01Plan is a collectively bargained planNo
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – General assets of the sponsorYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – General assets of the sponsorYes
2015: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – General assets of the sponsorYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – General assets of the sponsorYes
2014: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – General assets of the sponsorYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – General assets of the sponsorYes
2013: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – General assets of the sponsorYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – General assets of the sponsorYes
2012: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – General assets of the sponsorYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – General assets of the sponsorYes
2011: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – General assets of the sponsorYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – General assets of the sponsorYes
2010: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan funding arrangement – General assets of the sponsorYes
2010-08-01Plan benefit arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – General assets of the sponsorYes
2009: MCELROY MANUFACTURING, INC. WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan funding arrangement – General assets of the sponsorYes
2009-08-01Plan benefit arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0284114
Policy instance 4
Insurance contract or identification number0284114
Number of Individuals Covered577
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $2,065
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,065
Insurance broker organization code?3
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number12216
Policy instance 3
Insurance contract or identification number12216
Number of Individuals Covered310
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $19,766
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,766
Insurance broker organization code?3
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09401
Policy instance 2
Insurance contract or identification numberC09401
Number of Individuals Covered585
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of fees paid to insurance companyUSD $99,008
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $2,066,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees99008
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 1
Insurance contract or identification numberVDT960296
Number of Individuals Covered405
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $15,192
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $224,171
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,192
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 4
Insurance contract or identification numberVDT960296
Number of Individuals Covered324
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $29,878
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $214,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,878
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0284114
Policy instance 3
Insurance contract or identification number0284114
Number of Individuals Covered463
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $1,805
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,171
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,805
Insurance broker organization code?3
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09401
Policy instance 1
Insurance contract or identification numberC09401
Number of Individuals Covered501
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of fees paid to insurance companyUSD $86,604
Health Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $1,767,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees86604
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3342939
Policy instance 2
Insurance contract or identification number3342939
Number of Individuals Covered265
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $16,729
Total amount of fees paid to insurance companyUSD $1,459
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $169,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,729
Amount paid for insurance broker fees1459
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 1
Insurance contract or identification numberVDT960296
Number of Individuals Covered337
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $26,486
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $176,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,486
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3342939
Policy instance 4
Insurance contract or identification number3342939
Number of Individuals Covered271
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $16,355
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $165,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,355
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0284114
Policy instance 2
Insurance contract or identification number0284114
Number of Individuals Covered459
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $1,882
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,882
Insurance broker organization code?3
COMMUNITY CARE (National Association of Insurance Commissioners NAIC id number: 1001 )
Policy contract numberC09401
Policy instance 3
Insurance contract or identification numberC09401
Number of Individuals Covered505
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $84,980
Health Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,783,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $84,980
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 4
Insurance contract or identification numberVDT960296
Number of Individuals Covered539
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $25,254
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $168,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,254
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number915157
Policy instance 2
Insurance contract or identification number915157
Number of Individuals Covered510
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of fees paid to insurance companyUSD $96,741
Health Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,025,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees96741
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number0012216
Policy instance 1
Insurance contract or identification number0012216
Number of Individuals Covered245
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,358
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,358
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0284114
Policy instance 3
Insurance contract or identification number0284114
Number of Individuals Covered437
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $2,762
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,762
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0284114
Policy instance 1
Insurance contract or identification number0284114
Number of Individuals Covered448
Insurance policy start date2018-08-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $1,271
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $145,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,271
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 2
Insurance contract or identification numberVDT960296
Number of Individuals Covered444
Insurance policy start date2018-08-01
Insurance policy end date2018-08-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $13,192
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 numberVDT960296
Policy instance 2
Insurance contract or identification numberVDT960296
Number of Individuals Covered442
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $23,523
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $156,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0284114
Policy instance 1
Insurance contract or identification number0284114
Number of Individuals Covered448
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $13,952
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,815,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number710026
Policy instance 2
Insurance contract or identification number710026
Number of Individuals Covered369
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $2,048
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,048
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number000941
Policy instance 1
Insurance contract or identification number000941
Number of Individuals Covered543
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $104,814
Total amount of fees paid to insurance companyUSD $3,840
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,176,277
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $104,814
Amount paid for insurance broker fees3840
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 3
Insurance contract or identification numberVDT960296
Number of Individuals Covered342
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $25,612
Total amount of fees paid to insurance companyUSD $3,036
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $170,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,612
Amount paid for insurance broker fees3036
Additional information about fees paid to insurance brokerINCENTIVE
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 2
Insurance contract or identification numberVDT960296
Number of Individuals Covered359
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $27,406
Total amount of fees paid to insurance companyUSD $2,557
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $182,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,406
Amount paid for insurance broker fees2557
Additional information about fees paid to insurance brokerINCENTIVE
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number710026
Policy instance 1
Insurance contract or identification number710026
Number of Individuals Covered182
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $2,113
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,113
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number000941
Policy instance 3
Insurance contract or identification number000941
Number of Individuals Covered546
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $92,606
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,919,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $92,606
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 1
Insurance contract or identification numberVDT960296
Number of Individuals Covered396
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $22,961
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $154,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,961
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number000941
Policy instance 2
Insurance contract or identification number000941
Number of Individuals Covered559
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $98,019
Total amount of fees paid to insurance companyUSD $7,154
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,011,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $98,019
Amount paid for insurance broker fees7154
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number710026
Policy instance 3
Insurance contract or identification number710026
Number of Individuals Covered342
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $2,384
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $21,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,384
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT960296
Policy instance 1
Insurance contract or identification numberVDT960296
Number of Individuals Covered362
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $21,488
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $143,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,488
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANIES
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number000941
Policy instance 2
Insurance contract or identification number000941
Number of Individuals Covered534
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $102,274
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,048,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $102,274
Insurance broker organization code?3
Insurance broker nameCATAMOUNT COMPANY DBA BENEFIT PLAN
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX962991
Policy instance 5
Insurance contract or identification numberFLX962991
Number of Individuals Covered322
Insurance policy start date2011-08-01
Insurance policy end date2012-08-01
Total amount of commissions paid to insurance brokerUSD $7,225
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,168
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 numberVDT960496
Policy instance 6
Insurance contract or identification numberVDT960496
Number of Individuals Covered180
Insurance policy start date2011-08-01
Insurance policy end date2012-08-01
Total amount of commissions paid to insurance brokerUSD $4,945
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number2015
Policy instance 2
Insurance contract or identification number2015
Number of Individuals Covered442
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $1,932
Dental Insurance Welfare BenefitYes
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 numberOK 964656
Policy instance 4
Insurance contract or identification numberOK 964656
Number of Individuals Covered322
Insurance policy start date2011-08-01
Insurance policy end date2012-08-01
Total amount of commissions paid to insurance brokerUSD $113
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number710026
Policy instance 3
Insurance contract or identification number710026
Number of Individuals Covered342
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $81,582
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,621,138
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 numberVDT960296
Policy instance 1
Insurance contract or identification numberVDT960296
Number of Individuals Covered170
Insurance policy start date2011-08-01
Insurance policy end date2012-08-01
Total amount of commissions paid to insurance brokerUSD $5,566
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,161
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 numberVDT960496
Policy instance 6
Insurance contract or identification numberVDT960496
Number of Individuals Covered137
Insurance policy start date2010-08-01
Insurance policy end date2011-08-01
Total amount of commissions paid to insurance brokerUSD $5,281
Total amount of fees paid to insurance companyUSD $359
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number710026
Policy instance 3
Insurance contract or identification number710026
Number of Individuals Covered342
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $74,447
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,457,450
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 numberFLX962991
Policy instance 5
Insurance contract or identification numberFLX962991
Number of Individuals Covered255
Insurance policy start date2010-08-01
Insurance policy end date2011-08-01
Total amount of commissions paid to insurance brokerUSD $5,866
Total amount of fees paid to insurance companyUSD $354
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,108
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 numberOK 964656
Policy instance 4
Insurance contract or identification numberOK 964656
Number of Individuals Covered255
Insurance policy start date2010-08-01
Insurance policy end date2011-08-01
Total amount of commissions paid to insurance brokerUSD $96
Total amount of fees paid to insurance companyUSD $6
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $643
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 numberVDT960296
Policy instance 1
Insurance contract or identification numberVDT960296
Number of Individuals Covered139
Insurance policy start date2010-08-01
Insurance policy end date2011-08-01
Total amount of commissions paid to insurance brokerUSD $5,208
Total amount of fees paid to insurance companyUSD $363
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 )
Policy contract number2015
Policy instance 2
Insurance contract or identification number2015
Number of Individuals Covered371
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $1,893
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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