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DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 401k Plan overview

Plan NameDOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST
Plan identification number 501

DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

AMERICAN SUGAR REFINING INC. has sponsored the creation of one or more 401k plans.

Company Name:AMERICAN SUGAR REFINING INC.
Employer identification number (EIN):133366163
NAIC Classification:311300
NAIC Description: Sugar and Confectionery Product Manufacturing

Additional information about AMERICAN SUGAR REFINING INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1987-01-01
Company Identification Number: 0007397906
Legal Registered Office Address: 1 N CLEMATIS ST STE 200

WEST PALM BCH
United States of America (USA)
33401

More information about AMERICAN SUGAR REFINING INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-02-01CHRISTOPHER STEWART2024-01-22 KOURTNEY K. ROLLINS2024-01-22
5012021-02-01EUGENE JOHNSON JR.2022-12-08
5012020-02-01ISAAC D. GARRISON2021-12-17
5012019-02-01LEAVON ROBINSON2020-11-13
5012018-02-01LEAVON ROBINSON2019-11-04
5012017-02-01
5012016-02-01
5012015-02-01
5012014-02-01DANNY MENESSES
5012013-02-01DANNY MENESSES
5012012-02-01DANNY MENESSES
5012011-02-01DANNY MENESSES
5012010-02-01DANNY MENESSES

Plan Statistics for DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST

401k plan membership statisitcs for DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST

Measure Date Value
2022: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2022 401k membership
Total participants, beginning-of-year2022-02-01419
Total number of active participants reported on line 7a of the Form 55002022-02-01272
Number of retired or separated participants receiving benefits2022-02-01147
Number of other retired or separated participants entitled to future benefits2022-02-010
Total of all active and inactive participants2022-02-01419
2021: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2021 401k membership
Total participants, beginning-of-year2021-02-01433
Total number of active participants reported on line 7a of the Form 55002021-02-01278
Number of retired or separated participants receiving benefits2021-02-01155
Number of other retired or separated participants entitled to future benefits2021-02-010
Total of all active and inactive participants2021-02-01433
2020: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2020 401k membership
Total participants, beginning-of-year2020-02-01433
Total number of active participants reported on line 7a of the Form 55002020-02-01278
Number of retired or separated participants receiving benefits2020-02-01155
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-01433
2019: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2019 401k membership
Total participants, beginning-of-year2019-02-01424
Total number of active participants reported on line 7a of the Form 55002019-02-01252
Number of retired or separated participants receiving benefits2019-02-01172
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-01424
2018: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2018 401k membership
Total participants, beginning-of-year2018-02-01424
Total number of active participants reported on line 7a of the Form 55002018-02-01252
Number of retired or separated participants receiving benefits2018-02-01172
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-01424
2017: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2017 401k membership
Total participants, beginning-of-year2017-02-01418
Total number of active participants reported on line 7a of the Form 55002017-02-01249
Number of retired or separated participants receiving benefits2017-02-01169
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01418
2016: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2016 401k membership
Total participants, beginning-of-year2016-02-01418
Total number of active participants reported on line 7a of the Form 55002016-02-01249
Number of retired or separated participants receiving benefits2016-02-01169
Number of other retired or separated participants entitled to future benefits2016-02-010
Total of all active and inactive participants2016-02-01418
2015: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2015 401k membership
Total participants, beginning-of-year2015-02-01411
Total number of active participants reported on line 7a of the Form 55002015-02-01241
Number of retired or separated participants receiving benefits2015-02-01170
Number of other retired or separated participants entitled to future benefits2015-02-010
Total of all active and inactive participants2015-02-01411
2014: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2014 401k membership
Total participants, beginning-of-year2014-02-01411
Total number of active participants reported on line 7a of the Form 55002014-02-01241
Number of retired or separated participants receiving benefits2014-02-01170
Number of other retired or separated participants entitled to future benefits2014-02-010
Total of all active and inactive participants2014-02-01411
2013: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2013 401k membership
Total participants, beginning-of-year2013-02-01401
Total number of active participants reported on line 7a of the Form 55002013-02-01215
Number of retired or separated participants receiving benefits2013-02-01186
Number of other retired or separated participants entitled to future benefits2013-02-010
Total of all active and inactive participants2013-02-01401
2012: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2012 401k membership
Total participants, beginning-of-year2012-02-01401
Total number of active participants reported on line 7a of the Form 55002012-02-01215
Number of retired or separated participants receiving benefits2012-02-01186
Number of other retired or separated participants entitled to future benefits2012-02-010
Total of all active and inactive participants2012-02-01401
2011: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2011 401k membership
Total participants, beginning-of-year2011-02-01405
Total number of active participants reported on line 7a of the Form 55002011-02-01223
Number of retired or separated participants receiving benefits2011-02-01182
Number of other retired or separated participants entitled to future benefits2011-02-010
Total of all active and inactive participants2011-02-01405
2010: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2010 401k membership
Total participants, beginning-of-year2010-02-01425
Total number of active participants reported on line 7a of the Form 55002010-02-01248
Number of retired or separated participants receiving benefits2010-02-01177
Number of other retired or separated participants entitled to future benefits2010-02-010
Total of all active and inactive participants2010-02-01425

Financial Data on DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST

Measure Date Value
2023 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-31$18,445
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-31$2,394
Total income from all sources (including contributions)2023-01-31$4,954,639
Total loss/gain on sale of assets2023-01-31$0
Total of all expenses incurred2023-01-31$4,457,825
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-31$4,394,717
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-31$4,954,464
Value of total assets at end of year2023-01-31$4,537,274
Value of total assets at beginning of year2023-01-31$4,024,409
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-31$63,108
Total interest from all sources2023-01-31$175
Total dividends received (eg from common stock, registered investment company shares)2023-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-31No
Administrative expenses professional fees incurred2023-01-31$48,733
Was this plan covered by a fidelity bond2023-01-31Yes
Value of fidelity bond cover2023-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2023-01-31No
Contributions received from participants2023-01-31$765,717
Participant contributions at end of year2023-01-31$0
Participant contributions at beginning of year2023-01-31$0
Assets. Other investments not covered elsewhere at end of year2023-01-31$368,611
Assets. Other investments not covered elsewhere at beginning of year2023-01-31$1,141
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-01-31$537
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-01-31$1,286
Administrative expenses (other) incurred2023-01-31$7,238
Liabilities. Value of operating payables at end of year2023-01-31$17,908
Liabilities. Value of operating payables at beginning of year2023-01-31$1,108
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Value of net income/loss2023-01-31$496,814
Value of net assets at end of year (total assets less liabilities)2023-01-31$4,518,829
Value of net assets at beginning of year (total assets less liabilities)2023-01-31$4,022,015
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-31No
Were any leases to which the plan was party in default or uncollectible2023-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-01-31$4,168,663
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-01-31$4,023,268
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-01-31$4,023,268
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-01-31$175
Expenses. Payments to insurance carriers foe the provision of benefits2023-01-31$4,317,146
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-31No
Was there a failure to transmit to the plan any participant contributions2023-01-31No
Has the plan failed to provide any benefit when due under the plan2023-01-31No
Contributions received in cash from employer2023-01-31$4,188,747
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-31$77,571
Contract administrator fees2023-01-31$7,137
Assets. Value of buildings and other operty used in plan operation at end of year2023-01-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2023-01-31$0
Did the plan have assets held for investment2023-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-31No
Liabilities. Value of acquisition indebtedness at end of year2023-01-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2023-01-31$0
Opinion of an independent qualified public accountant for this plan2023-01-31Unqualified
Accountancy firm name2023-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2023-01-31720136870
2022 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-31$2,394
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-31$17,528
Total income from all sources (including contributions)2022-01-31$4,914,336
Total loss/gain on sale of assets2022-01-31$0
Total of all expenses incurred2022-01-31$4,608,156
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-31$4,548,669
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-31$4,914,336
Value of total assets at end of year2022-01-31$4,024,409
Value of total assets at beginning of year2022-01-31$3,733,363
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-31$59,487
Total interest from all sources2022-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-31No
Administrative expenses professional fees incurred2022-01-31$48,329
Was this plan covered by a fidelity bond2022-01-31Yes
Value of fidelity bond cover2022-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-01-31No
Contributions received from participants2022-01-31$761,319
Participant contributions at end of year2022-01-31$0
Participant contributions at beginning of year2022-01-31$66,732
Assets. Other investments not covered elsewhere at end of year2022-01-31$1,141
Assets. Other investments not covered elsewhere at beginning of year2022-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-01-31$1,286
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-01-31$728
Administrative expenses (other) incurred2022-01-31$6,358
Liabilities. Value of operating payables at end of year2022-01-31$1,108
Liabilities. Value of operating payables at beginning of year2022-01-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-31No
Value of net income/loss2022-01-31$306,180
Value of net assets at end of year (total assets less liabilities)2022-01-31$4,022,015
Value of net assets at beginning of year (total assets less liabilities)2022-01-31$3,715,835
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-31No
Were any leases to which the plan was party in default or uncollectible2022-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-01-31$4,023,268
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-01-31$3,274,002
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-01-31$3,274,002
Expenses. Payments to insurance carriers foe the provision of benefits2022-01-31$4,398,758
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-31No
Was there a failure to transmit to the plan any participant contributions2022-01-31No
Has the plan failed to provide any benefit when due under the plan2022-01-31No
Contributions received in cash from employer2022-01-31$4,153,017
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-31$149,911
Contract administrator fees2022-01-31$4,800
Assets. Value of buildings and other operty used in plan operation at end of year2022-01-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-01-31$392,629
Did the plan have assets held for investment2022-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-31No
Liabilities. Value of acquisition indebtedness at end of year2022-01-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2022-01-31$16,800
Opinion of an independent qualified public accountant for this plan2022-01-31Unqualified
Accountancy firm name2022-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2022-01-31720136870
2021 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-01-31$17,528
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-01-31$11,178
Total income from all sources (including contributions)2021-01-31$5,137,130
Total loss/gain on sale of assets2021-01-31$0
Total of all expenses incurred2021-01-31$4,454,061
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-01-31$4,397,292
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-01-31$5,137,130
Value of total assets at end of year2021-01-31$3,733,363
Value of total assets at beginning of year2021-01-31$3,043,944
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-01-31$56,769
Total interest from all sources2021-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-01-31No
Administrative expenses professional fees incurred2021-01-31$45,791
Was this plan covered by a fidelity bond2021-01-31Yes
Value of fidelity bond cover2021-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-01-31No
Contributions received from participants2021-01-31$939,946
Participant contributions at end of year2021-01-31$66,732
Participant contributions at beginning of year2021-01-31$0
Assets. Other investments not covered elsewhere at end of year2021-01-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-01-31$3,620
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-01-31$79,858
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-01-31$728
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-01-31$11,178
Administrative expenses (other) incurred2021-01-31$6,062
Liabilities. Value of operating payables at end of year2021-01-31$0
Liabilities. Value of operating payables at beginning of year2021-01-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-01-31No
Value of net income/loss2021-01-31$683,069
Value of net assets at end of year (total assets less liabilities)2021-01-31$3,715,835
Value of net assets at beginning of year (total assets less liabilities)2021-01-31$3,032,766
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-01-31No
Were any leases to which the plan was party in default or uncollectible2021-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-01-31$3,274,002
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-01-31$2,960,466
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-01-31$2,960,466
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-01-31No
Was there a failure to transmit to the plan any participant contributions2021-01-31No
Has the plan failed to provide any benefit when due under the plan2021-01-31No
Contributions received in cash from employer2021-01-31$4,197,184
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-01-31$4,397,292
Contract administrator fees2021-01-31$4,916
Assets. Value of buildings and other operty used in plan operation at end of year2021-01-31$392,629
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-01-31$0
Did the plan have assets held for investment2021-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-01-31No
Liabilities. Value of acquisition indebtedness at end of year2021-01-31$16,800
Liabilities. Value of acquisition indebtedness at beginning of year2021-01-31$0
Opinion of an independent qualified public accountant for this plan2021-01-31Unqualified
Accountancy firm name2021-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2021-01-31720136870
2020 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-01-31$0
Total unrealized appreciation/depreciation of assets2020-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-01-31$11,178
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-01-31$11,178
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-01-31$675
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-01-31$675
Total income from all sources (including contributions)2020-01-31$4,514,202
Total income from all sources (including contributions)2020-01-31$4,514,202
Total loss/gain on sale of assets2020-01-31$0
Total loss/gain on sale of assets2020-01-31$0
Total of all expenses incurred2020-01-31$3,741,440
Total of all expenses incurred2020-01-31$3,741,440
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-01-31$3,695,277
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-01-31$3,695,277
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-01-31$4,514,202
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-01-31$4,514,202
Value of total assets at end of year2020-01-31$3,043,944
Value of total assets at end of year2020-01-31$3,043,944
Value of total assets at beginning of year2020-01-31$2,260,679
Value of total assets at beginning of year2020-01-31$2,260,679
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-01-31$46,163
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-01-31$46,163
Total interest from all sources2020-01-31$0
Total interest from all sources2020-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-01-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-01-31No
Administrative expenses professional fees incurred2020-01-31$38,688
Administrative expenses professional fees incurred2020-01-31$38,688
Was this plan covered by a fidelity bond2020-01-31Yes
Value of fidelity bond cover2020-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2020-01-31No
Were there any nonexempt tranactions with any party-in-interest2020-01-31No
Contributions received from participants2020-01-31$769,052
Contributions received from participants2020-01-31$769,052
Assets. Other investments not covered elsewhere at end of year2020-01-31$3,620
Assets. Other investments not covered elsewhere at end of year2020-01-31$3,620
Assets. Other investments not covered elsewhere at beginning of year2020-01-31$6,799
Assets. Other investments not covered elsewhere at beginning of year2020-01-31$6,799
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-01-31$79,858
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-01-31$79,858
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-01-31$69,225
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-01-31$69,225
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-01-31$11,178
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-01-31$11,178
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-01-31$675
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-01-31$675
Administrative expenses (other) incurred2020-01-31$3,282
Administrative expenses (other) incurred2020-01-31$3,282
Liabilities. Value of operating payables at end of year2020-01-31$0
Liabilities. Value of operating payables at end of year2020-01-31$0
Liabilities. Value of operating payables at beginning of year2020-01-31$0
Liabilities. Value of operating payables at beginning of year2020-01-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-01-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-01-31No
Value of net income/loss2020-01-31$772,762
Value of net income/loss2020-01-31$772,762
Value of net assets at end of year (total assets less liabilities)2020-01-31$3,032,766
Value of net assets at end of year (total assets less liabilities)2020-01-31$3,032,766
Value of net assets at beginning of year (total assets less liabilities)2020-01-31$2,260,004
Value of net assets at beginning of year (total assets less liabilities)2020-01-31$2,260,004
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-01-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-01-31No
Were any leases to which the plan was party in default or uncollectible2020-01-31No
Were any leases to which the plan was party in default or uncollectible2020-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-01-31$2,960,466
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-01-31$2,960,466
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-01-31$2,184,655
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-01-31$2,184,655
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-01-31$2,184,655
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-01-31$2,184,655
Expenses. Payments to insurance carriers foe the provision of benefits2020-01-31$3,652,407
Expenses. Payments to insurance carriers foe the provision of benefits2020-01-31$3,652,407
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-01-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-01-31No
Was there a failure to transmit to the plan any participant contributions2020-01-31No
Was there a failure to transmit to the plan any participant contributions2020-01-31No
Has the plan failed to provide any benefit when due under the plan2020-01-31No
Has the plan failed to provide any benefit when due under the plan2020-01-31No
Contributions received in cash from employer2020-01-31$3,745,150
Contributions received in cash from employer2020-01-31$3,745,150
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-01-31$42,870
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-01-31$42,870
Contract administrator fees2020-01-31$4,193
Contract administrator fees2020-01-31$4,193
Did the plan have assets held for investment2020-01-31Yes
Did the plan have assets held for investment2020-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-01-31No
Opinion of an independent qualified public accountant for this plan2020-01-31Unqualified
Opinion of an independent qualified public accountant for this plan2020-01-31Unqualified
Accountancy firm name2020-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm name2020-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2020-01-31720136870
Accountancy firm EIN2020-01-31720136870
2019 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-01-31$675
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-01-31$16,580
Total income from all sources (including contributions)2019-01-31$4,314,258
Total loss/gain on sale of assets2019-01-31$0
Total of all expenses incurred2019-01-31$3,534,775
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-01-31$3,462,471
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-01-31$4,304,847
Value of total assets at end of year2019-01-31$2,260,679
Value of total assets at beginning of year2019-01-31$1,497,101
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-01-31$72,304
Total interest from all sources2019-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-01-31No
Administrative expenses professional fees incurred2019-01-31$44,679
Was this plan covered by a fidelity bond2019-01-31Yes
Value of fidelity bond cover2019-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-01-31No
Contributions received from participants2019-01-31$817,323
Assets. Other investments not covered elsewhere at end of year2019-01-31$6,799
Assets. Other investments not covered elsewhere at beginning of year2019-01-31$21,331
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-01-31$69,225
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-01-31$675
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-01-31$16,580
Other income not declared elsewhere2019-01-31$9,411
Administrative expenses (other) incurred2019-01-31$23,568
Liabilities. Value of operating payables at end of year2019-01-31$0
Liabilities. Value of operating payables at beginning of year2019-01-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-01-31No
Value of net income/loss2019-01-31$779,483
Value of net assets at end of year (total assets less liabilities)2019-01-31$2,260,004
Value of net assets at beginning of year (total assets less liabilities)2019-01-31$1,480,521
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-01-31No
Were any leases to which the plan was party in default or uncollectible2019-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-01-31$2,184,655
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-01-31$1,475,770
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-01-31$1,475,770
Expenses. Payments to insurance carriers foe the provision of benefits2019-01-31$3,403,958
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-01-31No
Was there a failure to transmit to the plan any participant contributions2019-01-31No
Has the plan failed to provide any benefit when due under the plan2019-01-31No
Contributions received in cash from employer2019-01-31$3,487,524
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-01-31$58,513
Contract administrator fees2019-01-31$4,057
Did the plan have assets held for investment2019-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-01-31No
Opinion of an independent qualified public accountant for this plan2019-01-31Unqualified
Accountancy firm name2019-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2019-01-31720136870
2018 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-01-31$16,580
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-01-31$325
Total income from all sources (including contributions)2018-01-31$4,220,603
Total loss/gain on sale of assets2018-01-31$0
Total of all expenses incurred2018-01-31$3,578,225
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-01-31$3,535,707
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-01-31$4,220,603
Value of total assets at end of year2018-01-31$1,497,101
Value of total assets at beginning of year2018-01-31$838,468
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-01-31$42,518
Total interest from all sources2018-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-01-31No
Administrative expenses professional fees incurred2018-01-31$35,045
Was this plan covered by a fidelity bond2018-01-31Yes
Value of fidelity bond cover2018-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-01-31No
Contributions received from participants2018-01-31$835,953
Assets. Other investments not covered elsewhere at end of year2018-01-31$21,331
Assets. Other investments not covered elsewhere at beginning of year2018-01-31$23,278
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-01-31$5,021
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-01-31$16,580
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-01-31$325
Administrative expenses (other) incurred2018-01-31$3,614
Liabilities. Value of operating payables at end of year2018-01-31$0
Liabilities. Value of operating payables at beginning of year2018-01-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-01-31No
Value of net income/loss2018-01-31$642,378
Value of net assets at end of year (total assets less liabilities)2018-01-31$1,480,521
Value of net assets at beginning of year (total assets less liabilities)2018-01-31$838,143
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-01-31No
Were any leases to which the plan was party in default or uncollectible2018-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-01-31$1,475,770
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-01-31$810,169
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-01-31$810,169
Expenses. Payments to insurance carriers foe the provision of benefits2018-01-31$3,508,480
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-01-31No
Was there a failure to transmit to the plan any participant contributions2018-01-31No
Has the plan failed to provide any benefit when due under the plan2018-01-31No
Contributions received in cash from employer2018-01-31$3,384,650
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-01-31$27,227
Contract administrator fees2018-01-31$3,859
Did the plan have assets held for investment2018-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-01-31No
Opinion of an independent qualified public accountant for this plan2018-01-31Unqualified
Accountancy firm name2018-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2018-01-31720136870
2017 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-01-31$325
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-01-31$16,572
Total income from all sources (including contributions)2017-01-31$3,895,967
Total loss/gain on sale of assets2017-01-31$0
Total of all expenses incurred2017-01-31$3,466,454
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-01-31$3,419,160
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-01-31$3,895,967
Value of total assets at end of year2017-01-31$838,468
Value of total assets at beginning of year2017-01-31$425,202
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-01-31$47,294
Total interest from all sources2017-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-01-31No
Administrative expenses professional fees incurred2017-01-31$37,162
Was this plan covered by a fidelity bond2017-01-31Yes
Value of fidelity bond cover2017-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-01-31No
Contributions received from participants2017-01-31$811,897
Assets. Other investments not covered elsewhere at end of year2017-01-31$23,278
Assets. Other investments not covered elsewhere at beginning of year2017-01-31$21,225
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-01-31$5,021
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-01-31$325
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-01-31$16,572
Administrative expenses (other) incurred2017-01-31$5,957
Liabilities. Value of operating payables at end of year2017-01-31$0
Liabilities. Value of operating payables at beginning of year2017-01-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-01-31No
Value of net income/loss2017-01-31$429,513
Value of net assets at end of year (total assets less liabilities)2017-01-31$838,143
Value of net assets at beginning of year (total assets less liabilities)2017-01-31$408,630
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-01-31No
Were any leases to which the plan was party in default or uncollectible2017-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-01-31$810,169
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-01-31$403,977
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-01-31$403,977
Expenses. Payments to insurance carriers foe the provision of benefits2017-01-31$3,374,964
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-01-31No
Was there a failure to transmit to the plan any participant contributions2017-01-31No
Has the plan failed to provide any benefit when due under the plan2017-01-31No
Contributions received in cash from employer2017-01-31$3,084,070
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-01-31$44,196
Contract administrator fees2017-01-31$4,175
Did the plan have assets held for investment2017-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-01-31No
Opinion of an independent qualified public accountant for this plan2017-01-31Unqualified
Accountancy firm name2017-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2017-01-31720136870
2016 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-01-31$16,572
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-01-31$752
Total income from all sources (including contributions)2016-01-31$3,421,128
Total loss/gain on sale of assets2016-01-31$0
Total of all expenses incurred2016-01-31$3,364,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-01-31$3,317,074
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-01-31$3,420,475
Value of total assets at end of year2016-01-31$425,202
Value of total assets at beginning of year2016-01-31$352,721
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-01-31$47,393
Total interest from all sources2016-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-01-31No
Administrative expenses professional fees incurred2016-01-31$36,220
Was this plan covered by a fidelity bond2016-01-31Yes
Value of fidelity bond cover2016-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-01-31No
Contributions received from participants2016-01-31$759,715
Assets. Other investments not covered elsewhere at end of year2016-01-31$21,225
Assets. Other investments not covered elsewhere at beginning of year2016-01-31$14,467
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-01-31$133,327
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-01-31$16,572
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-01-31$752
Other income not declared elsewhere2016-01-31$653
Administrative expenses (other) incurred2016-01-31$7,683
Liabilities. Value of operating payables at end of year2016-01-31$0
Liabilities. Value of operating payables at beginning of year2016-01-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-01-31No
Value of net income/loss2016-01-31$56,661
Value of net assets at end of year (total assets less liabilities)2016-01-31$408,630
Value of net assets at beginning of year (total assets less liabilities)2016-01-31$351,969
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-01-31No
Were any leases to which the plan was party in default or uncollectible2016-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-01-31$403,977
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-01-31$204,927
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-01-31$204,927
Expenses. Payments to insurance carriers foe the provision of benefits2016-01-31$3,271,418
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-01-31No
Was there a failure to transmit to the plan any participant contributions2016-01-31No
Has the plan failed to provide any benefit when due under the plan2016-01-31No
Contributions received in cash from employer2016-01-31$2,660,760
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-01-31$45,656
Contract administrator fees2016-01-31$3,490
Did the plan have assets held for investment2016-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-01-31No
Opinion of an independent qualified public accountant for this plan2016-01-31Unqualified
Accountancy firm name2016-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2016-01-31720136870
2015 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-01-31$752
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-01-31$44,840
Total income from all sources (including contributions)2015-01-31$3,202,745
Total loss/gain on sale of assets2015-01-31$0
Total of all expenses incurred2015-01-31$3,124,173
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-01-31$3,070,647
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-01-31$3,202,745
Value of total assets at end of year2015-01-31$352,721
Value of total assets at beginning of year2015-01-31$318,237
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-01-31$53,526
Total interest from all sources2015-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-01-31No
Administrative expenses professional fees incurred2015-01-31$41,917
Was this plan covered by a fidelity bond2015-01-31Yes
Value of fidelity bond cover2015-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-01-31No
Contributions received from participants2015-01-31$703,200
Assets. Other investments not covered elsewhere at end of year2015-01-31$14,467
Assets. Other investments not covered elsewhere at beginning of year2015-01-31$8,247
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-01-31$133,327
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-01-31$47,501
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-01-31$752
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-01-31$303
Administrative expenses (other) incurred2015-01-31$8,250
Liabilities. Value of operating payables at end of year2015-01-31$0
Liabilities. Value of operating payables at beginning of year2015-01-31$44,537
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-01-31No
Value of net income/loss2015-01-31$78,572
Value of net assets at end of year (total assets less liabilities)2015-01-31$351,969
Value of net assets at beginning of year (total assets less liabilities)2015-01-31$273,397
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-01-31No
Were any leases to which the plan was party in default or uncollectible2015-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-01-31$204,927
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-01-31$262,489
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-01-31$262,489
Expenses. Payments to insurance carriers foe the provision of benefits2015-01-31$3,031,786
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-01-31No
Was there a failure to transmit to the plan any participant contributions2015-01-31No
Has the plan failed to provide any benefit when due under the plan2015-01-31No
Contributions received in cash from employer2015-01-31$2,499,545
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-01-31$38,861
Contract administrator fees2015-01-31$3,359
Did the plan have assets held for investment2015-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-01-31No
Opinion of an independent qualified public accountant for this plan2015-01-31Disclaimer
Accountancy firm name2015-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2015-01-31720136870
2014 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-01-31$44,840
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-01-31$55,416
Total income from all sources (including contributions)2014-01-31$2,894,701
Total loss/gain on sale of assets2014-01-31$0
Total of all expenses incurred2014-01-31$2,836,967
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-01-31$2,798,956
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-01-31$2,894,512
Value of total assets at end of year2014-01-31$270,736
Value of total assets at beginning of year2014-01-31$223,578
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-01-31$38,011
Total interest from all sources2014-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-01-31No
Administrative expenses professional fees incurred2014-01-31$28,111
Was this plan covered by a fidelity bond2014-01-31Yes
Value of fidelity bond cover2014-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2014-01-31No
Contributions received from participants2014-01-31$539,972
Assets. Other investments not covered elsewhere at end of year2014-01-31$8,247
Assets. Other investments not covered elsewhere at beginning of year2014-01-31$5,802
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-01-31$303
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-01-31$529
Other income not declared elsewhere2014-01-31$189
Administrative expenses (other) incurred2014-01-31$6,559
Liabilities. Value of operating payables at end of year2014-01-31$44,537
Liabilities. Value of operating payables at beginning of year2014-01-31$54,887
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-01-31No
Value of net income/loss2014-01-31$57,734
Value of net assets at end of year (total assets less liabilities)2014-01-31$225,896
Value of net assets at beginning of year (total assets less liabilities)2014-01-31$168,162
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-01-31No
Were any leases to which the plan was party in default or uncollectible2014-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-01-31$262,489
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-01-31$217,776
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-01-31$217,776
Expenses. Payments to insurance carriers foe the provision of benefits2014-01-31$2,749,619
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-01-31No
Was there a failure to transmit to the plan any participant contributions2014-01-31No
Has the plan failed to provide any benefit when due under the plan2014-01-31No
Contributions received in cash from employer2014-01-31$2,354,540
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-01-31$49,337
Contract administrator fees2014-01-31$3,341
Did the plan have assets held for investment2014-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-01-31No
Opinion of an independent qualified public accountant for this plan2014-01-31Disclaimer
Accountancy firm name2014-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2014-01-31720136870
2013 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-01-31$55,416
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-01-31$401
Total income from all sources (including contributions)2013-01-31$2,914,808
Total loss/gain on sale of assets2013-01-31$0
Total of all expenses incurred2013-01-31$2,823,577
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-01-31$2,773,901
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-01-31$2,914,126
Value of total assets at end of year2013-01-31$223,578
Value of total assets at beginning of year2013-01-31$77,332
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-01-31$49,676
Total interest from all sources2013-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-01-31No
Administrative expenses professional fees incurred2013-01-31$37,635
Was this plan covered by a fidelity bond2013-01-31Yes
Value of fidelity bond cover2013-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2013-01-31No
Contributions received from participants2013-01-31$606,431
Assets. Other investments not covered elsewhere at end of year2013-01-31$5,802
Assets. Other investments not covered elsewhere at beginning of year2013-01-31$5,510
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-01-31$529
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-01-31$396
Other income not declared elsewhere2013-01-31$682
Administrative expenses (other) incurred2013-01-31$8,900
Liabilities. Value of operating payables at end of year2013-01-31$54,887
Liabilities. Value of operating payables at beginning of year2013-01-31$5
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-01-31No
Value of net income/loss2013-01-31$91,231
Value of net assets at end of year (total assets less liabilities)2013-01-31$168,162
Value of net assets at beginning of year (total assets less liabilities)2013-01-31$76,931
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-01-31No
Were any leases to which the plan was party in default or uncollectible2013-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-01-31$217,776
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-01-31$71,822
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-01-31$71,822
Expenses. Payments to insurance carriers foe the provision of benefits2013-01-31$2,737,866
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-01-31No
Was there a failure to transmit to the plan any participant contributions2013-01-31No
Has the plan failed to provide any benefit when due under the plan2013-01-31No
Contributions received in cash from employer2013-01-31$2,307,695
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-01-31$36,035
Contract administrator fees2013-01-31$3,141
Did the plan have assets held for investment2013-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-01-31No
Opinion of an independent qualified public accountant for this plan2013-01-31Disclaimer
Accountancy firm name2013-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2013-01-31720136870
2012 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-01-31$401
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-01-31$402
Total income from all sources (including contributions)2012-01-31$3,006,308
Total loss/gain on sale of assets2012-01-31$0
Total of all expenses incurred2012-01-31$3,007,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-01-31$2,960,293
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-01-31$3,005,385
Value of total assets at end of year2012-01-31$77,332
Value of total assets at beginning of year2012-01-31$78,492
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-01-31$47,174
Total interest from all sources2012-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-01-31No
Administrative expenses professional fees incurred2012-01-31$34,560
Was this plan covered by a fidelity bond2012-01-31Yes
Value of fidelity bond cover2012-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2012-01-31No
Contributions received from participants2012-01-31$595,445
Assets. Other investments not covered elsewhere at end of year2012-01-31$5,510
Assets. Other investments not covered elsewhere at beginning of year2012-01-31$2,666
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-01-31$396
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-01-31$368
Other income not declared elsewhere2012-01-31$923
Administrative expenses (other) incurred2012-01-31$10,165
Liabilities. Value of operating payables at end of year2012-01-31$5
Liabilities. Value of operating payables at beginning of year2012-01-31$34
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-01-31No
Value of net income/loss2012-01-31$-1,159
Value of net assets at end of year (total assets less liabilities)2012-01-31$76,931
Value of net assets at beginning of year (total assets less liabilities)2012-01-31$78,090
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-01-31No
Were any leases to which the plan was party in default or uncollectible2012-01-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-01-31$71,822
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-01-31$75,826
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-01-31$75,826
Expenses. Payments to insurance carriers foe the provision of benefits2012-01-31$2,922,913
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-01-31No
Was there a failure to transmit to the plan any participant contributions2012-01-31No
Has the plan failed to provide any benefit when due under the plan2012-01-31No
Contributions received in cash from employer2012-01-31$2,409,940
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-01-31$37,380
Contract administrator fees2012-01-31$2,449
Did the plan have assets held for investment2012-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-01-31No
Opinion of an independent qualified public accountant for this plan2012-01-31Disclaimer
Accountancy firm name2012-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2012-01-31720136870
2011 : DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-01-31$402
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-01-31$13,311
Total income from all sources (including contributions)2011-01-31$2,934,087
Total loss/gain on sale of assets2011-01-31$0
Total of all expenses incurred2011-01-31$2,987,205
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-01-31$2,943,378
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-01-31$2,919,496
Value of total assets at end of year2011-01-31$78,492
Value of total assets at beginning of year2011-01-31$144,519
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-01-31$43,827
Total interest from all sources2011-01-31$14,591
Total dividends received (eg from common stock, registered investment company shares)2011-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-01-31No
Administrative expenses professional fees incurred2011-01-31$30,285
Was this plan covered by a fidelity bond2011-01-31Yes
Value of fidelity bond cover2011-01-31$500,000
Were there any nonexempt tranactions with any party-in-interest2011-01-31No
Contributions received from participants2011-01-31$426,405
Assets. Other investments not covered elsewhere at end of year2011-01-31$2,666
Assets. Other investments not covered elsewhere at beginning of year2011-01-31$3,801
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-01-31$31,629
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-01-31$368
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-01-31$742
Administrative expenses (other) incurred2011-01-31$11,411
Liabilities. Value of operating payables at end of year2011-01-31$34
Liabilities. Value of operating payables at beginning of year2011-01-31$12,569
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-01-31No
Value of net income/loss2011-01-31$-53,118
Value of net assets at end of year (total assets less liabilities)2011-01-31$78,090
Value of net assets at beginning of year (total assets less liabilities)2011-01-31$131,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-01-31No
Were any leases to which the plan was party in default or uncollectible2011-01-31No
Interest earned on other investments2011-01-31$14,590
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-01-31$75,826
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-01-31$109,089
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-01-31$109,089
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-01-31$1
Expenses. Payments to insurance carriers foe the provision of benefits2011-01-31$2,902,544
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-01-31No
Was there a failure to transmit to the plan any participant contributions2011-01-31No
Has the plan failed to provide any benefit when due under the plan2011-01-31No
Contributions received in cash from employer2011-01-31$2,493,091
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-01-31$40,834
Contract administrator fees2011-01-31$2,131
Did the plan have assets held for investment2011-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-01-31No
Opinion of an independent qualified public accountant for this plan2011-01-31Disclaimer
Accountancy firm name2011-01-31BOURGEOIS BENNETT, L.L.C
Accountancy firm EIN2011-01-31720136870

Form 5500 Responses for DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST

2022: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Submission has been amendedNo
2022-02-01This submission is the final filingNo
2022-02-01This return/report is a short plan year return/report (less than 12 months)No
2022-02-01Plan is a collectively bargained planYes
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan funding arrangement – TrustYes
2022-02-01Plan benefit arrangement – InsuranceYes
2022-02-01Plan benefit arrangement - TrustYes
2021: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2021 form 5500 responses
2021-02-01Type of plan entitySingle employer plan
2021-02-01Submission has been amendedNo
2021-02-01This submission is the final filingNo
2021-02-01This return/report is a short plan year return/report (less than 12 months)No
2021-02-01Plan is a collectively bargained planYes
2021-02-01Plan funding arrangement – InsuranceYes
2021-02-01Plan funding arrangement – TrustYes
2021-02-01Plan benefit arrangement – InsuranceYes
2021-02-01Plan benefit arrangement - TrustYes
2020: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Submission has been amendedNo
2020-02-01This submission is the final filingNo
2020-02-01This return/report is a short plan year return/report (less than 12 months)No
2020-02-01Plan is a collectively bargained planYes
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan funding arrangement – TrustYes
2020-02-01Plan benefit arrangement – InsuranceYes
2020-02-01Plan benefit arrangement - TrustYes
2019: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Submission has been amendedNo
2019-02-01This submission is the final filingNo
2019-02-01This return/report is a short plan year return/report (less than 12 months)No
2019-02-01Plan is a collectively bargained planYes
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan funding arrangement – TrustYes
2019-02-01Plan benefit arrangement – InsuranceYes
2019-02-01Plan benefit arrangement - TrustYes
2018: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Submission has been amendedNo
2018-02-01This submission is the final filingNo
2018-02-01This return/report is a short plan year return/report (less than 12 months)No
2018-02-01Plan is a collectively bargained planYes
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan funding arrangement – TrustYes
2018-02-01Plan benefit arrangement – InsuranceYes
2018-02-01Plan benefit arrangement - TrustYes
2017: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planYes
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan funding arrangement – TrustYes
2017-02-01Plan benefit arrangement – InsuranceYes
2017-02-01Plan benefit arrangement - TrustYes
2016: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)No
2016-02-01Plan is a collectively bargained planYes
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan funding arrangement – TrustYes
2016-02-01Plan benefit arrangement – InsuranceYes
2016-02-01Plan benefit arrangement - TrustYes
2015: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)No
2015-02-01Plan is a collectively bargained planYes
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan funding arrangement – TrustYes
2015-02-01Plan benefit arrangement – InsuranceYes
2015-02-01Plan benefit arrangement - TrustYes
2014: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01Submission has been amendedNo
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)No
2014-02-01Plan is a collectively bargained planYes
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan funding arrangement – TrustYes
2014-02-01Plan benefit arrangement – InsuranceYes
2014-02-01Plan benefit arrangement - TrustYes
2013: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01Submission has been amendedNo
2013-02-01This submission is the final filingNo
2013-02-01This return/report is a short plan year return/report (less than 12 months)No
2013-02-01Plan is a collectively bargained planYes
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan funding arrangement – TrustYes
2013-02-01Plan benefit arrangement – InsuranceYes
2013-02-01Plan benefit arrangement - TrustYes
2012: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01Submission has been amendedNo
2012-02-01This submission is the final filingNo
2012-02-01This return/report is a short plan year return/report (less than 12 months)No
2012-02-01Plan is a collectively bargained planYes
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan funding arrangement – TrustYes
2012-02-01Plan benefit arrangement – InsuranceYes
2012-02-01Plan benefit arrangement - TrustYes
2011: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01Submission has been amendedNo
2011-02-01This submission is the final filingNo
2011-02-01This return/report is a short plan year return/report (less than 12 months)No
2011-02-01Plan is a collectively bargained planYes
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan funding arrangement – TrustYes
2011-02-01Plan benefit arrangement – InsuranceYes
2011-02-01Plan benefit arrangement - TrustYes
2010: DOMINO SUGAR CORP AND LOCAL 1101 UNITED FOOD AND COMMERCIAL WORKERS UNION HEALTH & WELFARE TRUST 2010 form 5500 responses
2010-02-01Type of plan entitySingle employer plan
2010-02-01Submission has been amendedNo
2010-02-01This submission is the final filingNo
2010-02-01This return/report is a short plan year return/report (less than 12 months)No
2010-02-01Plan is a collectively bargained planYes
2010-02-01Plan funding arrangement – InsuranceYes
2010-02-01Plan funding arrangement – TrustYes
2010-02-01Plan benefit arrangement – InsuranceYes
2010-02-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number924296
Policy instance 2
Insurance contract or identification number924296
Number of Individuals Covered604
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $184,528
Total amount of fees paid to insurance companyUSD $6,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,384,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $184,528
Amount paid for insurance broker fees6000
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number893830G
Policy instance 1
Insurance contract or identification number893830G
Number of Individuals Covered434
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $11,181
Total amount of fees paid to insurance companyUSD $1,520
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBAS AND DEP LIFE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $74,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,181
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
HUMANA (National Association of Insurance Commissioners NAIC id number: 95642 )
Policy contract number697354,314412
Policy instance 2
Insurance contract or identification number697354,314412
Number of Individuals Covered248
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $167,924
Total amount of fees paid to insurance companyUSD $11,300
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,346,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $154,875
Amount paid for insurance broker fees11300
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00512442
Policy instance 1
Insurance contract or identification number00512442
Number of Individuals Covered448
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $29,047
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $237,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,047
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00512442
Policy instance 1
Insurance contract or identification number00512442
Number of Individuals Covered461
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $29,992
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $246,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,992
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
HUMANA (National Association of Insurance Commissioners NAIC id number: 95642 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered252
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $141,516
Total amount of fees paid to insurance companyUSD $41,149
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,521,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $141,516
Amount paid for insurance broker fees41149
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00512442
Policy instance 1
Insurance contract or identification number00512442
Number of Individuals Covered452
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $28,517
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $235,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,517
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
HUMANA (National Association of Insurance Commissioners NAIC id number: 95642 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered288
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $161,270
Total amount of fees paid to insurance companyUSD $42,187
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,187,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $161,270
Amount paid for insurance broker fees42187
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00512442
Policy instance 1
Insurance contract or identification number00512442
Number of Individuals Covered434
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $26,244
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $216,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,902
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
HUMANA (National Association of Insurance Commissioners NAIC id number: 95642 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered289
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $165,123
Total amount of fees paid to insurance companyUSD $53,887
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,286,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $165,123
Amount paid for insurance broker fees53887
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00512442
Policy instance 1
Insurance contract or identification number00512442
Number of Individuals Covered443
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $21,428
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $182,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,284
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameNATIONAL BENEFIT CENTER LLC
HUMANA (National Association of Insurance Commissioners NAIC id number: 95642 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered290
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $95,222
Total amount of fees paid to insurance companyUSD $34,350
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,177,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $95,222
Amount paid for insurance broker fees34350
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05-575770
Policy instance 1
Insurance contract or identification numberKM05-575770
Number of Individuals Covered956
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $8,555
Total amount of fees paid to insurance companyUSD $999
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $77,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,555
Amount paid for insurance broker fees999
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered270
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $165,970
Total amount of fees paid to insurance companyUSD $35,104
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,190,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $165,970
Amount paid for insurance broker fees35104
Additional information about fees paid to insurance brokerBONUSES
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered272
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $135,120
Total amount of fees paid to insurance companyUSD $49,293
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,554,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $135,120
Amount paid for insurance broker fees49293
Additional information about fees paid to insurance brokerBONUSES AND NON-MONETARY COMP
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05-575770
Policy instance 1
Insurance contract or identification numberKM05-575770
Number of Individuals Covered956
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $9,114
Total amount of fees paid to insurance companyUSD $551
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $98,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,114
Amount paid for insurance broker fees551
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number06747
Policy instance 4
Insurance contract or identification number06747
Number of Individuals Covered132
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $5,252
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $35,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,170
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJEREMIAH T. TALTON
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1000 11682
Policy instance 3
Insurance contract or identification number1000 11682
Number of Individuals Covered110
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $9,361
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOL LIFE, VOL AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $46,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,553
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered258
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $132,753
Total amount of fees paid to insurance companyUSD $51,038
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,550,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $132,753
Amount paid for insurance broker fees51038
Additional information about fees paid to insurance brokerBONUSES
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05-575770
Policy instance 1
Insurance contract or identification numberKM05-575770
Number of Individuals Covered948
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $9,271
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $91,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,271
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10160580
Policy instance 5
Insurance contract or identification number10160580
Number of Individuals Covered120
Insurance policy start date2012-07-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $6,784
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $33,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,749
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
HUMANA (National Association of Insurance Commissioners NAIC id number: 95642 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered270
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $124,503
Total amount of fees paid to insurance companyUSD $50,633
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,491,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $124,503
Amount paid for insurance broker fees50633
Additional information about fees paid to insurance brokerBONUSES
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05-575770
Policy instance 1
Insurance contract or identification numberKM05-575770
Number of Individuals Covered953
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,222
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $136,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,222
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1000 11682
Policy instance 3
Insurance contract or identification number1000 11682
Number of Individuals Covered110
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $10,507
Total amount of fees paid to insurance companyUSD $444
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOL LIFE, VOL AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $52,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,839
Amount paid for insurance broker fees444
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number06747
Policy instance 6
Insurance contract or identification number06747
Number of Individuals Covered130
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $11,546
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $74,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,564
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameVICKI M. BUTLER
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10160579
Policy instance 4
Insurance contract or identification number10160579
Number of Individuals Covered48
Insurance policy start date2012-07-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $2,200
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,540
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameEUSTIS BENEFITS LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered282
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $89,575
Total amount of fees paid to insurance companyUSD $25,618
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,571,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05-575770
Policy instance 1
Insurance contract or identification numberKM05-575770
Number of Individuals Covered976
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $11,619
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $194,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05-575770
Policy instance 1
Insurance contract or identification numberKM05-575770
Number of Individuals Covered1032
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $11,963
Total amount of fees paid to insurance companyUSD $202
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $163,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number697354
Policy instance 2
Insurance contract or identification number697354
Number of Individuals Covered291
Insurance policy start date2009-06-01
Insurance policy end date2010-05-31
Total amount of commissions paid to insurance brokerUSD $111,938
Total amount of fees paid to insurance companyUSD $57,319
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,826,952
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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