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THE PC HEALTH BENEFIT PLAN 401k Plan overview

Plan NameTHE PC HEALTH BENEFIT PLAN
Plan identification number 501

THE PC HEALTH BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental

401k Sponsoring company profile

PEPSI-COLA NEWBURGH BOTTLING CO., INC. has sponsored the creation of one or more 401k plans.

Company Name:PEPSI-COLA NEWBURGH BOTTLING CO., INC.
Employer identification number (EIN):141263911
NAIC Classification:312110
NAIC Description: Soft Drink and Ice Manufacturing

Additional information about PEPSI-COLA NEWBURGH BOTTLING CO., INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1946-05-02
Company Identification Number: 58672
Legal Registered Office Address: 1 PEPSI WAY
New York
NEWBURGH
United States of America (USA)
12550

More information about PEPSI-COLA NEWBURGH BOTTLING CO., INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE PC HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01
5012021-04-01
5012020-04-01
5012019-04-01
5012018-04-01MARY ABRAMOWITZ MARY ABRAMOWITZ2019-07-03
5012017-04-01
5012016-04-01
5012015-04-01
5012014-04-01MARY ABRAMOWITZ
5012013-04-01MARY ABRAMOWITZ
5012012-04-01MARY ABRAMOWITZ
5012011-04-01MARY ABRAMOWITZ
5012010-04-01MARY ABRAMOWITZ
5012009-04-01MARY ABRAMOWITZ
5012008-04-01MARY ABRAMOWITZ
5012007-04-01MARY ABRAMOWITZ
5012006-04-01MARY ABRAMOWITZ
5012005-04-01MARY ABRAMOWITZ
5012004-04-01MARY ABRAMOWITZ
5012003-04-01MARY ABRAMOWITZ
5012002-04-01MARY ABRAMOWITZ
5012001-04-01MARY ABRAMOWITZ
5012000-04-01MARY ABRAMOWITZ
5011999-04-01MARY ABRAMOWITZ
5011998-04-01MARY ABRAMOWITZ
5011997-04-01MARY ABRAMOWITZ
5011996-04-01MARY ABRAMOWITZ
5011995-04-01MARY ABRAMOWITZ
5011994-04-01MARY ABRAMOWITZ
5011993-04-01MARY ABRAMOWITZ
5011992-04-01MARY ABRAMOWITZ

Plan Statistics for THE PC HEALTH BENEFIT PLAN

401k plan membership statisitcs for THE PC HEALTH BENEFIT PLAN

Measure Date Value
2022: THE PC HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01237
Total number of active participants reported on line 7a of the Form 55002022-04-01248
Total of all active and inactive participants2022-04-01248
Total participants2022-04-01248
2021: THE PC HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01243
Total number of active participants reported on line 7a of the Form 55002021-04-01237
Total of all active and inactive participants2021-04-01237
Total participants2021-04-01237
2020: THE PC HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01240
Total number of active participants reported on line 7a of the Form 55002020-04-01237
Total of all active and inactive participants2020-04-01237
Total participants2020-04-01237
2019: THE PC HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01248
Total number of active participants reported on line 7a of the Form 55002019-04-01238
Total of all active and inactive participants2019-04-01238
Total participants2019-04-01238
2018: THE PC HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01248
Total number of active participants reported on line 7a of the Form 55002018-04-01248
Total of all active and inactive participants2018-04-01248
Total participants2018-04-01248
2017: THE PC HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01252
Total number of active participants reported on line 7a of the Form 55002017-04-01236
Total of all active and inactive participants2017-04-01236
Total participants2017-04-01236
2016: THE PC HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01245
Total number of active participants reported on line 7a of the Form 55002016-04-01250
Total of all active and inactive participants2016-04-01250
Total participants2016-04-01250
2015: THE PC HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01225
Total number of active participants reported on line 7a of the Form 55002015-04-01235
Total of all active and inactive participants2015-04-01235
Total participants2015-04-01235
2014: THE PC HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01223
Total number of active participants reported on line 7a of the Form 55002014-04-01220
Total of all active and inactive participants2014-04-01220
Total participants2014-04-01220
2013: THE PC HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01238
Total number of active participants reported on line 7a of the Form 55002013-04-01220
Total of all active and inactive participants2013-04-01220
Total participants2013-04-01220
2012: THE PC HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01246
Total number of active participants reported on line 7a of the Form 55002012-04-01237
Total of all active and inactive participants2012-04-01237
Total participants2012-04-01237
2011: THE PC HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01247
Total number of active participants reported on line 7a of the Form 55002011-04-01246
Total of all active and inactive participants2011-04-01246
Total participants2011-04-01246
2010: THE PC HEALTH BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-04-01241
Total number of active participants reported on line 7a of the Form 55002010-04-01239
Total of all active and inactive participants2010-04-01239
Total participants2010-04-01239
2009: THE PC HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01263
Total number of active participants reported on line 7a of the Form 55002009-04-01236
Total of all active and inactive participants2009-04-01236
Total participants2009-04-01236
2008: THE PC HEALTH BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-04-01256
Total number of active participants reported on line 7a of the Form 55002008-04-01262
Total of all active and inactive participants2008-04-01262
Total participants2008-04-01262
2007: THE PC HEALTH BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-04-01249
Total number of active participants reported on line 7a of the Form 55002007-04-01249
Total of all active and inactive participants2007-04-01249
Total participants2007-04-01249
2006: THE PC HEALTH BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-04-01250
Total number of active participants reported on line 7a of the Form 55002006-04-01248
Total of all active and inactive participants2006-04-01248
Total participants2006-04-01248
2005: THE PC HEALTH BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-04-01253
Total number of active participants reported on line 7a of the Form 55002005-04-01247
Total of all active and inactive participants2005-04-01247
Total participants2005-04-01247
2004: THE PC HEALTH BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-04-01242
Total number of active participants reported on line 7a of the Form 55002004-04-01253
Total of all active and inactive participants2004-04-01253
Total participants2004-04-01253
2003: THE PC HEALTH BENEFIT PLAN 2003 401k membership
Total participants, beginning-of-year2003-04-01227
Total number of active participants reported on line 7a of the Form 55002003-04-01242
Total of all active and inactive participants2003-04-01242
Total participants2003-04-01242
2002: THE PC HEALTH BENEFIT PLAN 2002 401k membership
Total participants, beginning-of-year2002-04-01230
Total number of active participants reported on line 7a of the Form 55002002-04-01228
Total of all active and inactive participants2002-04-01228
Total participants2002-04-01228
2001: THE PC HEALTH BENEFIT PLAN 2001 401k membership
Total participants, beginning-of-year2001-04-01214
Total number of active participants reported on line 7a of the Form 55002001-04-01232
Total of all active and inactive participants2001-04-01232
Total participants2001-04-01232
2000: THE PC HEALTH BENEFIT PLAN 2000 401k membership
Total participants, beginning-of-year2000-04-01233
Total number of active participants reported on line 7a of the Form 55002000-04-01225
Total of all active and inactive participants2000-04-01225
Total participants2000-04-01225
1999: THE PC HEALTH BENEFIT PLAN 1999 401k membership
Total participants, beginning-of-year1999-04-01222
Total number of active participants reported on line 7a of the Form 55001999-04-01233
Total of all active and inactive participants1999-04-01233
Total participants1999-04-01233
1998: THE PC HEALTH BENEFIT PLAN 1998 401k membership
Total participants, beginning-of-year1998-04-01206
Total number of active participants reported on line 7a of the Form 55001998-04-01222
Total of all active and inactive participants1998-04-01222
Total participants1998-04-01222
1997: THE PC HEALTH BENEFIT PLAN 1997 401k membership
Total participants, beginning-of-year1997-04-01198
Total number of active participants reported on line 7a of the Form 55001997-04-01206
Total of all active and inactive participants1997-04-01206
Total participants1997-04-01206
1996: THE PC HEALTH BENEFIT PLAN 1996 401k membership
Total participants, beginning-of-year1996-04-01198
Total number of active participants reported on line 7a of the Form 55001996-04-01198
Total of all active and inactive participants1996-04-01198
Total participants1996-04-01198
1995: THE PC HEALTH BENEFIT PLAN 1995 401k membership
Total participants, beginning-of-year1995-04-01189
Total number of active participants reported on line 7a of the Form 55001995-04-01198
Total of all active and inactive participants1995-04-01198
Total participants1995-04-01198
1994: THE PC HEALTH BENEFIT PLAN 1994 401k membership
Total participants, beginning-of-year1994-04-01191
Total number of active participants reported on line 7a of the Form 55001994-04-01189
Total of all active and inactive participants1994-04-01189
Total participants1994-04-01189
1993: THE PC HEALTH BENEFIT PLAN 1993 401k membership
Total participants, beginning-of-year1993-04-01185
Total number of active participants reported on line 7a of the Form 55001993-04-01191
Total of all active and inactive participants1993-04-01191
Total participants1993-04-01191
1992: THE PC HEALTH BENEFIT PLAN 1992 401k membership
Total participants, beginning-of-year1992-04-01185
Total number of active participants reported on line 7a of the Form 55001992-04-01185
Total of all active and inactive participants1992-04-01185
Total participants1992-04-01185

Form 5500 Responses for THE PC HEALTH BENEFIT PLAN

2022: THE PC HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – General assets of the sponsorYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – General assets of the sponsorYes
2021: THE PC HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – General assets of the sponsorYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – General assets of the sponsorYes
2020: THE PC HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – General assets of the sponsorYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – General assets of the sponsorYes
2019: THE PC HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – General assets of the sponsorYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – General assets of the sponsorYes
2018: THE PC HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – General assets of the sponsorYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – General assets of the sponsorYes
2017: THE PC HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: THE PC HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – General assets of the sponsorYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – General assets of the sponsorYes
2015: THE PC HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – General assets of the sponsorYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – General assets of the sponsorYes
2014: THE PC HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – General assets of the sponsorYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – General assets of the sponsorYes
2013: THE PC HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan funding arrangement – General assets of the sponsorYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – General assets of the sponsorYes
2012: THE PC HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – General assets of the sponsorYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – General assets of the sponsorYes
2011: THE PC HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan funding arrangement – General assets of the sponsorYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – General assets of the sponsorYes
2010: THE PC HEALTH BENEFIT PLAN 2010 form 5500 responses
2010-04-01Type of plan entitySingle employer plan
2010-04-01Submission has been amendedNo
2010-04-01This submission is the final filingNo
2010-04-01This return/report is a short plan year return/report (less than 12 months)No
2010-04-01Plan is a collectively bargained planNo
2010-04-01Plan funding arrangement – General assets of the sponsorYes
2010-04-01Plan benefit arrangement – General assets of the sponsorYes
2009: THE PC HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedNo
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – General assets of the sponsorYes
2009-04-01Plan benefit arrangement – General assets of the sponsorYes
2008: THE PC HEALTH BENEFIT PLAN 2008 form 5500 responses
2008-04-01Type of plan entitySingle employer plan
2008-04-01Submission has been amendedNo
2008-04-01This submission is the final filingNo
2008-04-01This return/report is a short plan year return/report (less than 12 months)No
2008-04-01Plan is a collectively bargained planNo
2008-04-01Plan funding arrangement – General assets of the sponsorYes
2008-04-01Plan benefit arrangement – General assets of the sponsorYes
2007: THE PC HEALTH BENEFIT PLAN 2007 form 5500 responses
2007-04-01Type of plan entitySingle employer plan
2007-04-01Submission has been amendedNo
2007-04-01This submission is the final filingNo
2007-04-01This return/report is a short plan year return/report (less than 12 months)No
2007-04-01Plan is a collectively bargained planNo
2007-04-01Plan funding arrangement – General assets of the sponsorYes
2007-04-01Plan benefit arrangement – General assets of the sponsorYes
2006: THE PC HEALTH BENEFIT PLAN 2006 form 5500 responses
2006-04-01Type of plan entitySingle employer plan
2006-04-01Submission has been amendedNo
2006-04-01This submission is the final filingNo
2006-04-01This return/report is a short plan year return/report (less than 12 months)No
2006-04-01Plan is a collectively bargained planNo
2006-04-01Plan funding arrangement – General assets of the sponsorYes
2006-04-01Plan benefit arrangement – General assets of the sponsorYes
2005: THE PC HEALTH BENEFIT PLAN 2005 form 5500 responses
2005-04-01Type of plan entitySingle employer plan
2005-04-01Submission has been amendedNo
2005-04-01This submission is the final filingNo
2005-04-01This return/report is a short plan year return/report (less than 12 months)No
2005-04-01Plan is a collectively bargained planNo
2005-04-01Plan funding arrangement – General assets of the sponsorYes
2005-04-01Plan benefit arrangement – General assets of the sponsorYes
2004: THE PC HEALTH BENEFIT PLAN 2004 form 5500 responses
2004-04-01Type of plan entitySingle employer plan
2004-04-01Submission has been amendedNo
2004-04-01This submission is the final filingNo
2004-04-01This return/report is a short plan year return/report (less than 12 months)No
2004-04-01Plan is a collectively bargained planNo
2004-04-01Plan funding arrangement – General assets of the sponsorYes
2004-04-01Plan benefit arrangement – General assets of the sponsorYes
2003: THE PC HEALTH BENEFIT PLAN 2003 form 5500 responses
2003-04-01Type of plan entitySingle employer plan
2003-04-01Submission has been amendedNo
2003-04-01This submission is the final filingNo
2003-04-01This return/report is a short plan year return/report (less than 12 months)No
2003-04-01Plan is a collectively bargained planNo
2003-04-01Plan funding arrangement – General assets of the sponsorYes
2003-04-01Plan benefit arrangement – General assets of the sponsorYes
2002: THE PC HEALTH BENEFIT PLAN 2002 form 5500 responses
2002-04-01Type of plan entitySingle employer plan
2002-04-01Submission has been amendedNo
2002-04-01This submission is the final filingNo
2002-04-01This return/report is a short plan year return/report (less than 12 months)No
2002-04-01Plan is a collectively bargained planNo
2002-04-01Plan funding arrangement – General assets of the sponsorYes
2002-04-01Plan benefit arrangement – General assets of the sponsorYes
2001: THE PC HEALTH BENEFIT PLAN 2001 form 5500 responses
2001-04-01Type of plan entitySingle employer plan
2001-04-01Submission has been amendedNo
2001-04-01This submission is the final filingNo
2001-04-01This return/report is a short plan year return/report (less than 12 months)No
2001-04-01Plan is a collectively bargained planNo
2001-04-01Plan funding arrangement – General assets of the sponsorYes
2001-04-01Plan benefit arrangement – General assets of the sponsorYes
2000: THE PC HEALTH BENEFIT PLAN 2000 form 5500 responses
2000-04-01Type of plan entitySingle employer plan
2000-04-01Submission has been amendedNo
2000-04-01This submission is the final filingNo
2000-04-01This return/report is a short plan year return/report (less than 12 months)No
2000-04-01Plan is a collectively bargained planNo
2000-04-01Plan funding arrangement – General assets of the sponsorYes
2000-04-01Plan benefit arrangement – General assets of the sponsorYes
1999: THE PC HEALTH BENEFIT PLAN 1999 form 5500 responses
1999-04-01Type of plan entitySingle employer plan
1999-04-01Submission has been amendedNo
1999-04-01This submission is the final filingNo
1999-04-01This return/report is a short plan year return/report (less than 12 months)No
1999-04-01Plan is a collectively bargained planNo
1999-04-01Plan funding arrangement – General assets of the sponsorYes
1999-04-01Plan benefit arrangement – General assets of the sponsorYes
1998: THE PC HEALTH BENEFIT PLAN 1998 form 5500 responses
1998-04-01Type of plan entitySingle employer plan
1998-04-01Submission has been amendedNo
1998-04-01This submission is the final filingNo
1998-04-01This return/report is a short plan year return/report (less than 12 months)No
1998-04-01Plan is a collectively bargained planNo
1998-04-01Plan funding arrangement – InsuranceYes
1998-04-01Plan funding arrangement – General assets of the sponsorYes
1998-04-01Plan benefit arrangement – InsuranceYes
1998-04-01Plan benefit arrangement – General assets of the sponsorYes
1997: THE PC HEALTH BENEFIT PLAN 1997 form 5500 responses
1997-04-01Type of plan entitySingle employer plan
1997-04-01Submission has been amendedNo
1997-04-01This submission is the final filingNo
1997-04-01This return/report is a short plan year return/report (less than 12 months)No
1997-04-01Plan is a collectively bargained planNo
1997-04-01Plan funding arrangement – InsuranceYes
1997-04-01Plan funding arrangement – General assets of the sponsorYes
1997-04-01Plan benefit arrangement – InsuranceYes
1997-04-01Plan benefit arrangement – General assets of the sponsorYes
1996: THE PC HEALTH BENEFIT PLAN 1996 form 5500 responses
1996-04-01Type of plan entitySingle employer plan
1996-04-01Submission has been amendedNo
1996-04-01This submission is the final filingNo
1996-04-01This return/report is a short plan year return/report (less than 12 months)No
1996-04-01Plan is a collectively bargained planNo
1996-04-01Plan funding arrangement – General assets of the sponsorYes
1996-04-01Plan benefit arrangement – General assets of the sponsorYes
1995: THE PC HEALTH BENEFIT PLAN 1995 form 5500 responses
1995-04-01Type of plan entitySingle employer plan
1995-04-01Submission has been amendedNo
1995-04-01This submission is the final filingNo
1995-04-01This return/report is a short plan year return/report (less than 12 months)No
1995-04-01Plan is a collectively bargained planNo
1995-04-01Plan funding arrangement – InsuranceYes
1995-04-01Plan funding arrangement – General assets of the sponsorYes
1995-04-01Plan benefit arrangement – InsuranceYes
1995-04-01Plan benefit arrangement – General assets of the sponsorYes
1994: THE PC HEALTH BENEFIT PLAN 1994 form 5500 responses
1994-04-01Type of plan entitySingle employer plan
1994-04-01Submission has been amendedNo
1994-04-01This submission is the final filingNo
1994-04-01This return/report is a short plan year return/report (less than 12 months)No
1994-04-01Plan is a collectively bargained planNo
1994-04-01Plan funding arrangement – InsuranceYes
1994-04-01Plan funding arrangement – General assets of the sponsorYes
1994-04-01Plan benefit arrangement – InsuranceYes
1994-04-01Plan benefit arrangement – General assets of the sponsorYes
1993: THE PC HEALTH BENEFIT PLAN 1993 form 5500 responses
1993-04-01Type of plan entitySingle employer plan
1993-04-01Submission has been amendedNo
1993-04-01This submission is the final filingNo
1993-04-01This return/report is a short plan year return/report (less than 12 months)No
1993-04-01Plan is a collectively bargained planNo
1993-04-01Plan funding arrangement – InsuranceYes
1993-04-01Plan funding arrangement – General assets of the sponsorYes
1993-04-01Plan benefit arrangement – InsuranceYes
1993-04-01Plan benefit arrangement – General assets of the sponsorYes
1992: THE PC HEALTH BENEFIT PLAN 1992 form 5500 responses
1992-04-01Type of plan entitySingle employer plan
1992-04-01First time form 5500 has been submittedYes
1992-04-01Submission has been amendedNo
1992-04-01This submission is the final filingNo
1992-04-01This return/report is a short plan year return/report (less than 12 months)No
1992-04-01Plan is a collectively bargained planNo
1992-04-01Plan funding arrangement – InsuranceYes
1992-04-01Plan funding arrangement – General assets of the sponsorYes
1992-04-01Plan benefit arrangement – InsuranceYes
1992-04-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered264
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $5,244
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $62,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,244
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered251
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $5,433
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 $65,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,433
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered256
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $5,472
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
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 $66,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,472
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered255
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $5,521
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
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 $66,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,521
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered263
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $5,568
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
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 $68,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,568
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered267
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $5,633
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
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 $69,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered242
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $5,091
Total amount of fees paid to insurance companyUSD $2,577
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
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 $57,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,091
Amount paid for insurance broker fees2577
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered246
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $4,979
Total amount of fees paid to insurance companyUSD $2,070
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
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 $55,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,979
Amount paid for insurance broker fees2070
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered250
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $5,000
Total amount of fees paid to insurance companyUSD $3,138
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
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 $53,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,000
Amount paid for insurance broker fees3138
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberRV792
Policy instance 1
Insurance contract or identification numberRV792
Number of Individuals Covered245
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $4,890
Total amount of fees paid to insurance companyUSD $1,524
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
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 $52,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,890
Amount paid for insurance broker fees1524
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberGL204253
Policy instance 1
Insurance contract or identification numberGL204253
Number of Individuals Covered222
Insurance policy start date1998-04-01
Insurance policy end date1999-03-31
Total amount of commissions paid to insurance brokerUSD $2,238
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
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 $14,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,238
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberGL204253
Policy instance 1
Insurance contract or identification numberGL204253
Number of Individuals Covered206
Insurance policy start date1997-04-01
Insurance policy end date1998-03-31
Total amount of commissions paid to insurance brokerUSD $2,558
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
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 $13,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,558
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberGL204253
Policy instance 1
Insurance contract or identification numberGL204253
Number of Individuals Covered198
Insurance policy start date1995-04-01
Insurance policy end date1996-03-31
Total amount of commissions paid to insurance brokerUSD $2,476
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
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 $13,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,476
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberGL204253
Policy instance 1
Insurance contract or identification numberGL204253
Number of Individuals Covered189
Insurance policy start date1994-04-01
Insurance policy end date1995-03-31
Total amount of commissions paid to insurance brokerUSD $2,413
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
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 $13,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,413
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberGL204253
Policy instance 1
Insurance contract or identification numberGL204253
Number of Individuals Covered191
Insurance policy start date1993-04-01
Insurance policy end date1994-03-31
Total amount of commissions paid to insurance brokerUSD $2,598
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
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 $14,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,598
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberGL204253
Policy instance 1
Insurance contract or identification numberGL204253
Number of Individuals Covered185
Insurance policy start date1992-04-01
Insurance policy end date1993-03-31
Total amount of commissions paid to insurance brokerUSD $2,763
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
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 $13,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,763
Insurance broker organization code?3

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