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EMPLOYEE HEALTH PLAN OF ROJAN, INC. 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF ROJAN, INC.
Plan identification number 502

EMPLOYEE HEALTH PLAN OF ROJAN, INC. Benefits

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

401k Sponsoring company profile

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

Company Name:ROJAN, INC.
Employer identification number (EIN):760437011
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Additional information about ROJAN, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1998-03-12
Company Identification Number: 19981047365
Legal Registered Office Address: 5659 S QUATAR CT

AURORA
United States of America (USA)
80015

More information about ROJAN, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF ROJAN, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-05-01
5022021-05-01
5022020-05-01
5022019-05-01
5022018-05-01
5022017-05-01ROB GERASIMOWICZ
5022016-05-01ROB GERASIMOWICZ
5022015-05-01ROB GERASIMOWICZ
5022014-05-01ROB GERASIMOWICZ
5022013-05-01ROB GERASIMOWICZ
5022012-05-01ROB GERASIMOWICZ
5022011-05-01ROB GERASIMOWICZ

Plan Statistics for EMPLOYEE HEALTH PLAN OF ROJAN, INC.

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF ROJAN, INC.

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2022 401k membership
Total participants, beginning-of-year2022-05-015
Total number of active participants reported on line 7a of the Form 55002022-05-015
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-015
2021: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2021 401k membership
Total participants, beginning-of-year2021-05-0116
Total number of active participants reported on line 7a of the Form 55002021-05-015
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-015
2020: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2020 401k membership
Total participants, beginning-of-year2020-05-0116
Total number of active participants reported on line 7a of the Form 55002020-05-0116
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-0116
2019: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2019 401k membership
Total participants, beginning-of-year2019-05-0114
Total number of active participants reported on line 7a of the Form 55002019-05-0115
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-0115
2018: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2018 401k membership
Total participants, beginning-of-year2018-05-0115
Total number of active participants reported on line 7a of the Form 55002018-05-0115
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-0115
2017: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2017 401k membership
Total participants, beginning-of-year2017-05-0117
Total number of active participants reported on line 7a of the Form 55002017-05-0115
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-0115
2016: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2016 401k membership
Total participants, beginning-of-year2016-05-0115
Total number of active participants reported on line 7a of the Form 55002016-05-0114
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-0114
2015: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2015 401k membership
Total participants, beginning-of-year2015-05-0116
Total number of active participants reported on line 7a of the Form 55002015-05-0114
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-0114
2014: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2014 401k membership
Total participants, beginning-of-year2014-05-0111
Total number of active participants reported on line 7a of the Form 55002014-05-0116
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-0116
2013: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2013 401k membership
Total participants, beginning-of-year2013-05-0111
Total number of active participants reported on line 7a of the Form 55002013-05-0111
Number of retired or separated participants receiving benefits2013-05-010
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-0111
2012: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2012 401k membership
Total participants, beginning-of-year2012-05-0112
Total number of active participants reported on line 7a of the Form 55002012-05-0111
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-0111
2011: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2011 401k membership
Total participants, beginning-of-year2011-05-0111
Total number of active participants reported on line 7a of the Form 55002011-05-0112
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-0112

Financial Data on EMPLOYEE HEALTH PLAN OF ROJAN, INC.

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2023 401k financial data
Total income from all sources2023-04-30$69,678
Expenses. Total of all expenses incurred2023-04-30$51,122
Benefits paid (including direct rollovers)2023-04-30$16,983
Total plan assets at end of year2023-04-30$119,698
Total plan assets at beginning of year2023-04-30$101,142
Value of fidelity bond covering the plan2023-04-30$11,000
Expenses. Other expenses not covered elsewhere2023-04-30$34,139
Net income (gross income less expenses)2023-04-30$18,556
Net plan assets at end of year (total assets less liabilities)2023-04-30$119,698
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$101,142
Total contributions received or receivable from employer(s)2023-04-30$69,678
2022 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2022 401k financial data
Total income from all sources2022-04-30$92,877
Expenses. Total of all expenses incurred2022-04-30$117,920
Benefits paid (including direct rollovers)2022-04-30$71,009
Total plan assets at end of year2022-04-30$101,142
Total plan assets at beginning of year2022-04-30$126,185
Value of fidelity bond covering the plan2022-04-30$13,000
Expenses. Other expenses not covered elsewhere2022-04-30$46,911
Net income (gross income less expenses)2022-04-30$-25,043
Net plan assets at end of year (total assets less liabilities)2022-04-30$101,142
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$126,185
Total contributions received or receivable from employer(s)2022-04-30$92,877
2021 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$148,725
Expenses. Total of all expenses incurred2021-04-30$106,247
Benefits paid (including direct rollovers)2021-04-30$31,295
Total plan assets at end of year2021-04-30$126,185
Total plan assets at beginning of year2021-04-30$83,707
Value of fidelity bond covering the plan2021-04-30$90,000
Expenses. Other expenses not covered elsewhere2021-04-30$74,952
Net income (gross income less expenses)2021-04-30$42,478
Net plan assets at end of year (total assets less liabilities)2021-04-30$126,185
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$83,707
Total contributions received or receivable from employer(s)2021-04-30$148,725
2020 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2020 401k financial data
Total plan liabilities at end of year2020-04-30$0
Total plan liabilities at beginning of year2020-04-30$0
Total income from all sources2020-04-30$139,035
Expenses. Total of all expenses incurred2020-04-30$146,546
Benefits paid (including direct rollovers)2020-04-30$75,103
Total plan assets at end of year2020-04-30$83,707
Total plan assets at beginning of year2020-04-30$91,218
Value of fidelity bond covering the plan2020-04-30$90,000
Expenses. Other expenses not covered elsewhere2020-04-30$71,443
Net income (gross income less expenses)2020-04-30$-7,511
Net plan assets at end of year (total assets less liabilities)2020-04-30$83,707
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$91,218
Total contributions received or receivable from employer(s)2020-04-30$139,035
2019 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2019 401k financial data
Total plan liabilities at end of year2019-04-30$0
Total plan liabilities at beginning of year2019-04-30$0
Total income from all sources2019-04-30$132,186
Expenses. Total of all expenses incurred2019-04-30$143,246
Benefits paid (including direct rollovers)2019-04-30$72,872
Total plan assets at end of year2019-04-30$91,218
Total plan assets at beginning of year2019-04-30$102,278
Value of fidelity bond covering the plan2019-04-30$90,000
Expenses. Other expenses not covered elsewhere2019-04-30$70,374
Net income (gross income less expenses)2019-04-30$-11,060
Net plan assets at end of year (total assets less liabilities)2019-04-30$91,218
Net plan assets at beginning of year (total assets less liabilities)2019-04-30$102,278
Total contributions received or receivable from employer(s)2019-04-30$132,186
2018 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2018 401k financial data
Total plan liabilities at end of year2018-04-30$0
Total plan liabilities at beginning of year2018-04-30$0
Total income from all sources2018-04-30$135,182
Expenses. Total of all expenses incurred2018-04-30$102,299
Benefits paid (including direct rollovers)2018-04-30$29,575
Total plan assets at end of year2018-04-30$102,278
Total plan assets at beginning of year2018-04-30$69,395
Value of fidelity bond covering the plan2018-04-30$70,000
Expenses. Other expenses not covered elsewhere2018-04-30$72,724
Net income (gross income less expenses)2018-04-30$32,883
Net plan assets at end of year (total assets less liabilities)2018-04-30$102,278
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$69,395
Total contributions received or receivable from employer(s)2018-04-30$135,182
2017 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2017 401k financial data
Total plan liabilities at end of year2017-04-30$0
Total plan liabilities at beginning of year2017-04-30$0
Total income from all sources2017-04-30$147,312
Expenses. Total of all expenses incurred2017-04-30$123,059
Benefits paid (including direct rollovers)2017-04-30$42,392
Total plan assets at end of year2017-04-30$69,395
Total plan assets at beginning of year2017-04-30$45,142
Value of fidelity bond covering the plan2017-04-30$70,000
Expenses. Other expenses not covered elsewhere2017-04-30$80,667
Net income (gross income less expenses)2017-04-30$24,253
Net plan assets at end of year (total assets less liabilities)2017-04-30$69,395
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$45,142
Total contributions received or receivable from employer(s)2017-04-30$147,312
2016 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$911
Total income from all sources2016-04-30$142,486
Expenses. Total of all expenses incurred2016-04-30$107,102
Benefits paid (including direct rollovers)2016-04-30$29,378
Total plan assets at end of year2016-04-30$45,142
Total plan assets at beginning of year2016-04-30$10,669
Value of fidelity bond covering the plan2016-04-30$45,000
Expenses. Other expenses not covered elsewhere2016-04-30$77,724
Net income (gross income less expenses)2016-04-30$35,384
Net plan assets at end of year (total assets less liabilities)2016-04-30$45,142
Net plan assets at beginning of year (total assets less liabilities)2016-04-30$9,758
Total contributions received or receivable from employer(s)2016-04-30$142,486
2015 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2015 401k financial data
Total plan liabilities at end of year2015-04-30$911
Total plan liabilities at beginning of year2015-04-30$2,435
Total income from all sources2015-04-30$140,602
Expenses. Total of all expenses incurred2015-04-30$130,844
Benefits paid (including direct rollovers)2015-04-30$55,868
Total plan assets at end of year2015-04-30$10,669
Total plan assets at beginning of year2015-04-30$2,435
Value of fidelity bond covering the plan2015-04-30$25,000
Expenses. Other expenses not covered elsewhere2015-04-30$74,976
Net income (gross income less expenses)2015-04-30$9,758
Net plan assets at end of year (total assets less liabilities)2015-04-30$9,758
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$0
Total contributions received or receivable from employer(s)2015-04-30$140,602
2014 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2014 401k financial data
Total plan liabilities at end of year2014-04-30$2,435
Total plan liabilities at beginning of year2014-04-30$1,281
Total income from all sources2014-04-30$93,405
Expenses. Total of all expenses incurred2014-04-30$93,405
Benefits paid (including direct rollovers)2014-04-30$39,844
Total plan assets at end of year2014-04-30$2,435
Total plan assets at beginning of year2014-04-30$1,281
Value of fidelity bond covering the plan2014-04-30$25,000
Expenses. Other expenses not covered elsewhere2014-04-30$53,561
Net income (gross income less expenses)2014-04-30$0
Net plan assets at end of year (total assets less liabilities)2014-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2014-04-30$0
Total contributions received or receivable from employer(s)2014-04-30$93,405
2013 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2013 401k financial data
Total plan liabilities at end of year2013-04-30$1,281
Total plan liabilities at beginning of year2013-04-30$2,988
Total income from all sources2013-04-30$114,202
Expenses. Total of all expenses incurred2013-04-30$114,202
Benefits paid (including direct rollovers)2013-04-30$55,346
Total plan assets at end of year2013-04-30$1,281
Total plan assets at beginning of year2013-04-30$2,988
Expenses. Other expenses not covered elsewhere2013-04-30$58,856
Net income (gross income less expenses)2013-04-30$0
Net plan assets at end of year (total assets less liabilities)2013-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2013-04-30$0
Total contributions received or receivable from employer(s)2013-04-30$114,202
2012 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2012 401k financial data
Total plan liabilities at end of year2012-04-30$2,988
Total plan liabilities at beginning of year2012-04-30$2,382
Total income from all sources2012-04-30$107,805
Expenses. Total of all expenses incurred2012-04-30$107,805
Benefits paid (including direct rollovers)2012-04-30$51,218
Total plan assets at end of year2012-04-30$2,988
Total plan assets at beginning of year2012-04-30$2,382
Expenses. Other expenses not covered elsewhere2012-04-30$56,587
Net income (gross income less expenses)2012-04-30$0
Net plan assets at end of year (total assets less liabilities)2012-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$0
Total contributions received or receivable from employer(s)2012-04-30$107,805
2011 : EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2011 401k financial data
Total plan liabilities at end of year2011-04-30$2,382
Total plan liabilities at beginning of year2011-04-30$0
Total income from all sources2011-04-30$84,552
Expenses. Total of all expenses incurred2011-04-30$84,552
Benefits paid (including direct rollovers)2011-04-30$43,899
Total plan assets at end of year2011-04-30$2,382
Total plan assets at beginning of year2011-04-30$0
Expenses. Other expenses not covered elsewhere2011-04-30$40,653
Net income (gross income less expenses)2011-04-30$0
Net plan assets at end of year (total assets less liabilities)2011-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2011-04-30$0
Total contributions received or receivable from employer(s)2011-04-30$84,552

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF ROJAN, INC.

2022: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2016: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – TrustYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement - TrustYes
2015: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement - TrustYes
2014: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2013: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: EMPLOYEE HEALTH PLAN OF ROJAN, INC. 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered12
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $29,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered12
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $39,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered34
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $61,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered31
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $58,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered31
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $56,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered30
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $57,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered25
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $60,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered31
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $59,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered22
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $39,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered25
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $43,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered28
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $41,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number13970 NFA 0182
Policy instance 1
Insurance contract or identification number13970 NFA 0182
Number of Individuals Covered24
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $32,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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