HALLSTAR SERVICES CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HALLSTAR SERVICES CORPORATION VISION PLAN
| Measure | Date | Value |
|---|
| 2017: HALLSTAR SERVICES CORPORATION VISION PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 120 |
| Number of retired or separated participants receiving benefits | 2017-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
| Total of all active and inactive participants | 2017-10-01 | 120 |
| 2016: HALLSTAR SERVICES CORPORATION VISION PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 116 |
| Number of retired or separated participants receiving benefits | 2016-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
| Total of all active and inactive participants | 2016-10-01 | 116 |
| 2015: HALLSTAR SERVICES CORPORATION VISION PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 124 |
| Number of retired or separated participants receiving benefits | 2015-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-10-01 | 0 |
| Total of all active and inactive participants | 2015-10-01 | 124 |
| 2014: HALLSTAR SERVICES CORPORATION VISION PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 128 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 132 |
| Number of retired or separated participants receiving benefits | 2014-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-10-01 | 0 |
| Total of all active and inactive participants | 2014-10-01 | 132 |
| 2013: HALLSTAR SERVICES CORPORATION VISION PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 128 |
| Number of retired or separated participants receiving benefits | 2013-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-10-01 | 0 |
| Total of all active and inactive participants | 2013-10-01 | 128 |
| 2012: HALLSTAR SERVICES CORPORATION VISION PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 128 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 124 |
| Number of retired or separated participants receiving benefits | 2012-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-10-01 | 0 |
| Total of all active and inactive participants | 2012-10-01 | 124 |
| 2011: HALLSTAR SERVICES CORPORATION VISION PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 128 |
| Number of retired or separated participants receiving benefits | 2011-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-10-01 | 0 |
| Total of all active and inactive participants | 2011-10-01 | 128 |
| 2009: HALLSTAR SERVICES CORPORATION VISION PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 113 |
| Number of retired or separated participants receiving benefits | 2009-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-10-01 | 0 |
| Total of all active and inactive participants | 2009-10-01 | 113 |
| Measure | Date | Value |
|---|
| 2017 : HALLSTAR SERVICES CORPORATION VISION PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-09-30 | $15,644 |
| Expenses. Total of all expenses incurred | 2017-09-30 | $15,644 |
| Benefits paid (including direct rollovers) | 2017-09-30 | $14,695 |
| Value of fidelity bond covering the plan | 2017-09-30 | $5,000,000 |
| Total contributions received or receivable from participants | 2017-09-30 | $11,339 |
| Net income (gross income less expenses) | 2017-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2017-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2017-09-30 | $4,305 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-09-30 | $949 |
| 2016 : HALLSTAR SERVICES CORPORATION VISION PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-09-30 | $15,791 |
| Expenses. Total of all expenses incurred | 2016-09-30 | $15,791 |
| Value of fidelity bond covering the plan | 2016-09-30 | $3,000,000 |
| Total contributions received or receivable from participants | 2016-09-30 | $10,225 |
| Net income (gross income less expenses) | 2016-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2016-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2016-09-30 | $5,566 |
| Value of corrective distributions | 2016-09-30 | $14,835 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-09-30 | $956 |
| 2015 : HALLSTAR SERVICES CORPORATION VISION PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-09-30 | $14,243 |
| Expenses. Total of all expenses incurred | 2015-09-30 | $14,243 |
| Benefits paid (including direct rollovers) | 2015-09-30 | $13,342 |
| Value of fidelity bond covering the plan | 2015-09-30 | $3,000,000 |
| Total contributions received or receivable from participants | 2015-09-30 | $10,088 |
| Expenses. Other expenses not covered elsewhere | 2015-09-30 | $901 |
| Net income (gross income less expenses) | 2015-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2015-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2015-09-30 | $4,155 |
| 2014 : HALLSTAR SERVICES CORPORATION VISION PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-09-30 | $14,002 |
| Expenses. Total of all expenses incurred | 2014-09-30 | $14,002 |
| Benefits paid (including direct rollovers) | 2014-09-30 | $13,110 |
| Total contributions received or receivable from participants | 2014-09-30 | $9,572 |
| Expenses. Other expenses not covered elsewhere | 2014-09-30 | $892 |
| Net income (gross income less expenses) | 2014-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2014-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2014-09-30 | $4,430 |
| 2013 : HALLSTAR SERVICES CORPORATION VISION PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-09-30 | $14,509 |
| Expenses. Total of all expenses incurred | 2013-09-30 | $14,509 |
| Benefits paid (including direct rollovers) | 2013-09-30 | $13,598 |
| Total contributions received or receivable from participants | 2013-09-30 | $9,532 |
| Expenses. Other expenses not covered elsewhere | 2013-09-30 | $911 |
| Net income (gross income less expenses) | 2013-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2013-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2013-09-30 | $4,977 |
| 2012 : HALLSTAR SERVICES CORPORATION VISION PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-09-30 | $14,386 |
| Expenses. Total of all expenses incurred | 2012-09-30 | $14,386 |
| Benefits paid (including direct rollovers) | 2012-09-30 | $13,480 |
| Total contributions received or receivable from participants | 2012-09-30 | $9,798 |
| Expenses. Other expenses not covered elsewhere | 2012-09-30 | $906 |
| Net income (gross income less expenses) | 2012-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2012-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2012-09-30 | $4,588 |
| 2011 : HALLSTAR SERVICES CORPORATION VISION PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-09-30 | $13,705 |
| Expenses. Total of all expenses incurred | 2011-09-30 | $13,705 |
| Benefits paid (including direct rollovers) | 2011-09-30 | $12,823 |
| Total contributions received or receivable from participants | 2011-09-30 | $9,463 |
| Expenses. Other expenses not covered elsewhere | 2011-09-30 | $882 |
| Net income (gross income less expenses) | 2011-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2011-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2011-09-30 | $4,242 |
| 2017: HALLSTAR SERVICES CORPORATION VISION PLAN 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Submission has been amended | No |
| 2017-10-01 | This submission is the final filing | No |
| 2017-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-10-01 | Plan is a collectively bargained plan | No |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: HALLSTAR SERVICES CORPORATION VISION PLAN 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Submission has been amended | No |
| 2016-10-01 | This submission is the final filing | No |
| 2016-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-10-01 | Plan is a collectively bargained plan | No |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: HALLSTAR SERVICES CORPORATION VISION PLAN 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Submission has been amended | No |
| 2015-10-01 | This submission is the final filing | No |
| 2015-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-10-01 | Plan is a collectively bargained plan | No |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: HALLSTAR SERVICES CORPORATION VISION PLAN 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | Submission has been amended | No |
| 2014-10-01 | This submission is the final filing | No |
| 2014-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-10-01 | Plan is a collectively bargained plan | No |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: HALLSTAR SERVICES CORPORATION VISION PLAN 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | Submission has been amended | No |
| 2013-10-01 | This submission is the final filing | No |
| 2013-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-10-01 | Plan is a collectively bargained plan | No |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: HALLSTAR SERVICES CORPORATION VISION PLAN 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Submission has been amended | No |
| 2012-10-01 | This submission is the final filing | No |
| 2012-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-10-01 | Plan is a collectively bargained plan | No |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: HALLSTAR SERVICES CORPORATION VISION PLAN 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Submission has been amended | No |
| 2011-10-01 | This submission is the final filing | No |
| 2011-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-10-01 | Plan is a collectively bargained plan | No |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: HALLSTAR SERVICES CORPORATION VISION PLAN 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | First time form 5500 has been submitted | Yes |
| 2009-10-01 | Submission has been amended | No |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-10-01 | Plan is a collectively bargained plan | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30005803 |
| Policy instance | 1 |
| Insurance contract or identification number | 30005803 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $989 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $16,673 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30005803 |
| Policy instance | 1 |
| Insurance contract or identification number | 30005803 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2015-10-01 | | Insurance policy end date | 2016-09-30 | | Total amount of commissions paid to insurance broker | USD $956 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $15,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $956 | | Insurance broker organization code? | 4 | | Insurance broker name | EBCG LLC |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30005803 |
| Policy instance | 1 |
| Insurance contract or identification number | 30005803 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $901 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $14,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $901 | | Insurance broker organization code? | 4 | | Insurance broker name | EMPLOYEE BENEFIT CONSULTANTS |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30005803 |
| Policy instance | 1 |
| Insurance contract or identification number | 30005803 | | Number of Individuals Covered | 128 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $892 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $14,002 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $892 | | Insurance broker organization code? | 4 | | Insurance broker name | EMPLOYEE BENEFIT CONSULTANTS |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30005803 |
| Policy instance | 1 |
| Insurance contract or identification number | 30005803 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $911 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $14,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $911 | | Insurance broker organization code? | 4 | | Insurance broker name | EMPLOYEE BENEFIT CONSULTANTS |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30005803 |
| Policy instance | 1 |
| Insurance contract or identification number | 30005803 | | Number of Individuals Covered | 128 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $906 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $14,386 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30005803 |
| Policy instance | 1 |
| Insurance contract or identification number | 30005803 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $882 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $13,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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