VILLANUEVA & COMPANY, P.C. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN
401k plan membership statisitcs for VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN
Measure | Date | Value |
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2020: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-12-01 | 3 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 3 |
Number of retired or separated participants receiving benefits | 2020-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-12-01 | 0 |
Total of all active and inactive participants | 2020-12-01 | 3 |
2019: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-12-01 | 3 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 3 |
Number of retired or separated participants receiving benefits | 2019-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-12-01 | 0 |
Total of all active and inactive participants | 2019-12-01 | 3 |
2018: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-12-01 | 8 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 8 |
Number of retired or separated participants receiving benefits | 2018-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-12-01 | 0 |
Total of all active and inactive participants | 2018-12-01 | 8 |
2017: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-12-01 | 8 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 8 |
Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
Total of all active and inactive participants | 2017-12-01 | 8 |
2015: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-12-01 | 8 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 8 |
Number of retired or separated participants receiving benefits | 2015-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-12-01 | 0 |
Total of all active and inactive participants | 2015-12-01 | 8 |
2014: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-12-01 | 8 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 8 |
Number of retired or separated participants receiving benefits | 2014-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-12-01 | 0 |
Total of all active and inactive participants | 2014-12-01 | 8 |
2013: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-12-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-12-01 | 10 |
Number of retired or separated participants receiving benefits | 2013-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-12-01 | 0 |
Total of all active and inactive participants | 2013-12-01 | 10 |
2012: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-12-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-12-01 | 10 |
Number of retired or separated participants receiving benefits | 2012-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-12-01 | 0 |
Total of all active and inactive participants | 2012-12-01 | 10 |
2011: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-12-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-12-01 | 10 |
Number of retired or separated participants receiving benefits | 2011-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-12-01 | 0 |
Total of all active and inactive participants | 2011-12-01 | 10 |
2009: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-12-01 | 6 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-12-01 | 6 |
Number of retired or separated participants receiving benefits | 2009-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-12-01 | 0 |
Total of all active and inactive participants | 2009-12-01 | 6 |
Measure | Date | Value |
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2021 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2021 401k financial data |
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Total plan liabilities at end of year | 2021-11-30 | $185,254 |
Total plan liabilities at beginning of year | 2021-11-30 | $183,766 |
Total income from all sources | 2021-11-30 | $0 |
Expenses. Total of all expenses incurred | 2021-11-30 | $0 |
Total plan assets at end of year | 2021-11-30 | $185,254 |
Total plan assets at beginning of year | 2021-11-30 | $183,766 |
Net income (gross income less expenses) | 2021-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2021-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2021-11-30 | $0 |
2020 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2020 401k financial data |
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Total plan liabilities at end of year | 2020-11-30 | $183,766 |
Total plan liabilities at beginning of year | 2020-11-30 | $182,322 |
Total income from all sources | 2020-11-30 | $0 |
Expenses. Total of all expenses incurred | 2020-11-30 | $0 |
Total plan assets at end of year | 2020-11-30 | $183,766 |
Total plan assets at beginning of year | 2020-11-30 | $182,322 |
Net income (gross income less expenses) | 2020-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2020-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2020-11-30 | $0 |
2019 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2019 401k financial data |
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Total plan liabilities at end of year | 2019-11-30 | $182,322 |
Total plan liabilities at beginning of year | 2019-11-30 | $180,921 |
Total income from all sources | 2019-11-30 | $0 |
Expenses. Total of all expenses incurred | 2019-11-30 | $0 |
Total plan assets at end of year | 2019-11-30 | $182,322 |
Total plan assets at beginning of year | 2019-11-30 | $180,921 |
Net income (gross income less expenses) | 2019-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2019-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2019-11-30 | $0 |
2016 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2016 401k financial data |
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Total plan liabilities at end of year | 2016-11-30 | $178,243 |
Total plan liabilities at beginning of year | 2016-11-30 | $176,095 |
Total income from all sources | 2016-11-30 | $0 |
Expenses. Total of all expenses incurred | 2016-11-30 | $0 |
Total plan assets at end of year | 2016-11-30 | $178,243 |
Total plan assets at beginning of year | 2016-11-30 | $176,095 |
Net income (gross income less expenses) | 2016-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2016-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2016-11-30 | $0 |
2015 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2015 401k financial data |
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Total plan liabilities at end of year | 2015-11-30 | $176,095 |
Total plan liabilities at beginning of year | 2015-11-30 | $169,322 |
Total income from all sources | 2015-11-30 | $2,940 |
Expenses. Total of all expenses incurred | 2015-11-30 | $2,940 |
Total plan assets at end of year | 2015-11-30 | $176,095 |
Total plan assets at beginning of year | 2015-11-30 | $169,322 |
Net income (gross income less expenses) | 2015-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2015-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2015-11-30 | $0 |
Total contributions received or receivable from employer(s) | 2015-11-30 | $2,940 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2015-11-30 | $2,940 |
2014 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2014 401k financial data |
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Total plan liabilities at end of year | 2014-11-30 | $169,322 |
Total plan liabilities at beginning of year | 2014-11-30 | $156,008 |
Total income from all sources | 2014-11-30 | $11,765 |
Expenses. Total of all expenses incurred | 2014-11-30 | $11,765 |
Total plan assets at end of year | 2014-11-30 | $169,322 |
Total plan assets at beginning of year | 2014-11-30 | $156,008 |
Expenses. Other expenses not covered elsewhere | 2014-11-30 | $11,765 |
Net income (gross income less expenses) | 2014-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2014-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2014-11-30 | $0 |
Total contributions received or receivable from employer(s) | 2014-11-30 | $11,765 |
2013 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2013 401k financial data |
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Total plan liabilities at end of year | 2013-11-30 | $156,008 |
Total plan liabilities at beginning of year | 2013-11-30 | $143,066 |
Total income from all sources | 2013-11-30 | $1,570 |
Expenses. Total of all expenses incurred | 2013-11-30 | $1,570 |
Total plan assets at end of year | 2013-11-30 | $156,008 |
Total plan assets at beginning of year | 2013-11-30 | $143,066 |
Net income (gross income less expenses) | 2013-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2013-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2013-11-30 | $0 |
Total contributions received or receivable from employer(s) | 2013-11-30 | $1,570 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2013-11-30 | $1,570 |
2012 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2012 401k financial data |
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Total plan liabilities at end of year | 2012-11-30 | $143,066 |
Total plan liabilities at beginning of year | 2012-11-30 | $140,534 |
Total income from all sources | 2012-11-30 | $24,223 |
Expenses. Total of all expenses incurred | 2012-11-30 | $24,223 |
Total plan assets at end of year | 2012-11-30 | $143,066 |
Total plan assets at beginning of year | 2012-11-30 | $140,534 |
Expenses. Other expenses not covered elsewhere | 2012-11-30 | $22,893 |
Other income received | 2012-11-30 | $1 |
Net income (gross income less expenses) | 2012-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2012-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2012-11-30 | $0 |
Total contributions received or receivable from employer(s) | 2012-11-30 | $24,222 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2012-11-30 | $1,330 |
2011 : VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2011 401k financial data |
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Total plan liabilities at end of year | 2011-11-30 | $140,534 |
Total plan liabilities at beginning of year | 2011-11-30 | $133,196 |
Total income from all sources | 2011-11-30 | $11,389 |
Expenses. Total of all expenses incurred | 2011-11-30 | $11,389 |
Total plan assets at end of year | 2011-11-30 | $140,534 |
Total plan assets at beginning of year | 2011-11-30 | $133,196 |
Expenses. Other expenses not covered elsewhere | 2011-11-30 | $9,849 |
Net income (gross income less expenses) | 2011-11-30 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2011-11-30 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2011-11-30 | $0 |
Total contributions received or receivable from employer(s) | 2011-11-30 | $11,389 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2011-11-30 | $1,540 |
2020: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2020 form 5500 responses |
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2020-12-01 | Type of plan entity | Single employer plan |
2020-12-01 | Submission has been amended | No |
2020-12-01 | This submission is the final filing | No |
2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-12-01 | Plan is a collectively bargained plan | No |
2020-12-01 | Plan funding arrangement – Insurance | Yes |
2020-12-01 | Plan funding arrangement – Trust | Yes |
2020-12-01 | Plan benefit arrangement – Insurance | Yes |
2020-12-01 | Plan benefit arrangement - Trust | Yes |
2019: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2019 form 5500 responses |
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2019-12-01 | Type of plan entity | Single employer plan |
2019-12-01 | Submission has been amended | No |
2019-12-01 | This submission is the final filing | No |
2019-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-12-01 | Plan is a collectively bargained plan | No |
2019-12-01 | Plan funding arrangement – Insurance | Yes |
2019-12-01 | Plan funding arrangement – Trust | Yes |
2019-12-01 | Plan benefit arrangement – Insurance | Yes |
2019-12-01 | Plan benefit arrangement - Trust | Yes |
2018: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2018 form 5500 responses |
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2018-12-01 | Type of plan entity | Single employer plan |
2018-12-01 | Submission has been amended | No |
2018-12-01 | This submission is the final filing | No |
2018-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-12-01 | Plan is a collectively bargained plan | No |
2018-12-01 | Plan funding arrangement – Insurance | Yes |
2018-12-01 | Plan funding arrangement – Trust | Yes |
2018-12-01 | Plan benefit arrangement – Insurance | Yes |
2018-12-01 | Plan benefit arrangement - Trust | Yes |
2017: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2017 form 5500 responses |
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2017-12-01 | Type of plan entity | Single employer plan |
2017-12-01 | Submission has been amended | No |
2017-12-01 | This submission is the final filing | No |
2017-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-12-01 | Plan is a collectively bargained plan | No |
2017-12-01 | Plan funding arrangement – Insurance | Yes |
2017-12-01 | Plan funding arrangement – Trust | Yes |
2017-12-01 | Plan benefit arrangement – Insurance | Yes |
2017-12-01 | Plan benefit arrangement - Trust | Yes |
2015: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2015 form 5500 responses |
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2015-12-01 | Type of plan entity | Single employer plan |
2015-12-01 | Submission has been amended | No |
2015-12-01 | This submission is the final filing | No |
2015-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-12-01 | Plan is a collectively bargained plan | No |
2015-12-01 | Plan funding arrangement – Insurance | Yes |
2015-12-01 | Plan funding arrangement – Trust | Yes |
2015-12-01 | Plan benefit arrangement – Insurance | Yes |
2015-12-01 | Plan benefit arrangement - Trust | Yes |
2014: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2014 form 5500 responses |
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2014-12-01 | Type of plan entity | Single employer plan |
2014-12-01 | Submission has been amended | No |
2014-12-01 | This submission is the final filing | No |
2014-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-12-01 | Plan is a collectively bargained plan | No |
2014-12-01 | Plan funding arrangement – Insurance | Yes |
2014-12-01 | Plan funding arrangement – Trust | Yes |
2014-12-01 | Plan benefit arrangement – Insurance | Yes |
2014-12-01 | Plan benefit arrangement - Trust | Yes |
2013: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2013 form 5500 responses |
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2013-12-01 | Type of plan entity | Single employer plan |
2013-12-01 | Submission has been amended | No |
2013-12-01 | This submission is the final filing | No |
2013-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-12-01 | Plan is a collectively bargained plan | No |
2013-12-01 | Plan funding arrangement – Insurance | Yes |
2013-12-01 | Plan funding arrangement – Trust | Yes |
2013-12-01 | Plan benefit arrangement – Insurance | Yes |
2013-12-01 | Plan benefit arrangement - Trust | Yes |
2012: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2012 form 5500 responses |
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2012-12-01 | Type of plan entity | Single employer plan |
2012-12-01 | Submission has been amended | No |
2012-12-01 | This submission is the final filing | No |
2012-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-12-01 | Plan is a collectively bargained plan | No |
2012-12-01 | Plan funding arrangement – Insurance | Yes |
2012-12-01 | Plan funding arrangement – Trust | Yes |
2012-12-01 | Plan benefit arrangement – Insurance | Yes |
2012-12-01 | Plan benefit arrangement - Trust | Yes |
2011: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2011 form 5500 responses |
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2011-12-01 | Type of plan entity | Single employer plan |
2011-12-01 | Submission has been amended | No |
2011-12-01 | This submission is the final filing | No |
2011-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-12-01 | Plan is a collectively bargained plan | No |
2011-12-01 | Plan funding arrangement – Insurance | Yes |
2011-12-01 | Plan funding arrangement – Trust | Yes |
2011-12-01 | Plan benefit arrangement – Insurance | Yes |
2011-12-01 | Plan benefit arrangement - Trust | Yes |
2009: VILLANUEVA & COMPANY, P.C. WELFARE BENEFIT PLAN 2009 form 5500 responses |
---|
2009-12-01 | Type of plan entity | Single employer plan |
2009-12-01 | Submission has been amended | No |
2009-12-01 | This submission is the final filing | No |
2009-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-12-01 | Plan is a collectively bargained plan | No |
2009-12-01 | Plan funding arrangement – Insurance | Yes |
2009-12-01 | Plan funding arrangement – Trust | Yes |
2009-12-01 | Plan benefit arrangement – Insurance | Yes |
2009-12-01 | Plan benefit arrangement - Trust | Yes |
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 3 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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 | Insurance broker organization code? | 5 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 8 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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 | Insurance broker organization code? | 5 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 8 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 5 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 8 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 8 | Insurance policy start date | 2015-12-01 | Insurance policy end date | 2016-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ADMINISTRATION FEES | Insurance broker organization code? | 5 | Insurance broker name | CJA & ASSOCIATES |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 8 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $2,940 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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 | Amount paid for insurance broker fees | 2940 | Additional information about fees paid to insurance broker | ADMINISTRATION FEES | Insurance broker organization code? | 5 | Insurance broker name | CJA & ASSOCIATES |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 10 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ADMINISTRATION FEES | Insurance broker organization code? | 5 | Insurance broker name | CJA & ASSOCIATES |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 10 | Insurance policy start date | 2012-12-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,570 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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 | Amount paid for insurance broker fees | 1570 | Additional information about fees paid to insurance broker | ADMINISTRATION FEES | Insurance broker organization code? | 5 | Insurance broker name | CJA & ASSOCIATES |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | FA-566-9021 |
Policy instance | 1 |
Insurance contract or identification number | FA-566-9021 | Number of Individuals Covered | 10 | Insurance policy start date | 2011-12-01 | Insurance policy end date | 2012-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $3,110 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ANNUITY | 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? | Yes |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9021 |
Policy instance | 1 |
Insurance contract or identification number | 9021 | Number of Individuals Covered | 9 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2011-11-30 | Total amount of commissions paid to insurance broker | USD $17 | Total amount of fees paid to insurance company | USD $1,540 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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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