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HIJI BROTHERS INC. WELFARE BENEFITS PLAN 401k Plan overview

Plan NameHIJI BROTHERS INC. WELFARE BENEFITS PLAN
Plan identification number 501

HIJI BROTHERS INC. WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

HIJI BROTHERS INC. has sponsored the creation of one or more 401k plans.

Company Name:HIJI BROTHERS INC.
Employer identification number (EIN):952988388
NAIC Classification:111210
NAIC Description:Vegetable and Melon Farming

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HIJI BROTHERS INC. WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-11-01ROBERT HIJI
5012014-11-01ROBERT HIJI
5012013-11-01ROBERT HIJI
5012012-11-01ROBERT HIJI
5012011-11-01ROBERT HIJI
5012009-11-01ROBERT HIJI
5012008-11-01JOHN MIYAMOTO
5012007-11-01JOHN MIYAMOTO
5012006-11-01JOHN MIYAMOTO
5012005-11-01JOHN MIYAMOTO
5012004-11-01JOHN MIYAMOTO
5012003-11-01JOHN MIYAMOTO
5012002-11-01JOHN MIYAMOTO
5012001-11-01JOHN MIYAMOTO

Plan Statistics for HIJI BROTHERS INC. WELFARE BENEFITS PLAN

401k plan membership statisitcs for HIJI BROTHERS INC. WELFARE BENEFITS PLAN

Measure Date Value
2015: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-01127
Total number of active participants reported on line 7a of the Form 55002015-11-010
Number of retired or separated participants receiving benefits2015-11-010
Number of other retired or separated participants entitled to future benefits2015-11-010
Total of all active and inactive participants2015-11-010
2014: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-01153
Total number of active participants reported on line 7a of the Form 55002014-11-01127
Number of retired or separated participants receiving benefits2014-11-010
Number of other retired or separated participants entitled to future benefits2014-11-010
Total of all active and inactive participants2014-11-01127
2013: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-01151
Total number of active participants reported on line 7a of the Form 55002013-11-01144
Number of retired or separated participants receiving benefits2013-11-019
Number of other retired or separated participants entitled to future benefits2013-11-010
Total of all active and inactive participants2013-11-01153
2012: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-01143
Total number of active participants reported on line 7a of the Form 55002012-11-01145
Number of retired or separated participants receiving benefits2012-11-016
Number of other retired or separated participants entitled to future benefits2012-11-010
Total of all active and inactive participants2012-11-01151
2011: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-01131
Total number of active participants reported on line 7a of the Form 55002011-11-01142
Number of retired or separated participants receiving benefits2011-11-011
Number of other retired or separated participants entitled to future benefits2011-11-010
Total of all active and inactive participants2011-11-01143
2009: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-01191
Total number of active participants reported on line 7a of the Form 55002009-11-01138
Number of retired or separated participants receiving benefits2009-11-0136
Number of other retired or separated participants entitled to future benefits2009-11-010
Total of all active and inactive participants2009-11-01174
2008: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year2008-11-01188
Total number of active participants reported on line 7a of the Form 55002008-11-01191
Number of retired or separated participants receiving benefits2008-11-010
Number of other retired or separated participants entitled to future benefits2008-11-010
Total of all active and inactive participants2008-11-01191
2007: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year2007-11-01186
Total number of active participants reported on line 7a of the Form 55002007-11-01188
Number of retired or separated participants receiving benefits2007-11-010
Number of other retired or separated participants entitled to future benefits2007-11-010
Total of all active and inactive participants2007-11-01188
2006: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2006 401k membership
Total participants, beginning-of-year2006-11-01195
Total number of active participants reported on line 7a of the Form 55002006-11-01186
Number of retired or separated participants receiving benefits2006-11-010
Number of other retired or separated participants entitled to future benefits2006-11-010
Total of all active and inactive participants2006-11-01186
2005: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2005 401k membership
Total participants, beginning-of-year2005-11-01199
Total number of active participants reported on line 7a of the Form 55002005-11-01195
Number of retired or separated participants receiving benefits2005-11-010
Number of other retired or separated participants entitled to future benefits2005-11-010
Total of all active and inactive participants2005-11-01195
2004: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2004 401k membership
Total participants, beginning-of-year2004-11-01192
Total number of active participants reported on line 7a of the Form 55002004-11-01199
Number of retired or separated participants receiving benefits2004-11-010
Number of other retired or separated participants entitled to future benefits2004-11-010
Total of all active and inactive participants2004-11-01199
2003: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2003 401k membership
Total participants, beginning-of-year2003-11-01192
Total number of active participants reported on line 7a of the Form 55002003-11-01194
Number of retired or separated participants receiving benefits2003-11-010
Number of other retired or separated participants entitled to future benefits2003-11-010
Total of all active and inactive participants2003-11-01194
2002: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2002 401k membership
Total participants, beginning-of-year2002-11-01188
Total number of active participants reported on line 7a of the Form 55002002-11-01192
Number of retired or separated participants receiving benefits2002-11-010
Number of other retired or separated participants entitled to future benefits2002-11-010
Total of all active and inactive participants2002-11-01192
2001: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2001 401k membership
Total participants, beginning-of-year2001-11-01188
Total number of active participants reported on line 7a of the Form 55002001-11-01188
Number of retired or separated participants receiving benefits2001-11-010
Number of other retired or separated participants entitled to future benefits2001-11-010
Total of all active and inactive participants2001-11-01188

Form 5500 Responses for HIJI BROTHERS INC. WELFARE BENEFITS PLAN

2015: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingYes
2015-11-01This return/report is a short plan year return/report (less than 12 months)No
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – General assets of the sponsorYes
2015-11-01Plan benefit arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – General assets of the sponsorYes
2014: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – General assets of the sponsorYes
2014-11-01Plan benefit arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – General assets of the sponsorYes
2013: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedNo
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)No
2013-11-01Plan is a collectively bargained planNo
2013-11-01Plan funding arrangement – General assets of the sponsorYes
2013-11-01Plan benefit arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – General assets of the sponsorYes
2012: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – General assets of the sponsorYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – General assets of the sponsorYes
2011: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Submission has been amendedNo
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – General assets of the sponsorYes
2011-11-01Plan benefit arrangement – InsuranceYes
2011-11-01Plan benefit arrangement – General assets of the sponsorYes
2009: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan funding arrangement – General assets of the sponsorYes
2009-11-01Plan benefit arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – General assets of the sponsorYes
2008: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2008 form 5500 responses
2008-11-01Type of plan entitySingle employer plan
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planNo
2008-11-01Plan funding arrangement – General assets of the sponsorYes
2008-11-01Plan benefit arrangement – General assets of the sponsorYes
2007: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2007 form 5500 responses
2007-11-01Type of plan entitySingle employer plan
2007-11-01Submission has been amendedNo
2007-11-01This submission is the final filingNo
2007-11-01This return/report is a short plan year return/report (less than 12 months)No
2007-11-01Plan is a collectively bargained planNo
2007-11-01Plan funding arrangement – General assets of the sponsorYes
2007-11-01Plan benefit arrangement – General assets of the sponsorYes
2006: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2006 form 5500 responses
2006-11-01Type of plan entitySingle employer plan
2006-11-01Submission has been amendedNo
2006-11-01This submission is the final filingNo
2006-11-01This return/report is a short plan year return/report (less than 12 months)No
2006-11-01Plan is a collectively bargained planNo
2006-11-01Plan funding arrangement – General assets of the sponsorYes
2006-11-01Plan benefit arrangement – General assets of the sponsorYes
2005: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2005 form 5500 responses
2005-11-01Type of plan entitySingle employer plan
2005-11-01Submission has been amendedNo
2005-11-01This submission is the final filingNo
2005-11-01This return/report is a short plan year return/report (less than 12 months)No
2005-11-01Plan is a collectively bargained planNo
2005-11-01Plan funding arrangement – General assets of the sponsorYes
2005-11-01Plan benefit arrangement – General assets of the sponsorYes
2004: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2004 form 5500 responses
2004-11-01Type of plan entitySingle employer plan
2004-11-01Submission has been amendedNo
2004-11-01This submission is the final filingNo
2004-11-01This return/report is a short plan year return/report (less than 12 months)No
2004-11-01Plan is a collectively bargained planNo
2004-11-01Plan funding arrangement – General assets of the sponsorYes
2004-11-01Plan benefit arrangement – General assets of the sponsorYes
2003: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2003 form 5500 responses
2003-11-01Type of plan entitySingle employer plan
2003-11-01Submission has been amendedNo
2003-11-01This submission is the final filingNo
2003-11-01This return/report is a short plan year return/report (less than 12 months)No
2003-11-01Plan is a collectively bargained planNo
2003-11-01Plan funding arrangement – General assets of the sponsorYes
2003-11-01Plan benefit arrangement – General assets of the sponsorYes
2002: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2002 form 5500 responses
2002-11-01Type of plan entitySingle employer plan
2002-11-01Submission has been amendedNo
2002-11-01This submission is the final filingNo
2002-11-01This return/report is a short plan year return/report (less than 12 months)No
2002-11-01Plan is a collectively bargained planNo
2002-11-01Plan funding arrangement – General assets of the sponsorYes
2002-11-01Plan benefit arrangement – General assets of the sponsorYes
2001: HIJI BROTHERS INC. WELFARE BENEFITS PLAN 2001 form 5500 responses
2001-11-01Type of plan entitySingle employer plan
2001-11-01First time form 5500 has been submittedYes
2001-11-01Submission has been amendedNo
2001-11-01This submission is the final filingNo
2001-11-01This return/report is a short plan year return/report (less than 12 months)No
2001-11-01Plan is a collectively bargained planNo
2001-11-01Plan funding arrangement – General assets of the sponsorYes
2001-11-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10095090
Policy instance 1
Insurance contract or identification number10095090
Number of Individuals Covered5
Insurance policy start date2015-11-01
Insurance policy end date2016-10-31
Total amount of commissions paid to insurance brokerUSD $497
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $497
Insurance broker organization code?3
Insurance broker nameTHE INSURANCE GROUP
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10095090
Policy instance 1
Insurance contract or identification number10095090
Number of Individuals Covered127
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $666
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $666
Insurance broker organization code?3
Insurance broker nameTHE INSURANCE GROUP
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10095090
Policy instance 1
Insurance contract or identification number10095090
Number of Individuals Covered144
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $639
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $639
Insurance broker organization code?3
Insurance broker nameTHE INSURANCE GROUP
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10095090
Policy instance 1
Insurance contract or identification number10095090
Number of Individuals Covered145
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $681
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $681
Insurance broker organization code?3
Insurance broker nameBARKLEY INSURANCE & RISK MANAGEMENT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10095090
Policy instance 1
Insurance contract or identification number10095090
Number of Individuals Covered142
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $602
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10095090
Policy instance 1
Insurance contract or identification number10095090
Number of Individuals Covered125
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $636
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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