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UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 401k Plan overview

Plan NameUNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN
Plan identification number 002

UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY has sponsored the creation of one or more 401k plans.

Company Name:UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY
Employer identification number (EIN):951856340
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022023-01-01SHIRLEY HORNER2024-07-15
0022022-01-01
0022021-07-01
0022019-07-01
0022018-07-01RAMIN BASCHSHI2023-11-07
0022017-07-01RAMIN BASCHSHI2023-11-07
0022016-07-01KASHIF KHAN2018-03-23 KASHIF KHAN2018-03-23
0022016-07-01RAMIN BASCHSHI2023-11-07
0022015-07-01KASHIF KHAN2017-01-10
0022014-07-01KASHIF KHAN2016-03-18
0022013-07-01DEBORAH LEVY2014-08-01
0022012-07-01DEBORAH LEVY2014-02-28
0022011-07-01CATHLEEN COLLINS2012-11-13
0022010-07-01CATHLEEN COLLINS2012-01-13

Plan Statistics for UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN

401k plan membership statisitcs for UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN

Measure Date Value
2022: UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01170
Total number of active participants reported on line 7a of the Form 55002022-01-01126
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0123
Total of all active and inactive participants2022-01-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01149
Number of participants with account balances2022-01-0161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01141
Total number of active participants reported on line 7a of the Form 55002021-07-01125
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-0134
Total of all active and inactive participants2021-07-01159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-07-010
Total participants2021-07-01159
Number of participants with account balances2021-07-0160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-07-010
2019: UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01122
Total number of active participants reported on line 7a of the Form 55002019-07-01126
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-0119
Total of all active and inactive participants2019-07-01145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-01145
Number of participants with account balances2019-07-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-010

Financial Data on UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN

Measure Date Value
2022 : UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$0
Total transfer of assets from this plan2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-97,396
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$514,350
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$489,663
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$190,755
Value of total assets at end of year2022-12-31$1,165,695
Value of total assets at beginning of year2022-12-31$1,777,441
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$24,687
Total interest from all sources2022-12-31$194
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$29,734
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$29,734
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$178,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$131,520
Participant contributions at end of year2022-12-31$8,018
Administrative expenses (other) incurred2022-12-31$24,687
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-611,746
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,165,695
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,777,441
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$1,157,666
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$1,775,690
Interest on participant loans2022-12-31$194
Value of interest in common/collective trusts at end of year2022-12-31$11
Value of interest in common/collective trusts at beginning of year2022-12-31$1,751
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-318,081
Net investment gain or loss from common/collective trusts2022-12-31$2
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$59,235
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$489,663
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31HASKELL & WHITE LLP
Accountancy firm EIN2022-12-31330310569
2021 : UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets from this plan2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$99,117
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$3,518
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$55,704
Value of total assets at end of year2021-12-31$1,777,441
Value of total assets at beginning of year2021-12-31$1,681,842
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$3,518
Total interest from all sources2021-12-31$22
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$249,215
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$249,215
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$169,000
If this is an individual account plan, was there a blackout period2021-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$55,704
Participant contributions at beginning of year2021-12-31$1,248
Administrative expenses (other) incurred2021-12-31$3,518
Total non interest bearing cash at beginning of year2021-12-31$1,751
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$95,599
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,777,441
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,681,842
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,775,690
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$1,678,843
Interest on participant loans2021-12-31$22
Value of interest in common/collective trusts at end of year2021-12-31$1,751
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$-205,824
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31Yes
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31HASKELL & WHITE LLP
Accountancy firm EIN2021-12-31330310569
2020 : UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets2020-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2020-06-30$0
Total unrealized appreciation/depreciation of assets2020-06-30$0
Total transfer of assets to this plan2020-06-30$0
Total transfer of assets from this plan2020-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Expenses. Interest paid2020-06-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022020-06-30$0
Total income from all sources (including contributions)2020-06-30$137,911
Total loss/gain on sale of assets2020-06-30$0
Total of all expenses incurred2020-06-30$6,030
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-06-30$625
Expenses. Certain deemed distributions of participant loans2020-06-30$0
Value of total corrective distributions2020-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-06-30$71,111
Value of total assets at end of year2020-06-30$1,291,058
Value of total assets at beginning of year2020-06-30$1,159,177
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-06-30$5,405
Total income from rents2020-06-30$0
Total interest from all sources2020-06-30$136
Total dividends received (eg from common stock, registered investment company shares)2020-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2020-06-30$0
Assets. Real estate other than employer real property at end of year2020-06-30$0
Assets. Real estate other than employer real property at beginning of year2020-06-30$0
Administrative expenses professional fees incurred2020-06-30$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2020-06-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2020-06-30$0
Was this plan covered by a fidelity bond2020-06-30Yes
Value of fidelity bond cover2020-06-30$100,000
If this is an individual account plan, was there a blackout period2020-06-30No
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Contributions received from participants2020-06-30$71,111
Participant contributions at end of year2020-06-30$3,601
Participant contributions at beginning of year2020-06-30$0
Participant contributions at end of year2020-06-30$0
Participant contributions at beginning of year2020-06-30$0
Assets. Other investments not covered elsewhere at end of year2020-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2020-06-30$0
Income. Received or receivable in cash from other sources (including rollovers)2020-06-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-06-30$0
Assets. Loans (other than to participants) at end of year2020-06-30$0
Assets. Loans (other than to participants) at beginning of year2020-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-06-30$0
Other income not declared elsewhere2020-06-30$0
Administrative expenses (other) incurred2020-06-30$0
Liabilities. Value of operating payables at end of year2020-06-30$0
Liabilities. Value of operating payables at beginning of year2020-06-30$0
Total non interest bearing cash at end of year2020-06-30$1,751
Total non interest bearing cash at beginning of year2020-06-30$1,751
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Income. Non cash contributions2020-06-30$0
Value of net income/loss2020-06-30$131,881
Value of net assets at end of year (total assets less liabilities)2020-06-30$1,291,058
Value of net assets at beginning of year (total assets less liabilities)2020-06-30$1,159,177
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Assets. partnership/joint venture interests at end of year2020-06-30$0
Assets. partnership/joint venture interests at beginning of year2020-06-30$0
Investment advisory and management fees2020-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-06-30$1,285,706
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-06-30$1,157,426
Value of interest in pooled separate accounts at end of year2020-06-30$0
Value of interest in pooled separate accounts at beginning of year2020-06-30$0
Interest on participant loans2020-06-30$136
Income. Interest from loans (other than to participants)2020-06-30$0
Interest earned on other investments2020-06-30$0
Income. Interest from US Government securities2020-06-30$0
Income. Interest from corporate debt instruments2020-06-30$0
Value of interest in master investment trust accounts at end of year2020-06-30$0
Value of interest in master investment trust accounts at beginning of year2020-06-30$0
Value of interest in common/collective trusts at end of year2020-06-30$0
Value of interest in common/collective trusts at beginning of year2020-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-06-30$0
Assets. Value of investments in 103.12 investment entities at end of year2020-06-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2020-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-06-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2020-06-30$0
Asset value of US Government securities at end of year2020-06-30$0
Asset value of US Government securities at beginning of year2020-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-06-30$66,664
Net investment gain/loss from pooled separate accounts2020-06-30$0
Net investment gain or loss from common/collective trusts2020-06-30$0
Net gain/loss from 103.12 investment entities2020-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30Yes
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Assets. Invements in employer securities at end of year2020-06-30$0
Assets. Invements in employer securities at beginning of year2020-06-30$0
Assets. Value of employer real property at end of year2020-06-30$0
Assets. Value of employer real property at beginning of year2020-06-30$0
Contributions received in cash from employer2020-06-30$0
Employer contributions (assets) at end of year2020-06-30$0
Employer contributions (assets) at beginning of year2020-06-30$0
Income. Dividends from preferred stock2020-06-30$0
Income. Dividends from common stock2020-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-06-30$625
Asset. Corporate debt instrument preferred debt at end of year2020-06-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2020-06-30$0
Asset. Corporate debt instrument debt (other) at end of year2020-06-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2020-06-30$0
Contract administrator fees2020-06-30$5,405
Assets. Corporate common stocks other than exployer securities at end of year2020-06-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2020-06-30$0
Liabilities. Value of benefit claims payable at end of year2020-06-30$0
Liabilities. Value of benefit claims payable at beginning of year2020-06-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2020-06-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-06-30$0
Did the plan have assets held for investment2020-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
Aggregate proceeds on sale of assets2020-06-30$0
Aggregate carrying amount (costs) on sale of assets2020-06-30$0
Liabilities. Value of acquisition indebtedness at end of year2020-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2020-06-30$0
Opinion of an independent qualified public accountant for this plan2020-06-30Disclaimer
Accountancy firm name2020-06-30HASKELL & WHITE LLP
Accountancy firm EIN2020-06-30330310569

Form 5500 Responses for UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN

2022: UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement - TrustYes
2019: UNITED CEREBRAL PALSY ASSOC OF ORANGE COUNTY 401(K) PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number114890
Policy instance 1
Insurance contract or identification number114890
Number of Individuals Covered62
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,762
Total amount of fees paid to insurance companyUSD $701
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,762
Insurance broker organization code?3
Amount paid for insurance broker fees701
Additional information about fees paid to insurance brokerTPA FEES/COMPENSATION

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