CHEROKEE NATION BUSINESSES, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN
401k plan membership statisitcs for CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 3,442 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 4,764 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 804 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 804 |
| Total of all active and inactive participants | 2023-01-01 | 6,372 |
| 2022: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 3,446 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 3,442 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 14 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 96 |
| Total of all active and inactive participants | 2022-01-01 | 3,552 |
| 2021: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 3,435 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 3,159 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 14 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 96 |
| Total of all active and inactive participants | 2021-01-01 | 3,269 |
| 2020: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 4,060 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 3,301 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 15 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 119 |
| Total of all active and inactive participants | 2020-01-01 | 3,435 |
| 2019: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 4,137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 3,869 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 8 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 183 |
| Total of all active and inactive participants | 2019-01-01 | 4,060 |
| 2017: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-05-01 | 9,742 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 5,453 |
| Number of retired or separated participants receiving benefits | 2017-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-05-01 | 354 |
| Total of all active and inactive participants | 2017-05-01 | 5,807 |
| 2016: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 10,021 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 9,732 |
| Number of retired or separated participants receiving benefits | 2016-05-01 | 10 |
| Number of other retired or separated participants entitled to future benefits | 2016-05-01 | 0 |
| Total of all active and inactive participants | 2016-05-01 | 9,742 |
| 2015: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 5,409 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 5,732 |
| Number of retired or separated participants receiving benefits | 2015-05-01 | 22 |
| Number of other retired or separated participants entitled to future benefits | 2015-05-01 | 0 |
| Total of all active and inactive participants | 2015-05-01 | 5,754 |
| 2014: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 8,591 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 9,816 |
| Number of retired or separated participants receiving benefits | 2014-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-05-01 | 0 |
| Total of all active and inactive participants | 2014-05-01 | 9,816 |
| 2013: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 7,933 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 8,591 |
| Total of all active and inactive participants | 2013-05-01 | 8,591 |
| 2012: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 7,429 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 7,933 |
| Number of retired or separated participants receiving benefits | 2012-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-05-01 | 0 |
| Total of all active and inactive participants | 2012-05-01 | 7,933 |
| 2011: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 6,441 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 7,429 |
| Number of retired or separated participants receiving benefits | 2011-05-01 | 34 |
| Total of all active and inactive participants | 2011-05-01 | 7,463 |
| Total participants | 2011-05-01 | 7,463 |
| Measure | Date | Value |
|---|
| 2017 : CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2017 401k financial data |
|---|
| Total income from all sources (including contributions) | 2017-04-30 | $62,433,831 |
| Total of all expenses incurred | 2017-04-30 | $62,689,729 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-04-30 | $59,755,920 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-04-30 | $61,136,592 |
| Value of total assets at end of year | 2017-04-30 | $0 |
| Value of total assets at beginning of year | 2017-04-30 | $255,898 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-04-30 | $2,933,809 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-04-30 | No |
| Was this plan covered by a fidelity bond | 2017-04-30 | Yes |
| Value of fidelity bond cover | 2017-04-30 | $1,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-04-30 | No |
| Contributions received from participants | 2017-04-30 | $7,856,730 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2017-04-30 | $175,396 |
| Other income not declared elsewhere | 2017-04-30 | $1,297,239 |
| Total non interest bearing cash at end of year | 2017-04-30 | $0 |
| Total non interest bearing cash at beginning of year | 2017-04-30 | $255,898 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-04-30 | No |
| Value of net income/loss | 2017-04-30 | $-255,898 |
| Value of net assets at end of year (total assets less liabilities) | 2017-04-30 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-04-30 | $255,898 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-04-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-04-30 | $4,602,732 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-04-30 | No |
| Contributions received in cash from employer | 2017-04-30 | $53,104,466 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-04-30 | $55,153,188 |
| Contract administrator fees | 2017-04-30 | $2,933,809 |
| Did the plan have assets held for investment | 2017-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-04-30 | Unqualified |
| Accountancy firm name | 2017-04-30 | BKD, LLP |
| Accountancy firm EIN | 2017-04-30 | 440160260 |
| 2016 : CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2016 401k financial data |
|---|
| Total income from all sources (including contributions) | 2016-04-30 | $61,118,073 |
| Total of all expenses incurred | 2016-04-30 | $60,946,695 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-04-30 | $58,194,325 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-04-30 | $59,603,447 |
| Value of total assets at end of year | 2016-04-30 | $255,898 |
| Value of total assets at beginning of year | 2016-04-30 | $84,520 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-04-30 | $2,752,370 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-04-30 | No |
| Was this plan covered by a fidelity bond | 2016-04-30 | Yes |
| Value of fidelity bond cover | 2016-04-30 | $1,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-04-30 | No |
| Contributions received from participants | 2016-04-30 | $8,503,728 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2016-04-30 | $210,873 |
| Other income not declared elsewhere | 2016-04-30 | $1,514,626 |
| Total non interest bearing cash at end of year | 2016-04-30 | $255,898 |
| Total non interest bearing cash at beginning of year | 2016-04-30 | $84,520 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-04-30 | No |
| Value of net income/loss | 2016-04-30 | $171,378 |
| Value of net assets at end of year (total assets less liabilities) | 2016-04-30 | $255,898 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-04-30 | $84,520 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-04-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-04-30 | $4,369,678 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-04-30 | No |
| Contributions received in cash from employer | 2016-04-30 | $50,888,846 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-04-30 | $53,824,647 |
| Contract administrator fees | 2016-04-30 | $2,752,370 |
| Did the plan have assets held for investment | 2016-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-04-30 | Unqualified |
| Accountancy firm name | 2016-04-30 | BKD, LLP |
| Accountancy firm EIN | 2016-04-30 | 440160260 |
| 2015 : CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2015 401k financial data |
|---|
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-04-30 | $0 |
| Total income from all sources (including contributions) | 2015-04-30 | $49,425,568 |
| Total of all expenses incurred | 2015-04-30 | $49,499,380 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-04-30 | $46,959,089 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-04-30 | $48,796,259 |
| Value of total assets at end of year | 2015-04-30 | $84,520 |
| Value of total assets at beginning of year | 2015-04-30 | $158,332 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-04-30 | $2,540,291 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-04-30 | No |
| Assets. Real estate other than employer real property at beginning of year | 2015-04-30 | $0 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2015-04-30 | $0 |
| Was this plan covered by a fidelity bond | 2015-04-30 | Yes |
| Value of fidelity bond cover | 2015-04-30 | $1,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-04-30 | No |
| Contributions received from participants | 2015-04-30 | $6,963,614 |
| Participant contributions at beginning of year | 2015-04-30 | $0 |
| Participant contributions at beginning of year | 2015-04-30 | $0 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2015-04-30 | $114,758 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-04-30 | $0 |
| Assets. Loans (other than to participants) at beginning of year | 2015-04-30 | $0 |
| Other income not declared elsewhere | 2015-04-30 | $629,309 |
| Total non interest bearing cash at end of year | 2015-04-30 | $84,520 |
| Total non interest bearing cash at beginning of year | 2015-04-30 | $158,332 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-04-30 | No |
| Value of net income/loss | 2015-04-30 | $-73,812 |
| Value of net assets at end of year (total assets less liabilities) | 2015-04-30 | $84,520 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-04-30 | $158,332 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-04-30 | No |
| Assets. partnership/joint venture interests at beginning of year | 2015-04-30 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-04-30 | $0 |
| Value of interest in pooled separate accounts at beginning of year | 2015-04-30 | $0 |
| Value of interest in master investment trust accounts at beginning of year | 2015-04-30 | $0 |
| Value of interest in common/collective trusts at beginning of year | 2015-04-30 | $0 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-04-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-04-30 | $0 |
| Assets. Value of investments in 103.12 investment entities at beginning of year | 2015-04-30 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2015-04-30 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-04-30 | $4,585,459 |
| Asset value of US Government securities at beginning of year | 2015-04-30 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-04-30 | No |
| Contributions received in cash from employer | 2015-04-30 | $41,717,887 |
| Employer contributions (assets) at beginning of year | 2015-04-30 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-04-30 | $42,373,630 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2015-04-30 | $0 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2015-04-30 | $0 |
| Contract administrator fees | 2015-04-30 | $2,540,291 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2015-04-30 | $0 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-04-30 | $0 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-04-30 | $0 |
| Did the plan have assets held for investment | 2015-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-04-30 | Unqualified |
| Accountancy firm name | 2015-04-30 | BKD, LLP |
| Accountancy firm EIN | 2015-04-30 | 440160260 |
| 2014 : CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-04-30 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-04-30 | $0 |
| Total income from all sources (including contributions) | 2014-04-30 | $43,559,134 |
| Total of all expenses incurred | 2014-04-30 | $43,400,802 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-04-30 | $39,838,906 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-04-30 | $43,380,214 |
| Value of total assets at end of year | 2014-04-30 | $158,332 |
| Value of total assets at beginning of year | 2014-04-30 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-04-30 | $3,561,896 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-04-30 | No |
| Assets. Real estate other than employer real property at end of year | 2014-04-30 | $0 |
| Assets. Real estate other than employer real property at beginning of year | 2014-04-30 | $0 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2014-04-30 | $0 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2014-04-30 | $0 |
| Was this plan covered by a fidelity bond | 2014-04-30 | Yes |
| Value of fidelity bond cover | 2014-04-30 | $1,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-04-30 | No |
| Contributions received from participants | 2014-04-30 | $6,431,468 |
| Participant contributions at end of year | 2014-04-30 | $0 |
| Participant contributions at beginning of year | 2014-04-30 | $0 |
| Participant contributions at end of year | 2014-04-30 | $0 |
| Participant contributions at beginning of year | 2014-04-30 | $0 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2014-04-30 | $158,856 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-04-30 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-04-30 | $0 |
| Assets. Loans (other than to participants) at end of year | 2014-04-30 | $0 |
| Assets. Loans (other than to participants) at beginning of year | 2014-04-30 | $0 |
| Other income not declared elsewhere | 2014-04-30 | $178,920 |
| Total non interest bearing cash at end of year | 2014-04-30 | $158,332 |
| Total non interest bearing cash at beginning of year | 2014-04-30 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-04-30 | No |
| Value of net income/loss | 2014-04-30 | $158,332 |
| Value of net assets at end of year (total assets less liabilities) | 2014-04-30 | $158,332 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-04-30 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-04-30 | No |
| Assets. partnership/joint venture interests at end of year | 2014-04-30 | $0 |
| Assets. partnership/joint venture interests at beginning of year | 2014-04-30 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-04-30 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-04-30 | $0 |
| Value of interest in pooled separate accounts at end of year | 2014-04-30 | $0 |
| Value of interest in pooled separate accounts at beginning of year | 2014-04-30 | $0 |
| Value of interest in master investment trust accounts at end of year | 2014-04-30 | $0 |
| Value of interest in master investment trust accounts at beginning of year | 2014-04-30 | $0 |
| Value of interest in common/collective trusts at end of year | 2014-04-30 | $0 |
| Value of interest in common/collective trusts at beginning of year | 2014-04-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-04-30 | $0 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-04-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-04-30 | $0 |
| Assets. Value of investments in 103.12 investment entities at end of year | 2014-04-30 | $0 |
| Assets. Value of investments in 103.12 investment entities at beginning of year | 2014-04-30 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2014-04-30 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2014-04-30 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-04-30 | $3,352,687 |
| Asset value of US Government securities at end of year | 2014-04-30 | $0 |
| Asset value of US Government securities at beginning of year | 2014-04-30 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-04-30 | No |
| Contributions received in cash from employer | 2014-04-30 | $36,789,890 |
| Employer contributions (assets) at end of year | 2014-04-30 | $0 |
| Employer contributions (assets) at beginning of year | 2014-04-30 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-04-30 | $36,486,219 |
| Asset. Corporate debt instrument preferred debt at end of year | 2014-04-30 | $0 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2014-04-30 | $0 |
| Asset. Corporate debt instrument debt (other) at end of year | 2014-04-30 | $0 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2014-04-30 | $0 |
| Contract administrator fees | 2014-04-30 | $3,561,896 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2014-04-30 | $0 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2014-04-30 | $0 |
| Liabilities. Value of benefit claims payable at end of year | 2014-04-30 | $0 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-04-30 | $0 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2014-04-30 | $0 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2014-04-30 | $0 |
| Did the plan have assets held for investment | 2014-04-30 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-04-30 | Unqualified |
| Accountancy firm name | 2014-04-30 | BKD, LLP |
| Accountancy firm EIN | 2014-04-30 | 440160260 |
| 2023: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2017 form 5500 responses |
|---|
| 2017-05-01 | Type of plan entity | Single employer plan |
| 2017-05-01 | Submission has been amended | No |
| 2017-05-01 | This submission is the final filing | No |
| 2017-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-05-01 | Plan is a collectively bargained plan | No |
| 2017-05-01 | Plan funding arrangement – Insurance | Yes |
| 2017-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2016 form 5500 responses |
|---|
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | Submission has been amended | No |
| 2016-05-01 | This submission is the final filing | No |
| 2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-05-01 | Plan is a collectively bargained plan | No |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan funding arrangement – Trust | Yes |
| 2016-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement - Trust | Yes |
| 2016-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2015 form 5500 responses |
|---|
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | Submission has been amended | No |
| 2015-05-01 | This submission is the final filing | No |
| 2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-05-01 | Plan is a collectively bargained plan | No |
| 2015-05-01 | Plan funding arrangement – Insurance | Yes |
| 2015-05-01 | Plan funding arrangement – Trust | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement - Trust | Yes |
| 2014: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2014 form 5500 responses |
|---|
| 2014-05-01 | Type of plan entity | Single employer plan |
| 2014-05-01 | Submission has been amended | No |
| 2014-05-01 | This submission is the final filing | No |
| 2014-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-05-01 | Plan is a collectively bargained plan | No |
| 2014-05-01 | Plan funding arrangement – Insurance | Yes |
| 2014-05-01 | Plan funding arrangement – Trust | Yes |
| 2014-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-05-01 | Plan benefit arrangement - Trust | Yes |
| 2013: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2013 form 5500 responses |
|---|
| 2013-05-01 | Type of plan entity | Single employer plan |
| 2013-05-01 | Submission has been amended | No |
| 2013-05-01 | This submission is the final filing | No |
| 2013-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-05-01 | Plan is a collectively bargained plan | No |
| 2013-05-01 | Plan funding arrangement – Insurance | Yes |
| 2013-05-01 | Plan funding arrangement – Trust | Yes |
| 2013-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-05-01 | Plan benefit arrangement - Trust | Yes |
| 2012: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2012 form 5500 responses |
|---|
| 2012-05-01 | Type of plan entity | Single employer plan |
| 2012-05-01 | Submission has been amended | No |
| 2012-05-01 | This submission is the final filing | No |
| 2012-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-05-01 | Plan is a collectively bargained plan | No |
| 2012-05-01 | Plan funding arrangement – Insurance | Yes |
| 2012-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: CHEROKEE NATION BUSINESSES, LLC HEALTH & WELFARE PLAN 2011 form 5500 responses |
|---|
| 2011-05-01 | Type of plan entity | Single employer plan |
| 2011-05-01 | Submission has been amended | No |
| 2011-05-01 | This submission is the final filing | No |
| 2011-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-05-01 | Plan is a collectively bargained plan | No |
| 2011-05-01 | Plan funding arrangement – Insurance | Yes |
| 2011-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | TDI0980180 |
| Policy instance | 9 |
| Insurance contract or identification number | TDI0980180 | | Number of Individuals Covered | 4371 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $59,189 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30040115* |
| Policy instance | 1 |
| Insurance contract or identification number | 30040115* | | Number of Individuals Covered | 5688 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0000163785 |
| Policy instance | 2 |
| Insurance contract or identification number | 0000163785 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $165,478 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $462,557 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68209 ) |
| Policy contract number | 0000172088 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000172088 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $53 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $96 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX0980495 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX0980495 | | Number of Individuals Covered | 4370 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $73,812 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,678,418 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 0980382 |
| Policy instance | 5 |
| Insurance contract or identification number | LK 0980382 | | Number of Individuals Covered | 4371 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $26,589 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,361,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | NYD0068769 |
| Policy instance | 6 |
| Insurance contract or identification number | NYD0068769 | | Number of Individuals Covered | 4371 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $14,794 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 0980502 |
| Policy instance | 7 |
| Insurance contract or identification number | OK 0980502 | | Number of Individuals Covered | 4370 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $4,956 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $253,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SDJ0980156 |
| Policy instance | 8 |
| Insurance contract or identification number | SDJ0980156 | | Number of Individuals Covered | 4371 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,567 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30040115 |
| Policy instance | 1 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0000163785 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 426941 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30040115 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 426942 |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00489352 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968200 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 964591 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966678 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30040115 |
| Policy instance | 5 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968200 |
| Policy instance | 2 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0149359 |
| Policy instance | 6 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 95478 ) |
| Policy contract number | 30040115 |
| Policy instance | 5 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 964591 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966678 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00489352 |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00489352 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | GFZ02784 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 95478 ) |
| Policy contract number | 30040115 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0149359 |
| Policy instance | 4 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 230478 |
| Policy instance | 5 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | GFZ02784 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 0002B447 |
| Policy instance | 1 |
| KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 ) |
| Policy contract number | K100970 |
| Policy instance | 3 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | YN9799 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 95478 ) |
| Policy contract number | 30040115 |
| Policy instance | 5 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0149359 |
| Policy instance | 6 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | YN9799 |
| Policy instance | 7 |
| KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 ) |
| Policy contract number | K100970 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 149359-01 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | YN9799 |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 49285 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | YN9799 |
| Policy instance | 1 |
