NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 401k Plan overview

Plan Name	NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES
Plan identification number	518

NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES Benefits

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

401k Sponsoring company profile

NATIONAL FUEL GAS COMPANY has sponsored the creation of one or more 401k plans.

Company Name:	NATIONAL FUEL GAS COMPANY
Employer identification number (EIN):	131086010
NAIC Classification:	551112
NAIC Description:	Offices of Other Holding Companies

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
518	2021-10-01
518	2020-10-01
518	2019-10-01
518	2018-10-01
518	2017-10-01
518	2016-10-01	KAREN M CAMIOLO		KAREN M CAMIOLO	2018-07-10
518	2015-10-01	KAREN M CAMIOLO		KAREN M CAMIOLO	2017-07-11
518	2014-10-01	DAVID P BAUER		DAVID P BAUER	2016-06-13
518	2013-10-01	DAVID P BAUER		DAVID P BAUER	2015-06-30
518	2012-10-01	DAVID P BAUER		DAVID P BAUER	2014-07-09
518	2011-10-01	DAVID P BAUER		DAVID P BAUER	2013-07-11
518	2009-10-01	DAVID P BAUER		DAVID P BAUER	2011-07-07
518	2008-10-01

Plan Statistics for NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES

401k plan membership statisitcs for NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES

Measure	Date	Value
2021: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2021 401k membership
Total participants, beginning-of-year	2021-10-01	330
Number of retired or separated participants receiving benefits	2021-10-01	331
Total of all active and inactive participants	2021-10-01	331
2020: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2020 401k membership
Total participants, beginning-of-year	2020-10-01	342
Number of retired or separated participants receiving benefits	2020-10-01	330
Total of all active and inactive participants	2020-10-01	330
2019: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2019 401k membership
Total participants, beginning-of-year	2019-10-01	342
Number of retired or separated participants receiving benefits	2019-10-01	342
Total of all active and inactive participants	2019-10-01	342
2018: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2018 401k membership
Total participants, beginning-of-year	2018-10-01	335
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	0
Number of retired or separated participants receiving benefits	2018-10-01	342
Number of other retired or separated participants entitled to future benefits	2018-10-01	0
Total of all active and inactive participants	2018-10-01	342
2017: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2017 401k membership
Total participants, beginning-of-year	2017-10-01	334
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	0
Number of retired or separated participants receiving benefits	2017-10-01	335
Number of other retired or separated participants entitled to future benefits	2017-10-01	0
Total of all active and inactive participants	2017-10-01	335
2016: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2016 401k membership
Total participants, beginning-of-year	2016-10-01	332
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	0
Number of retired or separated participants receiving benefits	2016-10-01	334
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	334
2015: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2015 401k membership
Total participants, beginning-of-year	2015-10-01	327
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	0
Number of retired or separated participants receiving benefits	2015-10-01	332
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	332
2014: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2014 401k membership
Total participants, beginning-of-year	2014-10-01	316
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	0
Number of retired or separated participants receiving benefits	2014-10-01	327
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	327
2013: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2013 401k membership
Total participants, beginning-of-year	2013-10-01	312
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	0
Number of retired or separated participants receiving benefits	2013-10-01	316
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	316
2012: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2012 401k membership
Total participants, beginning-of-year	2012-10-01	308
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	0
Number of retired or separated participants receiving benefits	2012-10-01	312
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	312
2011: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2011 401k membership
Total participants, beginning-of-year	2011-10-01	311
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	0
Number of retired or separated participants receiving benefits	2011-10-01	308
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	308
2009: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2009 401k membership
Total participants, beginning-of-year	2009-10-01	299
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	0
Number of retired or separated participants receiving benefits	2009-10-01	303
Number of other retired or separated participants entitled to future benefits	2009-10-01	0
Total of all active and inactive participants	2009-10-01	303

Financial Data on NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES

Measure	Date	Value
2022 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-09-30	$-1,686,276
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-09-30	$890,087
Total income from all sources (including contributions)	2022-09-30	$-6,844,041
Total loss/gain on sale of assets	2022-09-30	$0
Total of all expenses incurred	2022-09-30	$2,485,779
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-09-30	$4,005,651
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-09-30	$1,861,096
Value of total assets at end of year	2022-09-30	$43,398,308
Value of total assets at beginning of year	2022-09-30	$55,304,491
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-09-30	$-1,519,872
Total interest from all sources	2022-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-09-30	$706,076
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-09-30	$706,076
Administrative expenses professional fees incurred	2022-09-30	$10,829
Was this plan covered by a fidelity bond	2022-09-30	Yes
Value of fidelity bond cover	2022-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2022-09-30	No
Contributions received from participants	2022-09-30	$698,149
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-09-30	$4,076
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-09-30	$46
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-09-30	$-1,939,130
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-09-30	$645,205
Administrative expenses (other) incurred	2022-09-30	$-1,734,334
Liabilities. Value of operating payables at end of year	2022-09-30	$7,700
Liabilities. Value of operating payables at beginning of year	2022-09-30	$8,428
Total non interest bearing cash at end of year	2022-09-30	$111,542
Total non interest bearing cash at beginning of year	2022-09-30	$36,758
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-09-30	No
Value of net income/loss	2022-09-30	$-9,329,820
Value of net assets at end of year (total assets less liabilities)	2022-09-30	$45,084,584
Value of net assets at beginning of year (total assets less liabilities)	2022-09-30	$54,414,404
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-09-30	No
Were any leases to which the plan was party in default or uncollectible	2022-09-30	No
Investment advisory and management fees	2022-09-30	$19,486
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-09-30	$32,259,843
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-09-30	$35,992,166
Value of interest in common/collective trusts at end of year	2022-09-30	$11,022,847
Value of interest in common/collective trusts at beginning of year	2022-09-30	$19,275,521
Expenses. Payments to insurance carriers foe the provision of benefits	2022-09-30	$4,005,651
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-09-30	$-6,228,441
Net investment gain or loss from common/collective trusts	2022-09-30	$-3,182,772
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2022-09-30	No
Has the plan failed to provide any benefit when due under the plan	2022-09-30	No
Contributions received in cash from employer	2022-09-30	$1,162,947
Contract administrator fees	2022-09-30	$184,147
Liabilities. Value of benefit claims payable at end of year	2022-09-30	$245,154
Liabilities. Value of benefit claims payable at beginning of year	2022-09-30	$236,454
Did the plan have assets held for investment	2022-09-30	Yes
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	2022-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-09-30	No
Opinion of an independent qualified public accountant for this plan	2022-09-30	Unqualified
Accountancy firm name	2022-09-30	BONADIO & CO. , LLP
Accountancy firm EIN	2022-09-30	161131146
2021 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-09-30	$890,087
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-09-30	$549,054
Total income from all sources (including contributions)	2021-09-30	$6,746,068
Total loss/gain on sale of assets	2021-09-30	$0
Total of all expenses incurred	2021-09-30	$5,253,856
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-09-30	$4,047,951
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-09-30	$1,819,024
Value of total assets at end of year	2021-09-30	$55,304,491
Value of total assets at beginning of year	2021-09-30	$53,471,246
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-09-30	$1,205,905
Total interest from all sources	2021-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-09-30	$420,933
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-09-30	$420,933
Administrative expenses professional fees incurred	2021-09-30	$10,171
Was this plan covered by a fidelity bond	2021-09-30	Yes
Value of fidelity bond cover	2021-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2021-09-30	No
Contributions received from participants	2021-09-30	$656,077
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-09-30	$46
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-09-30	$32,427
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-09-30	$645,205
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-09-30	$302,744
Administrative expenses (other) incurred	2021-09-30	$992,460
Liabilities. Value of operating payables at end of year	2021-09-30	$8,428
Liabilities. Value of operating payables at beginning of year	2021-09-30	$6,399
Total non interest bearing cash at end of year	2021-09-30	$36,758
Total non interest bearing cash at beginning of year	2021-09-30	$40,903
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-09-30	No
Value of net income/loss	2021-09-30	$1,492,212
Value of net assets at end of year (total assets less liabilities)	2021-09-30	$54,414,404
Value of net assets at beginning of year (total assets less liabilities)	2021-09-30	$52,922,192
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-09-30	No
Were any leases to which the plan was party in default or uncollectible	2021-09-30	No
Investment advisory and management fees	2021-09-30	$16,224
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-09-30	$35,992,166
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-09-30	$35,224,396
Value of interest in common/collective trusts at end of year	2021-09-30	$19,275,521
Value of interest in common/collective trusts at beginning of year	2021-09-30	$18,173,520
Expenses. Payments to insurance carriers foe the provision of benefits	2021-09-30	$4,047,951
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-09-30	$-345,890
Net investment gain or loss from common/collective trusts	2021-09-30	$4,852,001
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2021-09-30	No
Has the plan failed to provide any benefit when due under the plan	2021-09-30	No
Contributions received in cash from employer	2021-09-30	$1,162,947
Contract administrator fees	2021-09-30	$187,050
Liabilities. Value of benefit claims payable at end of year	2021-09-30	$236,454
Liabilities. Value of benefit claims payable at beginning of year	2021-09-30	$239,911
Did the plan have assets held for investment	2021-09-30	Yes
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	2021-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-09-30	No
Opinion of an independent qualified public accountant for this plan	2021-09-30	Disclaimer
Accountancy firm name	2021-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2021-09-30	161131146
2020 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-09-30	$549,054
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-09-30	$-79,270
Total income from all sources (including contributions)	2020-09-30	$5,121,114
Total loss/gain on sale of assets	2020-09-30	$0
Total of all expenses incurred	2020-09-30	$4,945,511
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-09-30	$4,111,166
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-09-30	$616,548
Value of total assets at end of year	2020-09-30	$53,471,246
Value of total assets at beginning of year	2020-09-30	$52,667,319
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-09-30	$834,345
Total interest from all sources	2020-09-30	$1
Total dividends received (eg from common stock, registered investment company shares)	2020-09-30	$661,182
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-09-30	$661,182
Administrative expenses professional fees incurred	2020-09-30	$14,356
Was this plan covered by a fidelity bond	2020-09-30	Yes
Value of fidelity bond cover	2020-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2020-09-30	No
Contributions received from participants	2020-09-30	$616,548
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-09-30	$32,427
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-09-30	$39,007
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-09-30	$302,744
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-09-30	$-312,695
Administrative expenses (other) incurred	2020-09-30	$615,439
Liabilities. Value of operating payables at end of year	2020-09-30	$6,399
Liabilities. Value of operating payables at beginning of year	2020-09-30	$7,801
Total non interest bearing cash at end of year	2020-09-30	$40,903
Total non interest bearing cash at beginning of year	2020-09-30	$70,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-09-30	No
Value of net income/loss	2020-09-30	$175,603
Value of net assets at end of year (total assets less liabilities)	2020-09-30	$52,922,192
Value of net assets at beginning of year (total assets less liabilities)	2020-09-30	$52,746,589
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-09-30	No
Were any leases to which the plan was party in default or uncollectible	2020-09-30	No
Investment advisory and management fees	2020-09-30	$15,538
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-09-30	$35,224,396
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-09-30	$31,963,956
Interest earned on other investments	2020-09-30	$1
Value of interest in common/collective trusts at end of year	2020-09-30	$18,173,520
Value of interest in common/collective trusts at beginning of year	2020-09-30	$20,594,181
Expenses. Payments to insurance carriers foe the provision of benefits	2020-09-30	$4,111,166
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-09-30	$1,690,389
Net investment gain or loss from common/collective trusts	2020-09-30	$2,152,994
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2020-09-30	No
Has the plan failed to provide any benefit when due under the plan	2020-09-30	No
Contract administrator fees	2020-09-30	$189,012
Liabilities. Value of benefit claims payable at end of year	2020-09-30	$239,911
Liabilities. Value of benefit claims payable at beginning of year	2020-09-30	$225,624
Did the plan have assets held for investment	2020-09-30	Yes
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	2020-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-09-30	Disclaimer
Accountancy firm name	2020-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2020-09-30	161131146
2019 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-09-30	$-79,270
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-09-30	$-474,421
Total income from all sources (including contributions)	2019-09-30	$3,528,380
Total loss/gain on sale of assets	2019-09-30	$0
Total of all expenses incurred	2019-09-30	$4,263,358
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-09-30	$3,638,769
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-09-30	$573,654
Value of total assets at end of year	2019-09-30	$52,667,319
Value of total assets at beginning of year	2019-09-30	$53,007,146
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-09-30	$624,589
Total interest from all sources	2019-09-30	$3
Total dividends received (eg from common stock, registered investment company shares)	2019-09-30	$968,439
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-09-30	$968,439
Administrative expenses professional fees incurred	2019-09-30	$9,178
Was this plan covered by a fidelity bond	2019-09-30	Yes
Value of fidelity bond cover	2019-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2019-09-30	No
Contributions received from participants	2019-09-30	$573,654
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-09-30	$39,007
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-09-30	$2,581
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-09-30	$-312,695
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-09-30	$-704,824
Administrative expenses (other) incurred	2019-09-30	$392,129
Liabilities. Value of operating payables at end of year	2019-09-30	$7,801
Liabilities. Value of operating payables at beginning of year	2019-09-30	$6,182
Total non interest bearing cash at end of year	2019-09-30	$70,175
Total non interest bearing cash at beginning of year	2019-09-30	$75,707
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-09-30	No
Value of net income/loss	2019-09-30	$-734,978
Value of net assets at end of year (total assets less liabilities)	2019-09-30	$52,746,589
Value of net assets at beginning of year (total assets less liabilities)	2019-09-30	$53,481,567
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-09-30	No
Were any leases to which the plan was party in default or uncollectible	2019-09-30	No
Investment advisory and management fees	2019-09-30	$17,756
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-09-30	$31,963,956
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-09-30	$31,445,738
Interest earned on other investments	2019-09-30	$3
Value of interest in common/collective trusts at end of year	2019-09-30	$20,594,181
Value of interest in common/collective trusts at beginning of year	2019-09-30	$21,483,120
Expenses. Payments to insurance carriers foe the provision of benefits	2019-09-30	$3,638,769
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-09-30	$1,898,195
Net investment gain or loss from common/collective trusts	2019-09-30	$88,089
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2019-09-30	No
Has the plan failed to provide any benefit when due under the plan	2019-09-30	No
Contract administrator fees	2019-09-30	$205,526
Liabilities. Value of benefit claims payable at end of year	2019-09-30	$225,624
Liabilities. Value of benefit claims payable at beginning of year	2019-09-30	$224,221
Did the plan have assets held for investment	2019-09-30	Yes
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	2019-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-09-30	Disclaimer
Accountancy firm name	2019-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2019-09-30	161131146
2018 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-09-30	$-474,421
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-09-30	$-303,678
Total income from all sources (including contributions)	2018-09-30	$2,768,973
Total loss/gain on sale of assets	2018-09-30	$0
Total of all expenses incurred	2018-09-30	$4,027,557
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-09-30	$3,964,409
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-09-30	$555,911
Value of total assets at end of year	2018-09-30	$53,007,146
Value of total assets at beginning of year	2018-09-30	$54,436,473
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-09-30	$63,148
Total interest from all sources	2018-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-09-30	$859,745
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-09-30	$859,745
Administrative expenses professional fees incurred	2018-09-30	$10,662
Was this plan covered by a fidelity bond	2018-09-30	Yes
Value of fidelity bond cover	2018-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2018-09-30	No
Contributions received from participants	2018-09-30	$555,911
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-09-30	$2,581
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-09-30	$926
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-09-30	$-704,824
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-09-30	$-534,150
Administrative expenses (other) incurred	2018-09-30	$-170,675
Liabilities. Value of operating payables at end of year	2018-09-30	$6,182
Liabilities. Value of operating payables at beginning of year	2018-09-30	$7,427
Total non interest bearing cash at end of year	2018-09-30	$75,707
Total non interest bearing cash at beginning of year	2018-09-30	$68,558
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-09-30	No
Value of net income/loss	2018-09-30	$-1,258,584
Value of net assets at end of year (total assets less liabilities)	2018-09-30	$53,481,567
Value of net assets at beginning of year (total assets less liabilities)	2018-09-30	$54,740,151
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-09-30	No
Were any leases to which the plan was party in default or uncollectible	2018-09-30	No
Investment advisory and management fees	2018-09-30	$20,581
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-09-30	$31,445,738
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-09-30	$32,203,542
Value of interest in common/collective trusts at end of year	2018-09-30	$21,483,120
Value of interest in common/collective trusts at beginning of year	2018-09-30	$22,163,447
Expenses. Payments to insurance carriers foe the provision of benefits	2018-09-30	$3,964,409
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-09-30	$-1,153,679
Net investment gain or loss from common/collective trusts	2018-09-30	$2,506,996
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2018-09-30	No
Has the plan failed to provide any benefit when due under the plan	2018-09-30	No
Contract administrator fees	2018-09-30	$202,580
Liabilities. Value of benefit claims payable at end of year	2018-09-30	$224,221
Liabilities. Value of benefit claims payable at beginning of year	2018-09-30	$223,045
Did the plan have assets held for investment	2018-09-30	Yes
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	2018-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-09-30	Disclaimer
Accountancy firm name	2018-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2018-09-30	161131146
2017 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-09-30	$-303,678
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-09-30	$-988,579
Total income from all sources (including contributions)	2017-09-30	$5,686,185
Total loss/gain on sale of assets	2017-09-30	$0
Total of all expenses incurred	2017-09-30	$4,963,960
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-09-30	$4,073,767
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-09-30	$1,394,396
Value of total assets at end of year	2017-09-30	$54,436,473
Value of total assets at beginning of year	2017-09-30	$53,029,347
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-09-30	$890,193
Total interest from all sources	2017-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-09-30	$697,913
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-09-30	$697,913
Administrative expenses professional fees incurred	2017-09-30	$7,356
Was this plan covered by a fidelity bond	2017-09-30	Yes
Value of fidelity bond cover	2017-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2017-09-30	No
Contributions received from participants	2017-09-30	$543,189
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-09-30	$926
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-09-30	$24
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-09-30	$-534,150
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-09-30	$-1,202,861
Administrative expenses (other) incurred	2017-09-30	$671,258
Liabilities. Value of operating payables at end of year	2017-09-30	$7,427
Liabilities. Value of operating payables at beginning of year	2017-09-30	$6,711
Total non interest bearing cash at end of year	2017-09-30	$68,558
Total non interest bearing cash at beginning of year	2017-09-30	$53,483
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-09-30	No
Value of net income/loss	2017-09-30	$722,225
Value of net assets at end of year (total assets less liabilities)	2017-09-30	$54,740,151
Value of net assets at beginning of year (total assets less liabilities)	2017-09-30	$54,017,926
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-09-30	No
Were any leases to which the plan was party in default or uncollectible	2017-09-30	No
Investment advisory and management fees	2017-09-30	$20,950
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-09-30	$32,203,542
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-09-30	$29,963,517
Value of interest in common/collective trusts at end of year	2017-09-30	$22,163,447
Value of interest in common/collective trusts at beginning of year	2017-09-30	$23,012,323
Expenses. Payments to insurance carriers foe the provision of benefits	2017-09-30	$4,073,767
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-09-30	$-549,822
Net investment gain or loss from common/collective trusts	2017-09-30	$4,143,698
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2017-09-30	No
Has the plan failed to provide any benefit when due under the plan	2017-09-30	No
Contributions received in cash from employer	2017-09-30	$851,207
Contract administrator fees	2017-09-30	$190,629
Liabilities. Value of benefit claims payable at end of year	2017-09-30	$223,045
Liabilities. Value of benefit claims payable at beginning of year	2017-09-30	$207,571
Did the plan have assets held for investment	2017-09-30	Yes
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	2017-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-09-30	Disclaimer
Accountancy firm name	2017-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2017-09-30	161131146
2016 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-09-30	$-988,579
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-09-30	$-1,013,936
Total income from all sources (including contributions)	2016-09-30	$4,377,981
Total loss/gain on sale of assets	2016-09-30	$0
Total of all expenses incurred	2016-09-30	$3,766,762
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-09-30	$3,509,787
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-09-30	$522,818
Value of total assets at end of year	2016-09-30	$53,029,347
Value of total assets at beginning of year	2016-09-30	$52,392,771
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-09-30	$256,975
Total interest from all sources	2016-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-09-30	$795,282
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-09-30	$795,282
Administrative expenses professional fees incurred	2016-09-30	$7,525
Was this plan covered by a fidelity bond	2016-09-30	Yes
Value of fidelity bond cover	2016-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2016-09-30	No
Contributions received from participants	2016-09-30	$522,818
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-09-30	$24
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-09-30	$40
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-09-30	$-1,202,861
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-09-30	$-1,229,322
Administrative expenses (other) incurred	2016-09-30	$46,535
Liabilities. Value of operating payables at end of year	2016-09-30	$6,711
Liabilities. Value of operating payables at beginning of year	2016-09-30	$8,001
Total non interest bearing cash at end of year	2016-09-30	$53,483
Total non interest bearing cash at beginning of year	2016-09-30	$50,531
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-09-30	No
Value of net income/loss	2016-09-30	$611,219
Value of net assets at end of year (total assets less liabilities)	2016-09-30	$54,017,926
Value of net assets at beginning of year (total assets less liabilities)	2016-09-30	$53,406,707
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-09-30	No
Were any leases to which the plan was party in default or uncollectible	2016-09-30	No
Investment advisory and management fees	2016-09-30	$17,412
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-09-30	$29,963,517
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-09-30	$29,863,863
Value of interest in common/collective trusts at end of year	2016-09-30	$23,012,323
Value of interest in common/collective trusts at beginning of year	2016-09-30	$22,478,337
Expenses. Payments to insurance carriers foe the provision of benefits	2016-09-30	$3,509,787
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-09-30	$453,570
Net investment gain or loss from common/collective trusts	2016-09-30	$2,606,311
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2016-09-30	No
Has the plan failed to provide any benefit when due under the plan	2016-09-30	No
Contract administrator fees	2016-09-30	$185,503
Liabilities. Value of benefit claims payable at end of year	2016-09-30	$207,571
Liabilities. Value of benefit claims payable at beginning of year	2016-09-30	$207,385
Did the plan have assets held for investment	2016-09-30	Yes
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	2016-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-09-30	Disclaimer
Accountancy firm name	2016-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2016-09-30	161131146
2015 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-09-30	$-1,013,936
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-09-30	$783,771
Total income from all sources (including contributions)	2015-09-30	$473,081
Total loss/gain on sale of assets	2015-09-30	$0
Total of all expenses incurred	2015-09-30	$3,023,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-09-30	$3,571,971
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-09-30	$461,348
Value of total assets at end of year	2015-09-30	$52,392,771
Value of total assets at beginning of year	2015-09-30	$56,740,819
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-09-30	$-548,549
Total interest from all sources	2015-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-09-30	$704,755
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-09-30	$704,755
Assets. Real estate other than employer real property at beginning of year	2015-09-30	$0
Administrative expenses professional fees incurred	2015-09-30	$6,879
Was this plan covered by a fidelity bond	2015-09-30	Yes
Value of fidelity bond cover	2015-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2015-09-30	No
Contributions received from participants	2015-09-30	$461,348
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-09-30	$40
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-09-30	$14
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-09-30	$-1,229,322
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-09-30	$561,496
Administrative expenses (other) incurred	2015-09-30	$-755,135
Liabilities. Value of operating payables at end of year	2015-09-30	$8,001
Liabilities. Value of operating payables at beginning of year	2015-09-30	$14,429
Total non interest bearing cash at end of year	2015-09-30	$50,531
Total non interest bearing cash at beginning of year	2015-09-30	$45,440
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-09-30	No
Value of net income/loss	2015-09-30	$-2,550,341
Value of net assets at end of year (total assets less liabilities)	2015-09-30	$53,406,707
Value of net assets at beginning of year (total assets less liabilities)	2015-09-30	$55,957,048
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-09-30	No
Were any leases to which the plan was party in default or uncollectible	2015-09-30	No
Investment advisory and management fees	2015-09-30	$12,484
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-09-30	$29,863,863
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-09-30	$30,549,010
Value of interest in common/collective trusts at end of year	2015-09-30	$22,478,337
Value of interest in common/collective trusts at beginning of year	2015-09-30	$26,146,355
Expenses. Payments to insurance carriers foe the provision of benefits	2015-09-30	$3,571,971
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-09-30	$-66,230
Net investment gain or loss from common/collective trusts	2015-09-30	$-626,792
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2015-09-30	No
Has the plan failed to provide any benefit when due under the plan	2015-09-30	No
Contributions received in cash from employer	2015-09-30	$0
Contract administrator fees	2015-09-30	$187,223
Liabilities. Value of benefit claims payable at end of year	2015-09-30	$207,385
Liabilities. Value of benefit claims payable at beginning of year	2015-09-30	$207,846
Did the plan have assets held for investment	2015-09-30	Yes
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	2015-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-09-30	Disclaimer
Accountancy firm name	2015-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2015-09-30	161131146
2014 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-09-30	$783,771
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-09-30	$988,898
Total income from all sources (including contributions)	2014-09-30	$5,342,461
Total loss/gain on sale of assets	2014-09-30	$0
Total of all expenses incurred	2014-09-30	$3,448,061
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-09-30	$3,435,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-09-30	$528,567
Value of total assets at end of year	2014-09-30	$56,740,819
Value of total assets at beginning of year	2014-09-30	$55,051,546
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-09-30	$12,295
Total interest from all sources	2014-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-09-30	$597,933
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-09-30	$597,933
Assets. Real estate other than employer real property at end of year	2014-09-30	$0
Assets. Real estate other than employer real property at beginning of year	2014-09-30	$16,578
Administrative expenses professional fees incurred	2014-09-30	$20,149
Was this plan covered by a fidelity bond	2014-09-30	Yes
Value of fidelity bond cover	2014-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2014-09-30	No
Contributions received from participants	2014-09-30	$467,287
Assets. Other investments not covered elsewhere at beginning of year	2014-09-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-09-30	$14
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-09-30	$14
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-09-30	$561,496
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-09-30	$761,356
Administrative expenses (other) incurred	2014-09-30	$-195,875
Liabilities. Value of operating payables at end of year	2014-09-30	$14,429
Liabilities. Value of operating payables at beginning of year	2014-09-30	$6,021
Total non interest bearing cash at end of year	2014-09-30	$45,440
Total non interest bearing cash at beginning of year	2014-09-30	$24,262
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-09-30	No
Value of net income/loss	2014-09-30	$1,894,400
Value of net assets at end of year (total assets less liabilities)	2014-09-30	$55,957,048
Value of net assets at beginning of year (total assets less liabilities)	2014-09-30	$54,062,648
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-09-30	No
Were any leases to which the plan was party in default or uncollectible	2014-09-30	No
Investment advisory and management fees	2014-09-30	$14,248
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-09-30	$30,549,010
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-09-30	$17,780,557
Value of interest in common/collective trusts at end of year	2014-09-30	$26,146,355
Value of interest in common/collective trusts at beginning of year	2014-09-30	$37,230,135
Expenses. Payments to insurance carriers foe the provision of benefits	2014-09-30	$3,435,766
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-09-30	$464,802
Net investment gain or loss from common/collective trusts	2014-09-30	$3,751,159
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2014-09-30	No
Has the plan failed to provide any benefit when due under the plan	2014-09-30	No
Contributions received in cash from employer	2014-09-30	$61,280
Contract administrator fees	2014-09-30	$173,773
Liabilities. Value of benefit claims payable at end of year	2014-09-30	$207,846
Liabilities. Value of benefit claims payable at beginning of year	2014-09-30	$221,521
Did the plan have assets held for investment	2014-09-30	Yes
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	2014-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-09-30	Disclaimer
Accountancy firm name	2014-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2014-09-30	161131146
2013 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-09-30	$16,574
Total unrealized appreciation/depreciation of assets	2013-09-30	$16,574
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-09-30	$988,898
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-09-30	$359,296
Total income from all sources (including contributions)	2013-09-30	$15,006,485
Total loss/gain on sale of assets	2013-09-30	$533,621
Total of all expenses incurred	2013-09-30	$4,477,790
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-09-30	$3,273,819
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-09-30	$7,333,820
Value of total assets at end of year	2013-09-30	$55,051,546
Value of total assets at beginning of year	2013-09-30	$43,893,249
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-09-30	$1,203,971
Total income from rents	2013-09-30	$37,818
Total interest from all sources	2013-09-30	$52,434
Total dividends received (eg from common stock, registered investment company shares)	2013-09-30	$459,358
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-09-30	$459,358
Assets. Real estate other than employer real property at end of year	2013-09-30	$16,578
Assets. Real estate other than employer real property at beginning of year	2013-09-30	$421,000
Administrative expenses professional fees incurred	2013-09-30	$31,585
Was this plan covered by a fidelity bond	2013-09-30	Yes
Value of fidelity bond cover	2013-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2013-09-30	No
Contributions received from participants	2013-09-30	$438,173
Assets. Other investments not covered elsewhere at end of year	2013-09-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-09-30	$1,634,494
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-09-30	$14
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-09-30	$435,785
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-09-30	$761,356
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-09-30	$26,973
Other income not declared elsewhere	2013-09-30	$0
Administrative expenses (other) incurred	2013-09-30	$1,010,715
Liabilities. Value of operating payables at end of year	2013-09-30	$6,021
Liabilities. Value of operating payables at beginning of year	2013-09-30	$24,326
Total non interest bearing cash at end of year	2013-09-30	$24,262
Total non interest bearing cash at beginning of year	2013-09-30	$20,380
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-09-30	No
Value of net income/loss	2013-09-30	$10,528,695
Value of net assets at end of year (total assets less liabilities)	2013-09-30	$54,062,648
Value of net assets at beginning of year (total assets less liabilities)	2013-09-30	$43,533,953
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-09-30	No
Were any leases to which the plan was party in default or uncollectible	2013-09-30	No
Investment advisory and management fees	2013-09-30	$16,339
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-09-30	$17,780,557
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-09-30	$13,951,026
Interest earned on other investments	2013-09-30	$52,434
Value of interest in common/collective trusts at end of year	2013-09-30	$37,230,135
Value of interest in common/collective trusts at beginning of year	2013-09-30	$27,430,564
Expenses. Payments to insurance carriers foe the provision of benefits	2013-09-30	$3,273,819
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-09-30	$-593,254
Net investment gain or loss from common/collective trusts	2013-09-30	$7,166,114
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2013-09-30	No
Has the plan failed to provide any benefit when due under the plan	2013-09-30	No
Contributions received in cash from employer	2013-09-30	$6,895,647
Contract administrator fees	2013-09-30	$145,332
Liabilities. Value of benefit claims payable at end of year	2013-09-30	$221,521
Liabilities. Value of benefit claims payable at beginning of year	2013-09-30	$307,997
Did the plan have assets held for investment	2013-09-30	Yes
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	2013-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-09-30	No
Aggregate proceeds on sale of assets	2013-09-30	$954,617
Aggregate carrying amount (costs) on sale of assets	2013-09-30	$420,996
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-09-30	Disclaimer
Accountancy firm name	2013-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2013-09-30	161131146
2012 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-09-30	$-79,068
Total unrealized appreciation/depreciation of assets	2012-09-30	$-79,068
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$359,296
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$257,348
Total income from all sources (including contributions)	2012-09-30	$13,807,422
Total loss/gain on sale of assets	2012-09-30	$0
Total of all expenses incurred	2012-09-30	$3,771,186
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-09-30	$3,111,553
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-09-30	$7,342,582
Value of total assets at end of year	2012-09-30	$43,893,249
Value of total assets at beginning of year	2012-09-30	$33,755,065
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-09-30	$659,633
Total interest from all sources	2012-09-30	$435,665
Total dividends received (eg from common stock, registered investment company shares)	2012-09-30	$362,352
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-09-30	$362,352
Assets. Real estate other than employer real property at end of year	2012-09-30	$421,000
Assets. Real estate other than employer real property at beginning of year	2012-09-30	$500,068
Administrative expenses professional fees incurred	2012-09-30	$38,454
Was this plan covered by a fidelity bond	2012-09-30	Yes
Value of fidelity bond cover	2012-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2012-09-30	No
Contributions received from participants	2012-09-30	$452,855
Assets. Other investments not covered elsewhere at end of year	2012-09-30	$1,634,494
Assets. Other investments not covered elsewhere at beginning of year	2012-09-30	$3,342,060
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-09-30	$435,785
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-09-30	$28
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-09-30	$26,973
Other income not declared elsewhere	2012-09-30	$21,729
Administrative expenses (other) incurred	2012-09-30	$478,985
Liabilities. Value of operating payables at end of year	2012-09-30	$24,326
Liabilities. Value of operating payables at beginning of year	2012-09-30	$1,988
Total non interest bearing cash at end of year	2012-09-30	$20,380
Total non interest bearing cash at beginning of year	2012-09-30	$76,490
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-09-30	No
Value of net income/loss	2012-09-30	$10,036,236
Value of net assets at end of year (total assets less liabilities)	2012-09-30	$43,533,953
Value of net assets at beginning of year (total assets less liabilities)	2012-09-30	$33,497,717
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-09-30	No
Were any leases to which the plan was party in default or uncollectible	2012-09-30	No
Investment advisory and management fees	2012-09-30	$14,699
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-09-30	$13,951,026
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-09-30	$9,828,115
Interest earned on other investments	2012-09-30	$435,665
Value of interest in common/collective trusts at end of year	2012-09-30	$27,430,564
Value of interest in common/collective trusts at beginning of year	2012-09-30	$20,008,304
Expenses. Payments to insurance carriers foe the provision of benefits	2012-09-30	$3,111,553
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-09-30	$677,780
Net investment gain or loss from common/collective trusts	2012-09-30	$5,046,382
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2012-09-30	No
Has the plan failed to provide any benefit when due under the plan	2012-09-30	No
Contributions received in cash from employer	2012-09-30	$6,889,727
Contract administrator fees	2012-09-30	$127,495
Liabilities. Value of benefit claims payable at end of year	2012-09-30	$307,997
Liabilities. Value of benefit claims payable at beginning of year	2012-09-30	$255,360
Did the plan have assets held for investment	2012-09-30	Yes
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	2012-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-09-30	Disclaimer
Accountancy firm name	2012-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2012-09-30	161131146
2011 : NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-09-30	$-987,826
Total unrealized appreciation/depreciation of assets	2011-09-30	$-987,826
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$257,348
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$270,463
Total income from all sources (including contributions)	2011-09-30	$4,818,608
Total loss/gain on sale of assets	2011-09-30	$0
Total of all expenses incurred	2011-09-30	$3,016,185
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-09-30	$3,657,832
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-09-30	$6,482,600
Value of total assets at end of year	2011-09-30	$33,755,065
Value of total assets at beginning of year	2011-09-30	$31,965,757
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-09-30	$-641,647
Total interest from all sources	2011-09-30	$3,198
Total dividends received (eg from common stock, registered investment company shares)	2011-09-30	$19,012
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-09-30	$19,012
Assets. Real estate other than employer real property at end of year	2011-09-30	$500,068
Assets. Real estate other than employer real property at beginning of year	2011-09-30	$1,487,894
Administrative expenses professional fees incurred	2011-09-30	$33,754
Was this plan covered by a fidelity bond	2011-09-30	Yes
Value of fidelity bond cover	2011-09-30	$25,000,000
Were there any nonexempt tranactions with any party-in-interest	2011-09-30	No
Contributions received from participants	2011-09-30	$423,332
Assets. Other investments not covered elsewhere at end of year	2011-09-30	$3,342,060
Assets. Other investments not covered elsewhere at beginning of year	2011-09-30	$2,498,389
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-09-30	$28
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-09-30	$58,184
Administrative expenses (other) incurred	2011-09-30	$-841,334
Liabilities. Value of operating payables at end of year	2011-09-30	$1,988
Liabilities. Value of operating payables at beginning of year	2011-09-30	$42,571
Total non interest bearing cash at end of year	2011-09-30	$76,490
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-09-30	No
Value of net income/loss	2011-09-30	$1,802,423
Value of net assets at end of year (total assets less liabilities)	2011-09-30	$33,497,717
Value of net assets at beginning of year (total assets less liabilities)	2011-09-30	$31,695,294
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-09-30	No
Were any leases to which the plan was party in default or uncollectible	2011-09-30	No
Investment advisory and management fees	2011-09-30	$12,825
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-09-30	$8,374,489
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-09-30	$612,835
Interest earned on other investments	2011-09-30	$3,122
Value of interest in common/collective trusts at end of year	2011-09-30	$21,461,930
Value of interest in common/collective trusts at beginning of year	2011-09-30	$27,308,455
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-09-30	$76
Expenses. Payments to insurance carriers foe the provision of benefits	2011-09-30	$3,657,832
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-09-30	$-178,511
Net investment gain or loss from common/collective trusts	2011-09-30	$-519,865
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-09-30	Yes
Was there a failure to transmit to the plan any participant contributions	2011-09-30	No
Has the plan failed to provide any benefit when due under the plan	2011-09-30	No
Contributions received in cash from employer	2011-09-30	$6,059,268
Contract administrator fees	2011-09-30	$153,108
Liabilities. Value of benefit claims payable at end of year	2011-09-30	$255,360
Liabilities. Value of benefit claims payable at beginning of year	2011-09-30	$227,892
Did the plan have assets held for investment	2011-09-30	Yes
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	2011-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-09-30	Disclaimer
Accountancy firm name	2011-09-30	BONADIO & CO., LLP
Accountancy firm EIN	2011-09-30	161131146

Form 5500 Responses for NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES

2021: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Submission has been amended	No
2021-10-01	This submission is the final filing	No
2021-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-10-01	Plan is a collectively bargained plan	No
2021-10-01	Plan funding arrangement – Trust	Yes
2021-10-01	Plan benefit arrangement – Insurance	Yes
2021-10-01	Plan benefit arrangement - Trust	Yes
2020: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Submission has been amended	No
2020-10-01	This submission is the final filing	No
2020-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-10-01	Plan is a collectively bargained plan	No
2020-10-01	Plan funding arrangement – Trust	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement - Trust	Yes
2019: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Submission has been amended	No
2019-10-01	This submission is the final filing	No
2019-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-10-01	Plan is a collectively bargained plan	No
2019-10-01	Plan funding arrangement – Trust	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement - Trust	Yes
2018: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Submission has been amended	No
2018-10-01	This submission is the final filing	No
2018-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-10-01	Plan is a collectively bargained plan	No
2018-10-01	Plan funding arrangement – Trust	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement - Trust	Yes
2017: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Submission has been amended	No
2017-10-01	This submission is the final filing	No
2017-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-10-01	Plan is a collectively bargained plan	No
2017-10-01	Plan funding arrangement – Trust	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement - Trust	Yes
2016: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Trust	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement - Trust	Yes
2015: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Trust	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement - Trust	Yes
2014: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Trust	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement - Trust	Yes
2013: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Trust	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement - Trust	Yes
2012: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Trust	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement - Trust	Yes
2011: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Trust	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement - Trust	Yes
2009: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Trust	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement - Trust	Yes
2008: NATIONAL FUEL GAS DIST. CORP. - NY DIVISION VOLUNTARY EMPLOYEES' BENEFICIARY ASSOC. FOR NON-COLLECTIVELY BARGAINED EMPLOYEES 2008 form 5500 responses
2008-10-01	Type of plan entity	Single employer plan
2008-10-01	Submission has been amended	No
2008-10-01	This submission is the final filing	No
2008-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-10-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	53033
Policy instance	6
Insurance contract or identification number 53033 Number of Individuals Covered 331 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 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 $191,646 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	22451-18
Policy instance	5
Insurance contract or identification number 22451-18 Number of Individuals Covered 36 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $263,536 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-10
Policy instance	4
Insurance contract or identification number 22451-10 Number of Individuals Covered 55 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $144,540 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-06-06
Policy instance	3
Insurance contract or identification number 22451-06-06 Number of Individuals Covered 7 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $18,615 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	2
Insurance contract or identification number 408862 Number of Individuals Covered 138 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $259,970 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	401217
Policy instance	1
Insurance contract or identification number 401217 Number of Individuals Covered 5 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes Dental Insurance Welfare Benefit Yes 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 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	401217
Policy instance	1
Insurance contract or identification number 401217 Number of Individuals Covered 3 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes Dental Insurance Welfare Benefit Yes 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 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	2
Insurance contract or identification number 408862 Number of Individuals Covered 130 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $301,061 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-06-06
Policy instance	3
Insurance contract or identification number 22451-06-06 Number of Individuals Covered 7 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $19,740 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-10
Policy instance	4
Insurance contract or identification number 22451-10 Number of Individuals Covered 58 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $155,346 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	22451-18
Policy instance	5
Insurance contract or identification number 22451-18 Number of Individuals Covered 39 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $275,528 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	53033
Policy instance	6
Insurance contract or identification number 53033 Number of Individuals Covered 330 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 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 $159,761 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	401217
Policy instance	1
Insurance contract or identification number 401217 Number of Individuals Covered 3 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes Dental Insurance Welfare Benefit Yes 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 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	2
Insurance contract or identification number 408862 Number of Individuals Covered 118 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $352,992 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-10
Policy instance	4
Insurance contract or identification number 22451-10 Number of Individuals Covered 51 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $175,460 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-06-06
Policy instance	3
Insurance contract or identification number 22451-06-06 Number of Individuals Covered 7 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $23,772 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	22451-18
Policy instance	5
Insurance contract or identification number 22451-18 Number of Individuals Covered 48 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $293,831 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	53033
Policy instance	6
Insurance contract or identification number 53033 Number of Individuals Covered 342 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 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 $166,674 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	401217
Policy instance	1
Insurance contract or identification number 401217 Number of Individuals Covered 3 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes Dental Insurance Welfare Benefit Yes 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 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	2
Insurance contract or identification number 408862 Number of Individuals Covered 106 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $329,107 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-06-06
Policy instance	3
Insurance contract or identification number 22451-06-06 Number of Individuals Covered 7 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $21,876 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-10
Policy instance	4
Insurance contract or identification number 22451-10 Number of Individuals Covered 52 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $176,508 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	22451-18
Policy instance	5
Insurance contract or identification number 22451-18 Number of Individuals Covered 43 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $235,607 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	53033
Policy instance	6
Insurance contract or identification number 53033 Number of Individuals Covered 342 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 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 $168,247 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	53033
Policy instance	7
Insurance contract or identification number 53033 Number of Individuals Covered 335 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 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 $128,833 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	22451-18
Policy instance	6
Insurance contract or identification number 22451-18 Number of Individuals Covered 41 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $187,232 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-10
Policy instance	5
Insurance contract or identification number 22451-10 Number of Individuals Covered 54 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $173,264 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-06-06
Policy instance	4
Insurance contract or identification number 22451-06-06 Number of Individuals Covered 6 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $20,400 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	3
Insurance contract or identification number 408862 Number of Individuals Covered 107 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes 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 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 $357,948 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	401217
Policy instance	2
Insurance contract or identification number 401217 Number of Individuals Covered 3 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 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 Yes Dental Insurance Welfare Benefit Yes 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 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	818899
Policy instance	1
Insurance contract or identification number 818899 Number of Individuals Covered 335 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 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 $55,047 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	32342K
Policy instance	3
Insurance contract or identification number 32342K Number of Individuals Covered 0 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	818899
Policy instance	1
Insurance contract or identification number 818899 Number of Individuals Covered 327 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $194,662 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-06-06
Policy instance	4
Insurance contract or identification number 22451-06-06 Number of Individuals Covered 5 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $2,884 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-10
Policy instance	5
Insurance contract or identification number 22451-10 Number of Individuals Covered 54 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $30,884 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	22451K-518
Policy instance	6
Insurance contract or identification number 22451K-518 Number of Individuals Covered 28 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $117,501 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	2
Insurance contract or identification number 408862 Number of Individuals Covered 99 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $196,796 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	30052K-518
Policy instance	1
Insurance contract or identification number 30052K-518 Number of Individuals Covered 24 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $119,555 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	32342K
Policy instance	6
Insurance contract or identification number 32342K Number of Individuals Covered 1 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $4,283 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-06-06
Policy instance	5
Insurance contract or identification number 22451-06-06 Number of Individuals Covered 4 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $1,752 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	22451-10
Policy instance	4
Insurance contract or identification number 22451-10 Number of Individuals Covered 50 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $20,156 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	818899
Policy instance	2
Insurance contract or identification number 818899 Number of Individuals Covered 317 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $184,831 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	3
Insurance contract or identification number 408862 Number of Individuals Covered 98 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $132,067 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	32342K
Policy instance	6
Insurance contract or identification number 32342K Number of Individuals Covered 1 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $4,449 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	32342M
Policy instance	5
Insurance contract or identification number 32342M Number of Individuals Covered 4 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $2,560 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	30052M-518
Policy instance	4
Insurance contract or identification number 30052M-518 Number of Individuals Covered 42 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $29,526 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	3
Insurance contract or identification number 408862 Number of Individuals Covered 73 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $92,938 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	818899
Policy instance	2
Insurance contract or identification number 818899 Number of Individuals Covered 314 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $184,435 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	30052K-518
Policy instance	1
Insurance contract or identification number 30052K-518 Number of Individuals Covered 25 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $131,403 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	32342M
Policy instance	5
Insurance contract or identification number 32342M Number of Individuals Covered 4 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $2,244 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	30052M-518
Policy instance	4
Insurance contract or identification number 30052M-518 Number of Individuals Covered 41 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $21,502 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	3
Insurance contract or identification number 408862 Number of Individuals Covered 61 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $66,779 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	818899
Policy instance	2
Insurance contract or identification number 818899 Number of Individuals Covered 343 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $183,312 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	30052K-518
Policy instance	1
Insurance contract or identification number 30052K-518 Number of Individuals Covered 26 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $111,760 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	32342K
Policy instance	6
Insurance contract or identification number 32342K Number of Individuals Covered 1 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $4,774 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	32342M
Policy instance	5
Insurance contract or identification number 32342M Number of Individuals Covered 3 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $1,521 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 )
Policy contract number	30052M-518
Policy instance	4
Insurance contract or identification number 30052M-518 Number of Individuals Covered 33 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $16,006 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	408862
Policy instance	3
Insurance contract or identification number 408862 Number of Individuals Covered 39 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $41,485 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	818899
Policy instance	2
Insurance contract or identification number 818899 Number of Individuals Covered 345 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $186,937 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	30052K-518
Policy instance	1
Insurance contract or identification number 30052K-518 Number of Individuals Covered 24 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $112,173 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number	32342K
Policy instance	6
Insurance contract or identification number 32342K Number of Individuals Covered 2 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating 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 Yes 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 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 $1,673 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No

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