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NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 401k Plan overview

Plan NameNEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST
Plan identification number 501

NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST Benefits

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

401k Sponsoring company profile

THE TRUSTEES OF THE NYS AUTOMOBILE DEALERS, INC. GRP. INS. TRUST has sponsored the creation of one or more 401k plans.

Company Name:THE TRUSTEES OF THE NYS AUTOMOBILE DEALERS, INC. GRP. INS. TRUST
Employer identification number (EIN):146021721
NAIC Classification:524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01ROBERT VANCAVAGE2023-10-13
5012021-01-01ROBERT VANCAVAGE2022-10-17
5012020-01-01ROBERT E. VANCAVAGE2021-10-14
5012019-01-01ROBERT E. VANCAVAGE2020-10-13
5012018-01-01ROBERT E. VANCAVAGE2019-10-13
5012017-01-01
5012016-01-01
5012015-01-01ROBERT E. VANCAVAGE
5012014-01-01ROBERT E. VANCAVAGE
5012013-01-01ROBERT E. VANCAVAGE
5012012-01-01ROBERT E. VANCAVAGE
5012011-01-01MICHELLE LANSBURG
5012010-01-01MICHELLE LANSBURG
5012009-01-01ROBERT E VANCAVAGE
5012009-01-01
5012009-01-01MICHELLE LANSBURG
5012009-01-01ROBERT E. VANCAVAGE

Plan Statistics for NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST

401k plan membership statisitcs for NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST

Measure Date Value
2022: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-015,874
Total number of active participants reported on line 7a of the Form 55002022-01-016,077
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-016,077
2021: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-016,619
Total number of active participants reported on line 7a of the Form 55002021-01-015,874
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-015,874
2020: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-015,422
Total number of active participants reported on line 7a of the Form 55002020-01-016,619
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-016,619
2019: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-017,232
Total number of active participants reported on line 7a of the Form 55002019-01-015,422
Total of all active and inactive participants2019-01-015,422
2018: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-017,068
Total number of active participants reported on line 7a of the Form 55002018-01-017,232
Total of all active and inactive participants2018-01-017,232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
2017: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-017,043
Total number of active participants reported on line 7a of the Form 55002017-01-017,068
Total of all active and inactive participants2017-01-017,068
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
2016: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-017,201
Total number of active participants reported on line 7a of the Form 55002016-01-017,043
Total of all active and inactive participants2016-01-017,043
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
2015: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-018,100
Total number of active participants reported on line 7a of the Form 55002015-01-017,201
Total of all active and inactive participants2015-01-017,201
2014: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-017,368
Total number of active participants reported on line 7a of the Form 55002014-01-018,100
Total of all active and inactive participants2014-01-018,100
2013: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-018,786
Total number of active participants reported on line 7a of the Form 55002013-01-017,368
Total of all active and inactive participants2013-01-017,368
2012: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-018,645
Total number of active participants reported on line 7a of the Form 55002012-01-018,786
Total of all active and inactive participants2012-01-018,786
2011: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-019,081
Total number of active participants reported on line 7a of the Form 55002011-01-018,645
Total of all active and inactive participants2011-01-018,645
2010: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-017,221
Total number of active participants reported on line 7a of the Form 55002010-01-019,081
Total of all active and inactive participants2010-01-019,081
2009: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-016,306
Total number of active participants reported on line 7a of the Form 55002009-01-017,221
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-017,221

Financial Data on NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST

Measure Date Value
2022 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-82,187
Total unrealized appreciation/depreciation of assets2022-12-31$-82,187
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$70,765
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$14,441
Total income from all sources (including contributions)2022-12-31$2,665,069
Total of all expenses incurred2022-12-31$2,376,997
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,138,101
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,727,274
Value of total assets at end of year2022-12-31$2,846,612
Value of total assets at beginning of year2022-12-31$2,502,216
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$238,896
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$19,982
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,990,910
Participant contributions at end of year2022-12-31$5,841
Participant contributions at beginning of year2022-12-31$1,679
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$8,909
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$71,881
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$30,329
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$10,710
Administrative expenses (other) incurred2022-12-31$235,221
Total non interest bearing cash at end of year2022-12-31$971,305
Total non interest bearing cash at beginning of year2022-12-31$503,428
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$288,072
Value of net assets at end of year (total assets less liabilities)2022-12-31$2,775,847
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,487,775
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$3,675
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$669,839
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$1,088,115
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$1,088,115
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$1,740,821
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$736,364
Employer contributions (assets) at end of year2022-12-31$2,161
Employer contributions (assets) at beginning of year2022-12-31$651
Income. Dividends from common stock2022-12-31$19,982
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$397,280
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$1,188,557
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$836,462
Liabilities. Value of benefit claims payable at end of year2022-12-31$40,436
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$3,731
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2022-12-31141662664
2021 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$72,414
Total unrealized appreciation/depreciation of assets2021-12-31$72,414
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$14,441
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$548,866
Total income from all sources (including contributions)2021-12-31$2,859,996
Total of all expenses incurred2021-12-31$2,410,118
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$2,227,801
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,783,854
Value of total assets at end of year2021-12-31$2,502,216
Value of total assets at beginning of year2021-12-31$2,586,763
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$182,317
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$3,728
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,006,324
Participant contributions at end of year2021-12-31$1,679
Participant contributions at beginning of year2021-12-31$8,983
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$71,881
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$1,124,851
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$10,710
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$16,703
Administrative expenses (other) incurred2021-12-31$61,215
Liabilities. Value of operating payables at beginning of year2021-12-31$11,423
Total non interest bearing cash at end of year2021-12-31$503,428
Total non interest bearing cash at beginning of year2021-12-31$771,136
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$449,878
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,487,775
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,037,897
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$121,102
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,088,115
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$672,828
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$672,828
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,864,908
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$777,530
Employer contributions (assets) at end of year2021-12-31$651
Employer contributions (assets) at beginning of year2021-12-31$3,516
Income. Dividends from common stock2021-12-31$3,728
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$362,893
Assets. Corporate common stocks other than exployer securities at end of year2021-12-31$836,462
Liabilities. Value of benefit claims payable at end of year2021-12-31$3,731
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$520,740
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-12-31$5,449
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2021-12-31141662664
2020 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$-9,960
Total unrealized appreciation/depreciation of assets2020-12-31$-9,960
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$548,866
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,140,878
Total income from all sources (including contributions)2020-12-31$2,265,555
Total of all expenses incurred2020-12-31$2,256,904
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$2,005,063
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,273,468
Value of total assets at end of year2020-12-31$2,586,763
Value of total assets at beginning of year2020-12-31$4,170,124
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$251,841
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$2,047
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,636,897
Participant contributions at end of year2020-12-31$8,983
Participant contributions at beginning of year2020-12-31$45,247
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$1,124,851
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$27,439
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$16,703
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$10,357
Administrative expenses (other) incurred2020-12-31$61,972
Liabilities. Value of operating payables at end of year2020-12-31$11,423
Liabilities. Value of operating payables at beginning of year2020-12-31$130,149
Total non interest bearing cash at end of year2020-12-31$771,136
Total non interest bearing cash at beginning of year2020-12-31$370,657
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$8,651
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,037,897
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,029,246
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$189,869
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$672,828
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$179,064
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$179,064
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$2,475,568
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,064,915
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$636,571
Employer contributions (assets) at end of year2020-12-31$3,516
Employer contributions (assets) at beginning of year2020-12-31$51,023
Income. Dividends from common stock2020-12-31$2,047
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$940,148
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$995,747
Liabilities. Value of benefit claims payable at end of year2020-12-31$520,740
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$2,000,372
Assets. Value of buildings and other operty used in plan operation at end of year2020-12-31$5,449
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-12-31$25,379
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2020-12-31141662664
2019 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets2019-12-31$478,272
Unrealized appreciation/depreciation of real estate assets2019-12-31$478,272
Total unrealized appreciation/depreciation of assets2019-12-31$478,272
Total unrealized appreciation/depreciation of assets2019-12-31$478,272
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,140,878
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,140,878
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$9,018,231
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$9,018,231
Total income from all sources (including contributions)2019-12-31$37,312,867
Total income from all sources (including contributions)2019-12-31$37,312,867
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$31,434,664
Total of all expenses incurred2019-12-31$31,434,664
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$27,863,159
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$27,863,159
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$36,795,490
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$36,795,490
Value of total assets at end of year2019-12-31$4,170,124
Value of total assets at end of year2019-12-31$4,170,124
Value of total assets at beginning of year2019-12-31$5,169,274
Value of total assets at beginning of year2019-12-31$5,169,274
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,571,505
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,571,505
Total interest from all sources2019-12-31$0
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$39,105
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$39,105
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$17,293,880
Contributions received from participants2019-12-31$17,293,880
Participant contributions at end of year2019-12-31$45,247
Participant contributions at end of year2019-12-31$45,247
Participant contributions at beginning of year2019-12-31$25,699
Participant contributions at beginning of year2019-12-31$25,699
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$27,439
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$27,439
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$76,236
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$76,236
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$10,357
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$310,297
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$310,297
Administrative expenses (other) incurred2019-12-31$2,867,714
Administrative expenses (other) incurred2019-12-31$2,867,714
Liabilities. Value of operating payables at end of year2019-12-31$130,149
Liabilities. Value of operating payables at end of year2019-12-31$130,149
Liabilities. Value of operating payables at beginning of year2019-12-31$177,204
Total non interest bearing cash at end of year2019-12-31$370,657
Total non interest bearing cash at beginning of year2019-12-31$576,380
Total non interest bearing cash at beginning of year2019-12-31$576,380
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$5,878,203
Value of net income/loss2019-12-31$5,878,203
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,029,246
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,029,246
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-3,848,957
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-3,848,957
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$703,791
Investment advisory and management fees2019-12-31$703,791
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$179,064
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$179,064
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$172,406
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$172,406
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$172,406
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$172,406
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,475,568
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,475,568
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$917,600
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$917,600
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$4,114,503
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$4,114,503
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$19,501,610
Employer contributions (assets) at end of year2019-12-31$51,023
Employer contributions (assets) at end of year2019-12-31$51,023
Employer contributions (assets) at beginning of year2019-12-31$29,963
Employer contributions (assets) at beginning of year2019-12-31$29,963
Income. Dividends from common stock2019-12-31$39,105
Income. Dividends from common stock2019-12-31$39,105
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$23,748,656
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$995,747
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$995,747
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$3,340,641
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$3,340,641
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,000,372
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,000,372
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$8,530,730
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$8,530,730
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$25,379
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$25,379
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$30,349
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$30,349
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31WEST & COMPANY, CPA'S PC
Accountancy firm name2019-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2019-12-31141662664
2018 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-582,099
Total unrealized appreciation/depreciation of assets2018-12-31$-582,099
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$9,018,231
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$5,706,198
Total income from all sources (including contributions)2018-12-31$47,081,918
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$54,182,526
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$51,730,488
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$47,542,543
Value of total assets at end of year2018-12-31$5,169,274
Value of total assets at beginning of year2018-12-31$8,957,849
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$2,452,038
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$121,474
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$21,950,392
Participant contributions at end of year2018-12-31$25,699
Participant contributions at beginning of year2018-12-31$64,852
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$76,236
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$57,940
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$310,297
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$30,599
Administrative expenses (other) incurred2018-12-31$1,670,680
Liabilities. Value of operating payables at end of year2018-12-31$177,204
Liabilities. Value of operating payables at beginning of year2018-12-31$99,376
Total non interest bearing cash at end of year2018-12-31$576,380
Total non interest bearing cash at beginning of year2018-12-31$238,420
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-7,100,608
Value of net assets at end of year (total assets less liabilities)2018-12-31$-3,848,957
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,251,651
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$781,358
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$172,406
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$348,069
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$348,069
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$917,600
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$923,800
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$7,362,048
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$25,592,151
Employer contributions (assets) at end of year2018-12-31$29,963
Employer contributions (assets) at beginning of year2018-12-31$66,828
Income. Dividends from common stock2018-12-31$121,474
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$44,368,440
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$3,340,641
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$7,235,780
Liabilities. Value of benefit claims payable at end of year2018-12-31$8,530,730
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$5,576,223
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$30,349
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$22,160
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31WEST & COMPANY CPA'S PC
Accountancy firm EIN2018-12-31141662664
2017 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$898,435
Total unrealized appreciation/depreciation of assets2017-12-31$898,435
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$5,706,198
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$6,887,615
Total income from all sources (including contributions)2017-12-31$48,039,414
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$47,428,769
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$45,260,226
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$46,997,859
Value of total assets at end of year2017-12-31$8,957,849
Value of total assets at beginning of year2017-12-31$9,528,621
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,168,543
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$143,120
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$23,146,446
Participant contributions at end of year2017-12-31$64,852
Participant contributions at beginning of year2017-12-31$80,938
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$57,940
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$63,556
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$30,599
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$88,780
Administrative expenses (other) incurred2017-12-31$1,413,529
Liabilities. Value of operating payables at end of year2017-12-31$99,376
Liabilities. Value of operating payables at beginning of year2017-12-31$92,471
Total non interest bearing cash at end of year2017-12-31$238,420
Total non interest bearing cash at beginning of year2017-12-31$1,873,551
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$610,645
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,251,651
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,641,006
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$755,014
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$348,069
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$461,581
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$461,581
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$923,800
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$879,700
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$6,738,913
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$23,851,413
Employer contributions (assets) at end of year2017-12-31$66,828
Employer contributions (assets) at beginning of year2017-12-31$50,519
Income. Dividends from common stock2017-12-31$143,120
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$38,521,313
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$7,235,780
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$6,095,537
Liabilities. Value of benefit claims payable at end of year2017-12-31$5,576,223
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$6,706,364
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$22,160
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$23,239
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2017-12-31141662664
2016 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$627,430
Total unrealized appreciation/depreciation of assets2016-12-31$627,430
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$6,887,615
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$5,228,152
Total income from all sources (including contributions)2016-12-31$45,772,634
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$46,262,967
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$43,188,666
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$44,978,145
Value of total assets at end of year2016-12-31$9,528,621
Value of total assets at beginning of year2016-12-31$8,359,491
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$3,074,301
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$167,059
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$17,542,128
Participant contributions at end of year2016-12-31$80,938
Participant contributions at beginning of year2016-12-31$10,894
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$17,045
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$63,556
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$333
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$88,780
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$24,080
Administrative expenses (other) incurred2016-12-31$2,344,087
Liabilities. Value of operating payables at end of year2016-12-31$92,471
Total non interest bearing cash at end of year2016-12-31$1,873,551
Total non interest bearing cash at beginning of year2016-12-31$1,655,191
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-490,333
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,641,006
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,131,339
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$730,214
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$461,581
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$23,262
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$23,262
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$879,700
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$879,200
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$6,373,673
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$27,436,017
Employer contributions (assets) at end of year2016-12-31$50,519
Employer contributions (assets) at beginning of year2016-12-31$7,156
Income. Dividends from preferred stock2016-12-31$167,059
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$36,814,993
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$6,095,537
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$5,753,405
Liabilities. Value of benefit claims payable at end of year2016-12-31$6,706,364
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$5,204,072
Assets. Value of buildings and other operty used in plan operation at end of year2016-12-31$23,239
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$13,005
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31WEST & COMPANY CPAS PC
Accountancy firm EIN2016-12-31141662664
2015 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets2015-12-31$-304,079
Total unrealized appreciation/depreciation of assets2015-12-31$-304,079
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$5,228,152
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$8,191,703
Total income from all sources (including contributions)2015-12-31$41,562,894
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$38,820,309
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$35,955,409
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$41,705,505
Value of total assets at end of year2015-12-31$8,359,491
Value of total assets at beginning of year2015-12-31$8,580,457
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,864,900
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$161,468
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$17,933,367
Participant contributions at end of year2015-12-31$10,894
Participant contributions at beginning of year2015-12-31$16,079
Assets. Other investments not covered elsewhere at end of year2015-12-31$17,045
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$17,035
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$333
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$37,133
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$24,080
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$73,167
Administrative expenses (other) incurred2015-12-31$2,155,701
Total non interest bearing cash at end of year2015-12-31$1,678,453
Total non interest bearing cash at beginning of year2015-12-31$1,026,982
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$2,742,585
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,131,339
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$388,754
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$709,199
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$879,200
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$879,200
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$5,969,254
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$23,772,138
Employer contributions (assets) at end of year2015-12-31$7,156
Employer contributions (assets) at beginning of year2015-12-31$2,372
Income. Dividends from common stock2015-12-31$161,468
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$29,986,155
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$152,733
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$5,753,405
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$6,431,609
Liabilities. Value of benefit claims payable at end of year2015-12-31$5,204,072
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$8,118,536
Assets. Value of buildings and other operty used in plan operation at end of year2015-12-31$13,005
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-12-31$17,314
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31WEST & COMPANY CPAS PC
Accountancy firm EIN2015-12-31141662664
2014 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets2014-12-31$-3,586
Total unrealized appreciation/depreciation of assets2014-12-31$-3,586
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$8,191,703
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$5,965,103
Total income from all sources (including contributions)2014-12-31$43,218,480
Total loss/gain on sale of assets2014-12-31$130,854
Total of all expenses incurred2014-12-31$44,235,869
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$41,438,714
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$42,913,302
Value of total assets at end of year2014-12-31$8,580,457
Value of total assets at beginning of year2014-12-31$7,371,246
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,797,155
Total interest from all sources2014-12-31$7,516
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$170,394
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$18,867,263
Participant contributions at end of year2014-12-31$16,079
Participant contributions at beginning of year2014-12-31$0
Assets. Other investments not covered elsewhere at end of year2014-12-31$17,035
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$16,386
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$37,133
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$333
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$73,167
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$60,957
Administrative expenses (other) incurred2014-12-31$2,118,212
Total non interest bearing cash at end of year2014-12-31$1,026,982
Total non interest bearing cash at beginning of year2014-12-31$426,136
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-1,017,389
Value of net assets at end of year (total assets less liabilities)2014-12-31$388,754
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,406,143
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$678,943
Income. Interest from corporate debt instruments2014-12-31$7,500
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$16
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$879,200
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$819,700
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$6,525,667
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$24,046,039
Employer contributions (assets) at end of year2014-12-31$2,372
Employer contributions (assets) at beginning of year2014-12-31$3,235
Income. Dividends from common stock2014-12-31$170,394
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$34,913,047
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$152,733
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$157,959
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$6,431,609
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$5,933,271
Liabilities. Value of benefit claims payable at end of year2014-12-31$8,118,536
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$5,904,146
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$17,314
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$14,226
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$964,408
Aggregate carrying amount (costs) on sale of assets2014-12-31$833,554
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2014-12-31141662664
2013 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-12-31$1,021,176
Total unrealized appreciation/depreciation of assets2013-12-31$1,021,176
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$5,965,103
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$6,321,874
Total income from all sources (including contributions)2013-12-31$39,561,884
Total loss/gain on sale of assets2013-12-31$100,895
Total of all expenses incurred2013-12-31$38,259,461
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$36,679,166
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$38,288,168
Value of total assets at end of year2013-12-31$7,371,246
Value of total assets at beginning of year2013-12-31$6,425,594
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,580,295
Total interest from all sources2013-12-31$10,641
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$141,004
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$16,162,370
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$26,669
Assets. Other investments not covered elsewhere at end of year2013-12-31$16,386
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$46,610
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$333
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$20,047
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$60,957
Administrative expenses (other) incurred2013-12-31$1,035,672
Total non interest bearing cash at end of year2013-12-31$426,136
Total non interest bearing cash at beginning of year2013-12-31$811,913
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,302,423
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,406,143
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$103,720
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$544,623
Income. Interest from corporate debt instruments2013-12-31$10,500
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$141
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$819,700
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$819,700
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$5,098,557
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$22,125,798
Employer contributions (assets) at end of year2013-12-31$3,235
Employer contributions (assets) at beginning of year2013-12-31$17,050
Income. Dividends from common stock2013-12-31$141,004
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$31,580,609
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$157,959
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$262,137
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$5,933,271
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$4,392,178
Liabilities. Value of benefit claims payable at end of year2013-12-31$5,904,146
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$6,321,874
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$14,226
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$29,290
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$873,110
Aggregate carrying amount (costs) on sale of assets2013-12-31$772,215
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2013-12-31141662664
2012 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-12-31$504,769
Total unrealized appreciation/depreciation of assets2012-12-31$504,769
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$6,321,874
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$10,459,448
Total income from all sources (including contributions)2012-12-31$36,582,699
Total loss/gain on sale of assets2012-12-31$-3,277
Total of all expenses incurred2012-12-31$31,608,065
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$30,255,111
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$35,917,776
Value of total assets at end of year2012-12-31$6,425,594
Value of total assets at beginning of year2012-12-31$5,588,534
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,352,954
Total interest from all sources2012-12-31$40,761
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$122,670
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$21,909,843
Participant contributions at end of year2012-12-31$26,669
Participant contributions at beginning of year2012-12-31$57,428
Assets. Other investments not covered elsewhere at end of year2012-12-31$46,610
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$42,039
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$20,047
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$313
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$28,821
Administrative expenses (other) incurred2012-12-31$818,279
Total non interest bearing cash at end of year2012-12-31$811,913
Total non interest bearing cash at beginning of year2012-12-31$630,161
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$4,974,634
Value of net assets at end of year (total assets less liabilities)2012-12-31$103,720
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-4,870,914
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$534,675
Income. Interest from corporate debt instruments2012-12-31$13,500
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$27,261
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$819,700
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$819,700
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$5,126,433
Asset value of US Government securities at beginning of year2012-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$14,007,933
Employer contributions (assets) at end of year2012-12-31$17,050
Employer contributions (assets) at beginning of year2012-12-31$39,907
Income. Dividends from common stock2012-12-31$122,670
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$25,128,678
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$262,137
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$253,382
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$4,392,178
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$3,706,349
Liabilities. Value of benefit claims payable at end of year2012-12-31$6,321,874
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$10,430,627
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$29,290
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$39,255
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$940,510
Aggregate carrying amount (costs) on sale of assets2012-12-31$943,787
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2012-12-31141662664
2011 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-171,692
Total unrealized appreciation/depreciation of assets2011-12-31$-171,692
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$10,459,448
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$10,003,913
Total income from all sources (including contributions)2011-12-31$38,734,538
Total loss/gain on sale of assets2011-12-31$50,805
Total of all expenses incurred2011-12-31$39,355,471
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$37,926,687
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$38,724,601
Value of total assets at end of year2011-12-31$5,588,534
Value of total assets at beginning of year2011-12-31$5,753,932
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,428,784
Total interest from all sources2011-12-31$22,240
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$108,584
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$38,724,601
Participant contributions at end of year2011-12-31$97,335
Participant contributions at beginning of year2011-12-31$252,832
Assets. Other investments not covered elsewhere at end of year2011-12-31$42,039
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$46,620
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$313
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$-9,110
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$28,821
Administrative expenses (other) incurred2011-12-31$794,007
Total non interest bearing cash at end of year2011-12-31$630,161
Total non interest bearing cash at beginning of year2011-12-31$209,221
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-620,933
Value of net assets at end of year (total assets less liabilities)2011-12-31$-4,870,914
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-4,249,981
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$634,777
Income. Interest from corporate debt instruments2011-12-31$7,849
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$97,862
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$97,862
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$14,391
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$819,700
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$797,000
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$6,036,613
Asset value of US Government securities at end of year2011-12-31$0
Asset value of US Government securities at beginning of year2011-12-31$401,028
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$15,877,086
Employer contributions (assets) at end of year2011-12-31$39,907
Employer contributions (assets) at beginning of year2011-12-31$111,246
Income. Dividends from common stock2011-12-31$108,584
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$31,890,074
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$253,382
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$254,403
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$3,706,349
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$3,652,130
Liabilities. Value of benefit claims payable at end of year2011-12-31$10,430,627
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$10,003,913
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$39,255
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$51,946
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$554,347
Aggregate carrying amount (costs) on sale of assets2011-12-31$503,542
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Qualified
Accountancy firm name2011-12-31WEST & COMPANY, CPAS, PC
Accountancy firm EIN2011-12-31141662664
2010 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$424,652
Total unrealized appreciation/depreciation of assets2010-12-31$424,652
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$10,003,913
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$7,121,824
Total income from all sources (including contributions)2010-12-31$38,359,987
Total loss/gain on sale of assets2010-12-31$34,993
Total of all expenses incurred2010-12-31$41,142,129
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$39,902,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$37,759,965
Value of total assets at end of year2010-12-31$5,753,932
Value of total assets at beginning of year2010-12-31$5,653,985
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,239,829
Total interest from all sources2010-12-31$23,864
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$116,513
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$37,759,965
Participant contributions at end of year2010-12-31$252,832
Participant contributions at beginning of year2010-12-31$47,020
Assets. Other investments not covered elsewhere at end of year2010-12-31$46,620
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$-9,110
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$135,308
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$34,263
Administrative expenses (other) incurred2010-12-31$603,752
Total non interest bearing cash at end of year2010-12-31$209,221
Total non interest bearing cash at beginning of year2010-12-31$284,658
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-2,782,142
Value of net assets at end of year (total assets less liabilities)2010-12-31$-4,249,981
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-1,467,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$636,077
Income. Interest from US Government securities2010-12-31$12,774
Income. Interest from corporate debt instruments2010-12-31$8,002
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$97,862
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$97,862
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$97,862
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$3,088
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$797,000
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$797,000
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$6,075,084
Asset value of US Government securities at end of year2010-12-31$401,028
Asset value of US Government securities at beginning of year2010-12-31$790,092
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$16,010,574
Employer contributions (assets) at end of year2010-12-31$111,246
Employer contributions (assets) at beginning of year2010-12-31$21,491
Income. Dividends from common stock2010-12-31$116,513
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$33,827,216
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$254,403
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$250,077
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$3,652,130
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$3,189,640
Liabilities. Value of benefit claims payable at end of year2010-12-31$10,003,913
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$7,087,561
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$51,946
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$62,328
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$1,133,086
Aggregate carrying amount (costs) on sale of assets2010-12-31$1,098,093
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Qualified
Accountancy firm name2010-12-31WEST & COMPANY, CPAS, PC
Accountancy firm EIN2010-12-31141662664
2009 : NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2009 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2009-12-31$708,872
Total unrealized appreciation/depreciation of assets2009-12-31$708,872
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2009-12-31$7,121,824
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2009-12-31$4,380,942
Total income from all sources (including contributions)2009-12-31$27,711,937
Total loss/gain on sale of assets2009-12-31$-383,407
Total of all expenses incurred2009-12-31$31,653,693
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2009-12-31$30,634,168
Total contributions o plan (from employers,participants, others, non cash contrinutions)2009-12-31$27,245,959
Value of total assets at end of year2009-12-31$5,653,985
Value of total assets at beginning of year2009-12-31$6,854,859
Total of administrative expenses incurred including professional, contract, advisory and management fees2009-12-31$1,019,525
Total interest from all sources2009-12-31$78,687
Total dividends received (eg from common stock, registered investment company shares)2009-12-31$61,826
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2009-12-31No
Was this plan covered by a fidelity bond2009-12-31Yes
Value of fidelity bond cover2009-12-31$1,000,000
If this is an individual account plan, was there a blackout period2009-12-31No
Were there any nonexempt tranactions with any party-in-interest2009-12-31No
Contributions received from participants2009-12-31$12,779,029
Participant contributions at end of year2009-12-31$25,529
Value of other receiveables (less allowance for doubtful accounts) at end of year2009-12-31$135,308
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2009-12-31$104,651
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2009-12-31$34,263
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2009-12-31$17,094
Administrative expenses (other) incurred2009-12-31$339,103
Total non interest bearing cash at end of year2009-12-31$284,658
Total non interest bearing cash at beginning of year2009-12-31$2,151,648
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2009-12-31No
Value of net income/loss2009-12-31$-3,941,756
Value of net assets at end of year (total assets less liabilities)2009-12-31$-1,467,839
Value of net assets at beginning of year (total assets less liabilities)2009-12-31$2,473,917
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2009-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2009-12-31No
Were any leases to which the plan was party in default or uncollectible2009-12-31No
Investment advisory and management fees2009-12-31$680,422
Income. Interest from US Government securities2009-12-31$18,267
Income. Interest from corporate debt instruments2009-12-31$2,810
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2009-12-31$97,862
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2009-12-31$290,681
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2009-12-31$290,681
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2009-12-31$57,610
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2009-12-31$797,000
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2009-12-31$797,000
Expenses. Payments to insurance carriers foe the provision of benefits2009-12-31$4,315,446
Asset value of US Government securities at end of year2009-12-31$790,092
Asset value of US Government securities at beginning of year2009-12-31$747,643
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2009-12-31No
Was there a failure to transmit to the plan any participant contributions2009-12-31No
Has the plan failed to provide any benefit when due under the plan2009-12-31No
Contributions received in cash from employer2009-12-31$14,466,930
Employer contributions (assets) at end of year2009-12-31$21,491
Income. Dividends from common stock2009-12-31$61,826
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2009-12-31$26,318,722
Asset. Corporate debt instrument debt (other) at end of year2009-12-31$250,077
Asset. Corporate debt instrument debt (other) at beginning of year2009-12-31$91,774
Assets. Corporate common stocks other than exployer securities at end of year2009-12-31$3,189,640
Assets. Corporate common stocks other than exployer securities at beginning of year2009-12-31$2,640,849
Liabilities. Value of benefit claims payable at end of year2009-12-31$7,087,561
Liabilities. Value of benefit claims payable at beginning of year2009-12-31$4,363,848
Assets. Value of buildings and other operty used in plan operation at end of year2009-12-31$62,328
Assets. Value of buildings and other operty used in plan operation at beginning of year2009-12-31$30,613
Did the plan have assets held for investment2009-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2009-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2009-12-31No
Aggregate proceeds on sale of assets2009-12-31$2,295,427
Aggregate carrying amount (costs) on sale of assets2009-12-31$2,678,834
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2009-12-31No
Opinion of an independent qualified public accountant for this plan2009-12-31Unqualified
Accountancy firm name2009-12-31WEST & COMPANY, CPA'S PC
Accountancy firm EIN2009-12-31141662664

Form 5500 Responses for NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST

2022: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2022 form 5500 responses
2022-01-01Type of plan entityMulitple employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2021 form 5500 responses
2021-01-01Type of plan entityMulitple employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2019 form 5500 responses
2019-01-01Type of plan entityMulitple employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2018 form 5500 responses
2018-01-01Type of plan entityMulitple employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2017 form 5500 responses
2017-01-01Type of plan entityMulitple employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2016 form 5500 responses
2016-01-01Type of plan entityMulitple employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2015 form 5500 responses
2015-01-01Type of plan entityMulitple employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2014 form 5500 responses
2014-01-01Type of plan entityMulitple employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2013 form 5500 responses
2013-01-01Type of plan entityMulitple employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2012 form 5500 responses
2012-01-01Type of plan entityMulitple employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2011 form 5500 responses
2011-01-01Type of plan entityMulitple employer plan
2011-01-01Submission has been amendedYes
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2010 form 5500 responses
2010-01-01Type of plan entityMulitple employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: NEW YORK STATE AUTOMOBILE DEALERS, INC. GRP. INS. TRUST 2009 form 5500 responses
2009-01-01Type of plan entityMulitple employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 1
Insurance contract or identification number00964966
Number of Individuals Covered31
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,020
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $180,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,020
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402730G
Policy instance 5
Insurance contract or identification number402730G
Number of Individuals Covered1634
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $25,532
Life Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (AD&D)
Welfare Benefit Premiums Paid to CarrierUSD $137,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,532
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507386
Policy instance 4
Insurance contract or identification number00507386
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $130
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 number00537978
Policy instance 3
Insurance contract or identification number00537978
Number of Individuals Covered460
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,723
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,723
Additional information about fees paid to insurance brokerCOMMISSIONS FEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506855
Policy instance 2
Insurance contract or identification number00506855
Number of Individuals Covered1163
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 1
Insurance contract or identification number00964966
Number of Individuals Covered39
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,785
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $250,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,785
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00537978
Policy instance 3
Insurance contract or identification number00537978
Number of Individuals Covered389
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,880
Total amount of fees paid to insurance companyUSD $402
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,880
Amount paid for insurance broker fees402
Additional information about fees paid to insurance brokerCOMMISSIONS FEES
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402730G
Policy instance 5
Insurance contract or identification number402730G
Number of Individuals Covered1789
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $25,667
Life Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (AD&D)
Welfare Benefit Premiums Paid to CarrierUSD $119,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,667
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507386
Policy instance 4
Insurance contract or identification number00507386
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $61
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees61
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 number00506855
Policy instance 2
Insurance contract or identification number00506855
Number of Individuals Covered1141
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,762
Total amount of fees paid to insurance companyUSD $3,240
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,762
Amount paid for insurance broker fees3240
Additional information about fees paid to insurance brokerCOMMISSIONS FEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507386
Policy instance 4
Insurance contract or identification number00507386
Number of Individuals Covered4
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $50
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees50
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 number00537978
Policy instance 3
Insurance contract or identification number00537978
Number of Individuals Covered327
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $878
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees878
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 number00506855
Policy instance 2
Insurance contract or identification number00506855
Number of Individuals Covered1348
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $3,571
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3571
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 1
Insurance contract or identification number00964966
Number of Individuals Covered46
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,780
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $251,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,780
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402730G
Policy instance 5
Insurance contract or identification number402730G
Number of Individuals Covered1819
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $23,704
Life Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (AD&D)
Welfare Benefit Premiums Paid to CarrierUSD $113,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,704
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number300312
Policy instance 4
Insurance contract or identification number300312
Number of Individuals Covered1082
Insurance policy start date2019-05-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $100,219
Total amount of fees paid to insurance companyUSD $121,680
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $730,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100,219
Amount paid for insurance broker fees121680
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 number00537978
Policy instance 7
Insurance contract or identification number00537978
Number of Individuals Covered597
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $265
Total amount of fees paid to insurance companyUSD $795
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 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 $19,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $265
Insurance broker organization code?3
Amount paid for insurance broker fees795
Additional information about fees paid to insurance brokerFEES
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number00000000
Policy instance 1
Insurance contract or identification number00000000
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506855
Policy instance 6
Insurance contract or identification number00506855
Number of Individuals Covered1973
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,129
Total amount of fees paid to insurance companyUSD $4,494
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 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 $85,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,762
Insurance broker organization code?3
Amount paid for insurance broker fees4494
Additional information about fees paid to insurance brokerFEES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402730G
Policy instance 8
Insurance contract or identification number402730G
Number of Individuals Covered2123
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $28,642
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 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 providedADD
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 $156,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,642
Insurance broker organization code?3
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 3
Insurance contract or identification number00964966
Number of Individuals Covered48
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,820
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 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 providedMEDICARE
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 $249,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,472
Insurance broker organization code?3
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 2
Insurance contract or identification number00916495
Number of Individuals Covered2689
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $18,074
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $9,037
Insurance broker organization code?3
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number0044337
Policy instance 5
Insurance contract or identification number0044337
Number of Individuals Covered1677
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,835
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,413
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00537978
Policy instance 6
Insurance contract or identification number00537978
Number of Individuals Covered511
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,005
Total amount of fees paid to insurance companyUSD $385
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 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 $15,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,005
Insurance broker organization code?3
Amount paid for insurance broker fees385
Additional information about fees paid to insurance brokerFEES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506855
Policy instance 5
Insurance contract or identification number00506855
Number of Individuals Covered2347
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,787
Total amount of fees paid to insurance companyUSD $5,280
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 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 $99,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,787
Insurance broker organization code?3
Amount paid for insurance broker fees5280
Additional information about fees paid to insurance brokerFEES
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 3
Insurance contract or identification number00916495
Number of Individuals Covered2933
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $239,963
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $128,004
Insurance broker organization code?3
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number00000000
Policy instance 1
Insurance contract or identification number00000000
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number0044337
Policy instance 4
Insurance contract or identification number0044337
Number of Individuals Covered2146
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $130,061
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 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 $740,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $130,061
Insurance broker organization code?3
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 2
Insurance contract or identification number00964966
Number of Individuals Covered58
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 providedMEDICARE
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 $257,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402730G
Policy instance 7
Insurance contract or identification number402730G
Number of Individuals Covered2365
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $30,734
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 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 providedADD
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 $140,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,734
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402730G
Policy instance 7
Insurance contract or identification number402730G
Number of Individuals Covered2265
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $32,978
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 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 providedADD
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 $164,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,978
Insurance broker organization code?3
Insurance broker nameSYNADS INSURANCE AGENCY, INC
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 2
Insurance contract or identification number00964966
Number of Individuals Covered62
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,348
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 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 $295,877
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,348
Insurance broker organization code?3
Insurance broker nameSYNADS INSURANCE AGENCY INC
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 3
Insurance contract or identification number00916495
Number of Individuals Covered3681
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $209,521
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $136,061
Insurance broker organization code?3
Insurance broker nameWEALTH PRESERVATION SOLUTIONS
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number00000000
Policy instance 1
Insurance contract or identification number00000000
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number16495
Policy instance 4
Insurance contract or identification number16495
Number of Individuals Covered2187
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $118,044
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $118,044
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER B SZEM
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506855
Policy instance 5
Insurance contract or identification number00506855
Number of Individuals Covered2670
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,815
Total amount of fees paid to insurance companyUSD $2,007
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 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 $82,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,815
Insurance broker organization code?3
Amount paid for insurance broker fees2007
Additional information about fees paid to insurance brokerFEES
Insurance broker nameBENECEPT CONSULTANTS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00537978
Policy instance 6
Insurance contract or identification number00537978
Number of Individuals Covered401
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,038
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 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 $5,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,038
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER SZEM
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number16495
Policy instance 3
Insurance contract or identification number16495
Number of Individuals Covered2182
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $129,339
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $129,339
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER B SZEM
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number402730G
Policy instance 7
Insurance contract or identification number402730G
Number of Individuals Covered2324
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $34,273
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 providedADD
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 $189,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,273
Insurance broker organization code?3
Insurance broker nameSYNADS INSURANCE AGENCY, INC
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 6
Insurance contract or identification number00916495
Number of Individuals Covered3277
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $187,665
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 providedPOS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $83,092
Insurance broker organization code?3
Insurance broker nameWEALTH PRESERVATION SOLUTIONS
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 5
Insurance contract or identification number00964966
Number of Individuals Covered78
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $13,102
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
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 $287,906
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,102
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER B SZEM
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506855
Policy instance 4
Insurance contract or identification number00506855
Number of Individuals Covered2791
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,679
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 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 $101,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,679
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER SZEM
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract numberNY00157
Policy instance 2
Insurance contract or identification numberNY00157
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $55,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number
Policy instance 1
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $78,924
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AMERICAN MEDICAL AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81418 )
Policy contract number70038-001
Policy instance 1
Insurance contract or identification number70038-001
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 providedA D & 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 $161,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number
Policy instance 5
Number of Individuals Covered123
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,547
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
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 $101,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,160
Insurance broker organization code?3
Insurance broker nameGREGG S. HORWITZ
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 2
Insurance contract or identification number00916495
Number of Individuals Covered3781
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $164,045
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 providedEPO,POS,PPO
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $79,460
Insurance broker organization code?3
Insurance broker nameDANCOLE ASSOCIATES
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number16495
Policy instance 3
Insurance contract or identification number16495
Number of Individuals Covered2260
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $113,683
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER B SZEM
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract numberNY00157
Policy instance 4
Insurance contract or identification numberNY00157
Number of Individuals Covered4995
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 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 $1,117,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 6
Insurance contract or identification number00964966
Number of Individuals Covered86
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $14,199
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
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 $367,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,199
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER B. SZEM
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00964966
Policy instance 6
Insurance contract or identification number00964966
Number of Individuals Covered93
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $15,146
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
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 $368,487
Commission paid to Insurance BrokerUSD $15,146
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER B. SZEM
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number
Policy instance 5
Number of Individuals Covered138
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $13,148
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
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 $129,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,200
Insurance broker organization code?3
Insurance broker nameADAM KELLY
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number16495
Policy instance 3
Insurance contract or identification number16495
Number of Individuals Covered2197
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $85,811
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $85,811
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER B SZEM
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract numberNY00157
Policy instance 4
Insurance contract or identification numberNY00157
Number of Individuals Covered5091
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $1,156,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 2
Insurance contract or identification number00916495
Number of Individuals Covered3744
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $101,230
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 providedEPO,POS,PPO
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,427
Insurance broker organization code?3
Insurance broker nameDANCOLE ASSOCIATES
AMERICAN MEDICAL AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81418 )
Policy contract number70038-001
Policy instance 1
Insurance contract or identification number70038-001
Number of Individuals Covered2675
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 providedA D & 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 $161,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 2
Insurance contract or identification number00916495
Number of Individuals Covered3676
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $50,610
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 providedEPO,POS,PPO
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,637
Insurance broker organization code?3
Insurance broker nameDANCOLE ASSOCIATES
AMERICAN MEDICAL AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81418 )
Policy contract number70038-001
Policy instance 1
Insurance contract or identification number70038-001
Number of Individuals Covered2942
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 providedA D & 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 $277,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number
Policy instance 5
Number of Individuals Covered138
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $9,017
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 BenefitYes
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 $124,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,938
Insurance broker organization code?3
Insurance broker nameEDDY SLOSHOWER
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract numberNY0157
Policy instance 4
Insurance contract or identification numberNY0157
Number of Individuals Covered5733
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $1,159,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number16495
Policy instance 3
Insurance contract or identification number16495
Number of Individuals Covered1808
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $82,921
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $82,921
Insurance broker organization code?3
Insurance broker nameCHRISTOPHER B SZEM
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number16495
Policy instance 4
Insurance contract or identification number16495
Number of Individuals Covered2308
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $70,358
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 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 $315,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number
Policy instance 1
Number of Individuals Covered145
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $8,231
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 BenefitYes
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 $133,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN MEDICAL AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81418 )
Policy contract number70038-001
Policy instance 2
Insurance contract or identification number70038-001
Number of Individuals Covered2911
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 providedA D & 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 $256,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract numberNY0157
Policy instance 3
Insurance contract or identification numberNY0157
Number of Individuals Covered3622
Insurance policy start date2010-12-14
Insurance policy end date2011-12-13
Total amount of commissions paid to insurance brokerUSD $0
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 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 $1,305,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 5
Insurance contract or identification number00916495
Number of Individuals Covered4441
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $80,400
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 providedEPO,POS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number
Policy instance 1
Number of Individuals Covered185
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitYes
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 $134,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN MEDICAL AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81418 )
Policy contract number70038-001
Policy instance 2
Insurance contract or identification number70038-001
Number of Individuals Covered3147
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 providedA D & 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 $236,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract numberNY0157
Policy instance 3
Insurance contract or identification numberNY0157
Number of Individuals Covered3686
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $1,388,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDCO CONTAINMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract number4050
Policy instance 6
Insurance contract or identification number4050
Number of Individuals Covered8033
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 5
Insurance contract or identification number00916495
Number of Individuals Covered4948
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $89,658
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 providedEPO
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number16495
Policy instance 4
Insurance contract or identification number16495
Number of Individuals Covered4064
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $622,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLSTATE LIFE INSURANCE CO. OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70874 )
Policy contract number
Policy instance 1
Number of Individuals Covered185
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitYes
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 $177,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number0157
Policy instance 3
Insurance contract or identification number0157
Number of Individuals Covered3891
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $1,580,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN MEDICAL AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 81418 )
Policy contract number70038-001
Policy instance 2
Insurance contract or identification number70038-001
Number of Individuals Covered254
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 $4,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number3321
Policy instance 4
Insurance contract or identification number3321
Number of Individuals Covered3354
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDCO CONTAINMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract number00000
Policy instance 6
Insurance contract or identification number00000
Number of Individuals Covered5816
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $0
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00916495
Policy instance 5
Insurance contract or identification number00916495
Number of Individuals Covered1387
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $53,130
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 providedEPO
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,710
Insurance broker organization code?3
Insurance broker nameDANCOLE ASSOCIATES, INC.

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