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EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF CAMPUS KING, INC.
Plan identification number 501

EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

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

Company Name:CAMPUS KING, INC.
Employer identification number (EIN):860880148
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-05-01
5012017-05-01AUDREY COWLEY
5012016-05-01AUDREY COWLEY
5012015-05-01AUDREY COWLEY
5012014-05-01AUDREY COWLEY
5012013-05-01AUDREY COWLEY
5012012-05-01AUDREY COWLEY
5012011-05-01AUDREY COWLEY
5012010-05-01AUDREY COWLEY

Plan Statistics for EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC.

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

Measure Date Value
2018: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2018 401k membership
Total participants, beginning-of-year2018-05-011
Total number of active participants reported on line 7a of the Form 55002018-05-011
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 participants2018-05-011
2017: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2017 401k membership
Total participants, beginning-of-year2017-05-011
Total number of active participants reported on line 7a of the Form 55002017-05-011
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 participants2017-05-011
2016: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2016 401k membership
Total participants, beginning-of-year2016-05-011
Total number of active participants reported on line 7a of the Form 55002016-05-012
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 participants2016-05-012
2015: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2015 401k membership
Total participants, beginning-of-year2015-05-012
Total number of active participants reported on line 7a of the Form 55002015-05-011
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 participants2015-05-011
2014: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2014 401k membership
Total participants, beginning-of-year2014-05-014
Total number of active participants reported on line 7a of the Form 55002014-05-012
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 participants2014-05-012
2013: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2013 401k membership
Total participants, beginning-of-year2013-05-014
Total number of active participants reported on line 7a of the Form 55002013-05-013
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 participants2013-05-013
2012: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2012 401k membership
Total participants, beginning-of-year2012-05-013
Total number of active participants reported on line 7a of the Form 55002012-05-014
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 participants2012-05-014
2011: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2011 401k membership
Total participants, beginning-of-year2011-05-014
Total number of active participants reported on line 7a of the Form 55002011-05-013
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 participants2011-05-013
2010: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2010 401k membership
Total participants, beginning-of-year2010-05-013
Total number of active participants reported on line 7a of the Form 55002010-05-014
Number of retired or separated participants receiving benefits2010-05-010
Number of other retired or separated participants entitled to future benefits2010-05-010
Total of all active and inactive participants2010-05-014

Financial Data on EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC.

Measure Date Value
2019 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, 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$805
Expenses. Total of all expenses incurred2019-04-30$805
Benefits paid (including direct rollovers)2019-04-30$415
Total plan assets at end of year2019-04-30$0
Total plan assets at beginning of year2019-04-30$0
Value of fidelity bond covering the plan2019-04-30$1,000
Expenses. Other expenses not covered elsewhere2019-04-30$390
Net income (gross income less expenses)2019-04-30$0
Net plan assets at end of year (total assets less liabilities)2019-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2019-04-30$0
Total contributions received or receivable from employer(s)2019-04-30$805
2018 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, 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$805
Expenses. Total of all expenses incurred2018-04-30$805
Benefits paid (including direct rollovers)2018-04-30$417
Total plan assets at end of year2018-04-30$0
Total plan assets at beginning of year2018-04-30$0
Value of fidelity bond covering the plan2018-04-30$1,000
Expenses. Other expenses not covered elsewhere2018-04-30$388
Net income (gross income less expenses)2018-04-30$0
Net plan assets at end of year (total assets less liabilities)2018-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$0
Total contributions received or receivable from employer(s)2018-04-30$805
2017 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, 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$805
Expenses. Total of all expenses incurred2017-04-30$805
Benefits paid (including direct rollovers)2017-04-30$386
Total plan assets at end of year2017-04-30$0
Total plan assets at beginning of year2017-04-30$0
Value of fidelity bond covering the plan2017-04-30$1,000
Expenses. Other expenses not covered elsewhere2017-04-30$419
Net income (gross income less expenses)2017-04-30$0
Net plan assets at end of year (total assets less liabilities)2017-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$0
Total contributions received or receivable from employer(s)2017-04-30$805
2016 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$0
Total income from all sources2016-04-30$1,306
Expenses. Total of all expenses incurred2016-04-30$1,306
Benefits paid (including direct rollovers)2016-04-30$737
Total plan assets at end of year2016-04-30$0
Total plan assets at beginning of year2016-04-30$0
Value of fidelity bond covering the plan2016-04-30$1,000
Expenses. Other expenses not covered elsewhere2016-04-30$569
Net income (gross income less expenses)2016-04-30$0
Net plan assets at end of year (total assets less liabilities)2016-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2016-04-30$0
Total contributions received or receivable from employer(s)2016-04-30$1,306
2015 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2015 401k financial data
Total plan liabilities at end of year2015-04-30$0
Total plan liabilities at beginning of year2015-04-30$36
Total income from all sources2015-04-30$2,231
Expenses. Total of all expenses incurred2015-04-30$2,231
Benefits paid (including direct rollovers)2015-04-30$1,323
Total plan assets at end of year2015-04-30$0
Total plan assets at beginning of year2015-04-30$36
Value of fidelity bond covering the plan2015-04-30$1,000
Expenses. Other expenses not covered elsewhere2015-04-30$908
Net income (gross income less expenses)2015-04-30$0
Net plan assets at end of year (total assets less liabilities)2015-04-30$0
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$2,231
2014 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2014 401k financial data
Total plan liabilities at end of year2014-04-30$36
Total plan liabilities at beginning of year2014-04-30$87
Total income from all sources2014-04-30$2,117
Expenses. Total of all expenses incurred2014-04-30$2,117
Benefits paid (including direct rollovers)2014-04-30$1,290
Total plan assets at end of year2014-04-30$36
Total plan assets at beginning of year2014-04-30$87
Value of fidelity bond covering the plan2014-04-30$1,000
Expenses. Other expenses not covered elsewhere2014-04-30$827
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$2,117
2013 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2013 401k financial data
Total plan liabilities at end of year2013-04-30$87
Total plan liabilities at beginning of year2013-04-30$80
Total income from all sources2013-04-30$2,338
Expenses. Total of all expenses incurred2013-04-30$3,494
Benefits paid (including direct rollovers)2013-04-30$2,727
Total plan assets at end of year2013-04-30$87
Total plan assets at beginning of year2013-04-30$1,236
Expenses. Other expenses not covered elsewhere2013-04-30$767
Net income (gross income less expenses)2013-04-30$-1,156
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$1,156
Total contributions received or receivable from employer(s)2013-04-30$2,338
2012 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2012 401k financial data
Total plan liabilities at end of year2012-04-30$80
Total plan liabilities at beginning of year2012-04-30$31
Total income from all sources2012-04-30$1,771
Expenses. Total of all expenses incurred2012-04-30$1,609
Benefits paid (including direct rollovers)2012-04-30$1,005
Total plan assets at end of year2012-04-30$1,236
Total plan assets at beginning of year2012-04-30$1,025
Expenses. Other expenses not covered elsewhere2012-04-30$604
Net income (gross income less expenses)2012-04-30$162
Net plan assets at end of year (total assets less liabilities)2012-04-30$1,156
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$994
Total contributions received or receivable from employer(s)2012-04-30$1,771
2011 : EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2011 401k financial data
Total plan liabilities at end of year2011-04-30$31
Total plan liabilities at beginning of year2011-04-30$0
Total income from all sources2011-04-30$2,647
Expenses. Total of all expenses incurred2011-04-30$1,653
Benefits paid (including direct rollovers)2011-04-30$684
Total plan assets at end of year2011-04-30$1,025
Total plan assets at beginning of year2011-04-30$0
Expenses. Other expenses not covered elsewhere2011-04-30$969
Net income (gross income less expenses)2011-04-30$994
Net plan assets at end of year (total assets less liabilities)2011-04-30$994
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$2,647

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC.

2018: EMPLOYEE HEALTH PLAN OF CAMPUS KING, 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 CAMPUS KING, 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 CAMPUS KING, 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 CAMPUS KING, 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 CAMPUS KING, 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 CAMPUS KING, 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 CAMPUS KING, 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 CAMPUS KING, 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
2010: EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01First time form 5500 has been submittedYes
2010-05-01Submission has been amendedNo
2010-05-01This submission is the final filingNo
2010-05-01This return/report is a short plan year return/report (less than 12 months)No
2010-05-01Plan is a collectively bargained planNo
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan funding arrangement – TrustYes
2010-05-01Plan benefit arrangement – InsuranceYes
2010-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number14220NFA0201
Policy instance 1
Insurance contract or identification number14220NFA0201
Number of Individuals Covered2
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 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 $237
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 number14220 NFA 0201
Policy instance 1
Insurance contract or identification number14220 NFA 0201
Number of Individuals Covered2
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 $237
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 number14220 NFA 0201
Policy instance 1
Insurance contract or identification number14220 NFA 0201
Number of Individuals Covered2
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 $383
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 number14220 NFA 0201
Policy instance 1
Insurance contract or identification number14220 NFA 0201
Number of Individuals Covered4
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 $644
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 number14220 NFA 0201
Policy instance 1
Insurance contract or identification number14220 NFA 0201
Number of Individuals Covered5
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 $628
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 number14220 NFA 0201
Policy instance 1
Insurance contract or identification number14220 NFA 0201
Number of Individuals Covered6
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 $541
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 number14220 NFA 0201
Policy instance 1
Insurance contract or identification number14220 NFA 0201
Number of Individuals Covered5
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 $436
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 number14220 NFA 0201
Policy instance 1
Insurance contract or identification number14220 NFA 0201
Number of Individuals Covered8
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 $770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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