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RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan NameRESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN
Plan identification number 503

RESTAURANT BRANDS INTERNATIONAL FLEXIBLE 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)
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

RESTAURANT BRANDS INTERNATIONAL has sponsored the creation of one or more 401k plans.

Company Name:RESTAURANT BRANDS INTERNATIONAL
Employer identification number (EIN):814290921
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-01-01JANELLE SCHNORF2024-10-14
5032022-01-01JANELLE SCHNORF2023-10-13
5032021-01-01JANELLE SCHNORF2022-10-14
5032020-01-01JANELLE SCHNORF2021-10-14 JOE WIENEKE2021-10-14

Financial Data on RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN

Measure Date Value
2023 : RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN 2023 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$2,500
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$1,250
Total income from all sources (including contributions)2023-12-31$12,964,442
Total of all expenses incurred2023-12-31$12,964,760
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$12,298,227
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$12,964,442
Value of total assets at end of year2023-12-31$75,734
Value of total assets at beginning of year2023-12-31$74,802
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$666,533
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$3,692,997
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$-318
Value of net assets at end of year (total assets less liabilities)2023-12-31$73,234
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$73,552
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$75,734
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$74,802
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$74,802
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$389,310
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$9,271,445
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$11,908,917
Contract administrator fees2023-12-31$666,533
Liabilities. Value of benefit claims payable at end of year2023-12-31$2,500
Liabilities. Value of benefit claims payable at beginning of year2023-12-31$1,250
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31CHERRY, BEKAERT LLP
Accountancy firm EIN2023-12-31560574444
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$2,500
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$1,250
Total income from all sources (including contributions)2023-01-01$12,964,442
Total of all expenses incurred2023-01-01$12,964,760
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$12,298,227
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-01$12,964,442
Value of total assets at end of year2023-01-01$75,734
Value of total assets at beginning of year2023-01-01$74,802
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$666,533
Was this plan covered by a fidelity bond2023-01-01Yes
Value of fidelity bond cover2023-01-01$15,000,000
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Contributions received from participants2023-01-01$3,692,997
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Value of net income/loss2023-01-01$-318
Value of net assets at end of year (total assets less liabilities)2023-01-01$73,234
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$73,552
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-01-01$75,734
Expenses. Payments to insurance carriers foe the provision of benefits2023-01-01$389,310
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Was there a failure to transmit to the plan any participant contributions2023-01-01No
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Contributions received in cash from employer2023-01-01$9,271,445
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-01$11,908,917
Contract administrator fees2023-01-01$666,533
Liabilities. Value of benefit claims payable at end of year2023-01-01$2,500
Liabilities. Value of benefit claims payable at beginning of year2023-01-01$1,250
Did the plan have assets held for investment2023-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-01No
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01CHERRY, BEKAERT LLP
Accountancy firm EIN2023-01-01560574444
2022 : RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,250
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,250
Total income from all sources (including contributions)2022-12-31$8,280,243
Total of all expenses incurred2022-12-31$8,281,797
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$7,754,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$8,280,243
Value of total assets at end of year2022-12-31$74,802
Value of total assets at beginning of year2022-12-31$76,356
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$527,716
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$527,716
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$3,021,050
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,554
Value of net assets at end of year (total assets less liabilities)2022-12-31$73,552
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$75,106
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 bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$74,802
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$76,356
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$76,356
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$145,375
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$5,259,193
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$7,608,706
Liabilities. Value of benefit claims payable at end of year2022-12-31$1,250
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$1,250
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 name2022-12-31CHERRY, BEKAERT LLP
Accountancy firm EIN2022-12-31560574444
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$1,250
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$1,250
Total income from all sources (including contributions)2022-01-01$8,280,243
Total of all expenses incurred2022-01-01$8,281,797
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$7,754,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$8,280,243
Value of total assets at end of year2022-01-01$74,802
Value of total assets at beginning of year2022-01-01$76,356
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$527,716
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01No
Administrative expenses professional fees incurred2022-01-01$527,716
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$15,000,000
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Contributions received from participants2022-01-01$3,021,050
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Value of net income/loss2022-01-01$-1,554
Value of net assets at end of year (total assets less liabilities)2022-01-01$73,552
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$75,106
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-01-01$74,802
Expenses. Payments to insurance carriers foe the provision of benefits2022-01-01$145,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01No
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$5,259,193
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-01$7,608,706
Liabilities. Value of benefit claims payable at end of year2022-01-01$1,250
Liabilities. Value of benefit claims payable at beginning of year2022-01-01$1,250
Did the plan have assets held for investment2022-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01CHERRY, BEKAERT LLP
Accountancy firm EIN2022-01-01560574444
2021 : RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,250
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,250
Total income from all sources (including contributions)2021-12-31$9,701,800
Total of all expenses incurred2021-12-31$9,704,295
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$9,251,175
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$9,701,800
Value of total assets at end of year2021-12-31$76,356
Value of total assets at beginning of year2021-12-31$78,851
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$453,120
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$453,120
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,471,273
Liabilities. Value of operating payables at end of year2021-12-31$1,250
Liabilities. Value of operating payables at beginning of year2021-12-31$1,250
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-2,495
Value of net assets at end of year (total assets less liabilities)2021-12-31$75,106
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$77,601
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 bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$76,356
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$78,851
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$78,851
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$384,313
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$7,230,527
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$8,866,862
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 name2021-12-31CHERRY, BEKAERT LLP
Accountancy firm EIN2021-12-31560574444
2020 : RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS 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$1,250
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$1,250
Total income from all sources (including contributions)2020-12-31$7,384,256
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$7,386,555
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$6,974,844
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$7,384,256
Value of total assets at end of year2020-12-31$78,851
Value of total assets at beginning of year2020-12-31$81,150
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$411,711
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$411,711
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$2,615,268
Liabilities. Value of operating payables at end of year2020-12-31$1,250
Liabilities. Value of operating payables at beginning of year2020-12-31$1,250
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-2,299
Value of net assets at end of year (total assets less liabilities)2020-12-31$77,601
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$79,900
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 bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$78,851
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$81,150
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$81,150
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$401,613
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$4,768,988
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$6,573,231
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 plan2020-12-31Unqualified
Accountancy firm name2020-12-31CHERRY, BEKAERT LLP
Accountancy firm EIN2020-12-31560574444

Form 5500 Responses for RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN

2023: RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: RESTAURANT BRANDS INTERNATIONAL FLEXIBLE BENEFITS 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 funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

CIGNA BEHAVIORAL HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5115
Policy instance 7
Insurance contract or identification number5115
Number of Individuals Covered6970
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $50,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10409611001
Policy instance 1
Insurance contract or identification number10409611001
Number of Individuals Covered1715
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $136,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number203608
Policy instance 2
Insurance contract or identification number203608
Number of Individuals Covered196
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,892
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $34,461
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 number802980
Policy instance 3
Insurance contract or identification number802980
Number of Individuals Covered826
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $206,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number715017G
Policy instance 4
Insurance contract or identification number715017G
Number of Individuals Covered3759
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $11,752
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $779,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number5115
Policy instance 5
Insurance contract or identification number5115
Number of Individuals Covered30
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 )
Policy contract numberGTA-101380
Policy instance 6
Insurance contract or identification numberGTA-101380
Number of Individuals Covered3759
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,529
Total amount of fees paid to insurance companyUSD $281
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $22,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number5115
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number715017G
Policy instance 2
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number203608
Policy instance 1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number137990
Policy instance 5
Insurance contract or identification number137990
Number of Individuals Covered1268
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $58,697
Total amount of fees paid to insurance companyUSD $4,500
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
Other welfare benefits providedHOSPITAL,CRITICAL ILLNESS,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $200,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 )
Policy contract numberGTA101380
Policy instance 4
Insurance contract or identification numberGTA101380
Number of Individuals Covered3091
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $18,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968582
Policy instance 5
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number137990
Policy instance 4
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberGTA101380
Policy instance 3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number5115
Policy instance 2
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number203608
Policy instance 1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0137990
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0218884
Policy instance 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0218885
Policy instance 4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0218886
Policy instance 5
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number203608
Policy instance 6
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK961020
Policy instance 7
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968582
Policy instance 8
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK970064
Policy instance 9
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYD068502
Policy instance 10
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0137989
Policy instance 1

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