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PRISMA HEALTH-UPSTATE 401A PLAN 401k Plan overview

Plan NamePRISMA HEALTH-UPSTATE 401A PLAN
Plan identification number 003

PRISMA HEALTH-UPSTATE 401A PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PRISMA HEALTH has sponsored the creation of one or more 401k plans.

Company Name:PRISMA HEALTH
Employer identification number (EIN):811723202
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRISMA HEALTH-UPSTATE 401A PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032022-01-01
0032020-01-01

Plan Statistics for PRISMA HEALTH-UPSTATE 401A PLAN

401k plan membership statisitcs for PRISMA HEALTH-UPSTATE 401A PLAN

Measure Date Value
2022: PRISMA HEALTH-UPSTATE 401A PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0130,023
Total number of active participants reported on line 7a of the Form 55002022-01-0121,235
Number of retired or separated participants receiving benefits2022-01-0163
Number of other retired or separated participants entitled to future benefits2022-01-014,962
Total of all active and inactive participants2022-01-0126,260
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0126,260
Number of participants with account balances2022-01-0126,260
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-01194
2020: PRISMA HEALTH-UPSTATE 401A PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0117,867
Total number of active participants reported on line 7a of the Form 55002020-01-0120,357
Number of retired or separated participants receiving benefits2020-01-0154
Number of other retired or separated participants entitled to future benefits2020-01-017,978
Total of all active and inactive participants2020-01-0128,389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-0128,390
Number of participants with account balances2020-01-0128,390
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-01417

Financial Data on PRISMA HEALTH-UPSTATE 401A PLAN

Measure Date Value
2022 : PRISMA HEALTH-UPSTATE 401A PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-64,417,389
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$70,759,338
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$70,411,345
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$59,155,343
Value of total assets at end of year2022-12-31$722,418,332
Value of total assets at beginning of year2022-12-31$857,595,059
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$347,993
Total interest from all sources2022-12-31$2,295,503
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$7,195,003
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$7,195,003
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$20,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Participant contributions at end of year2022-12-31$1,088,236
Participant contributions at beginning of year2022-12-31$2,221,369
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$304,145
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-135,176,727
Value of net assets at end of year (total assets less liabilities)2022-12-31$722,418,332
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$857,595,059
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$435,454,713
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$730,860,255
Value of interest in pooled separate accounts at end of year2022-12-31$1,665,655
Value of interest in pooled separate accounts at beginning of year2022-12-31$0
Interest on participant loans2022-12-31$100,668
Interest earned on other investments2022-12-31$2,194,835
Value of interest in common/collective trusts at end of year2022-12-31$162,684,481
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$121,525,247
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$124,513,435
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-94,743,253
Net investment gain/loss from pooled separate accounts2022-12-31$-258,752
Net investment gain or loss from common/collective trusts2022-12-31$-38,061,233
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$58,851,198
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$70,411,345
Contract administrator fees2022-12-31$347,993
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31ELLIOT DAVIS, LLLC
Accountancy firm EIN2022-12-31570381582
2021 : PRISMA HEALTH-UPSTATE 401A PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$165,302,038
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$73,892,533
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$73,436,685
Expenses. Certain deemed distributions of participant loans2021-12-31$127,600
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$54,386,110
Value of total assets at end of year2021-12-31$857,595,059
Value of total assets at beginning of year2021-12-31$766,185,554
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$328,248
Total interest from all sources2021-12-31$2,460,009
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$8,603,563
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$8,603,563
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$20,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Participant contributions at end of year2021-12-31$2,221,369
Participant contributions at beginning of year2021-12-31$4,210,552
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$78,705
Administrative expenses (other) incurred2021-12-31$328,248
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$91,409,505
Value of net assets at end of year (total assets less liabilities)2021-12-31$857,595,059
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$766,185,554
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$730,860,255
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$634,037,578
Interest on participant loans2021-12-31$188,147
Interest earned on other investments2021-12-31$2,271,862
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$124,513,435
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$127,937,424
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$61,370,491
Net investment gain or loss from common/collective trusts2021-12-31$38,481,865
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$54,307,405
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$73,436,685
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31ELLIOTT DAVIS, LLLC
Accountancy firm EIN2021-12-31570381582
2020 : PRISMA HEALTH-UPSTATE 401A PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$98,935,272
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$50,148,617
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$47,082,123
Expenses. Certain deemed distributions of participant loans2020-12-31$209,316
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$13,202,098
Value of total assets at end of year2020-12-31$766,185,554
Value of total assets at beginning of year2020-12-31$717,398,899
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$2,857,178
Total interest from all sources2020-12-31$3,652,361
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$7,067,603
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$7,067,603
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$20,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Participant contributions at end of year2020-12-31$4,210,552
Participant contributions at beginning of year2020-12-31$864,710
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$294,732
Administrative expenses (other) incurred2020-12-31$2,857,178
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$48,786,655
Value of net assets at end of year (total assets less liabilities)2020-12-31$766,185,554
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$717,398,899
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$634,037,578
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$559,619,929
Interest on participant loans2020-12-31$339,245
Interest earned on other investments2020-12-31$3,313,116
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$127,937,424
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$156,914,260
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$75,013,210
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$12,907,366
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$47,082,123
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31ELLIOTT DAVIS, LLLC
Accountancy firm EIN2020-12-31570381582

Form 5500 Responses for PRISMA HEALTH-UPSTATE 401A PLAN

2022: PRISMA HEALTH-UPSTATE 401A PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2020: PRISMA HEALTH-UPSTATE 401A PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57947
Policy instance 1
Insurance contract or identification number57947
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number041130
Policy instance 2
Insurance contract or identification number041130
Number of Individuals Covered26260
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57947
Policy instance 1
Insurance contract or identification number57947
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number041130
Policy instance 2
Insurance contract or identification number041130
Number of Individuals Covered30023
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57947
Policy instance 1
Insurance contract or identification number57947
Number of Individuals Covered61
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number041130
Policy instance 2
Insurance contract or identification number041130
Number of Individuals Covered28390
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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