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BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 401k Plan overview

Plan NameBOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP
Plan identification number 001

BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

BOULDER HILL DENTAL, LTD. has sponsored the creation of one or more 401k plans.

Company Name:BOULDER HILL DENTAL, LTD.
Employer identification number (EIN):202746608
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01
0012020-01-01MARK COMMEAN2021-03-26
0012019-01-01MARK COMMEAN2020-04-06
0012018-01-01MARK COMMEAN2019-06-25
0012017-01-01MARK COMMEAN2018-07-24
0012016-01-01MARK R COMMEAN2017-07-18
0012015-01-01MARK R COMMEAN2016-07-12
0012014-01-01MARK R COMMEAN
0012013-01-01M COMMEAN M COMMEAN2014-06-27
0012012-01-01M COMMEAN
0012011-01-01M COMMEAN
0012010-01-01M COMMEAN
0012009-01-01MARK R COMMEAN

Plan Statistics for BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP

401k plan membership statisitcs for BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP

Measure Date Value
2014: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2014 401k membership
Total participants, beginning-of-year2014-01-0112
Total number of active participants reported on line 7a of the Form 55002014-01-019
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0110
Number of participants with account balances2014-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2013 401k membership
Total participants, beginning-of-year2013-01-0112
Total number of active participants reported on line 7a of the Form 55002013-01-0110
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0111
Number of participants with account balances2013-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2012 401k membership
Total participants, beginning-of-year2012-01-0111
Total number of active participants reported on line 7a of the Form 55002012-01-0110
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-011
Total of all active and inactive participants2012-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0111
Number of participants with account balances2012-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2011 401k membership
Total participants, beginning-of-year2011-01-0112
Total number of active participants reported on line 7a of the Form 55002011-01-0111
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0111
Number of participants with account balances2011-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2010 401k membership
Total participants, beginning-of-year2010-01-0116
Total number of active participants reported on line 7a of the Form 55002010-01-0113
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0113
Number of participants with account balances2010-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2009 401k membership
Total participants, beginning-of-year2009-01-0113
Total number of active participants reported on line 7a of the Form 55002009-01-0112
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0113
Number of participants with account balances2009-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP

Measure Date Value
2014 : BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$85,632
Expenses. Total of all expenses incurred2014-12-31$81,872
Benefits paid (including direct rollovers)2014-12-31$72,481
Total plan assets at end of year2014-12-31$661,413
Total plan assets at beginning of year2014-12-31$657,653
Value of fidelity bond covering the plan2014-12-31$100,000
Total contributions received or receivable from participants2014-12-31$54,200
Expenses. Other expenses not covered elsewhere2014-12-31$16
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$31,432
Net income (gross income less expenses)2014-12-31$3,760
Net plan assets at end of year (total assets less liabilities)2014-12-31$661,413
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$657,653
Assets. Value of participant loans2014-12-31$374
Total contributions received or receivable from employer(s)2014-12-31$0
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$9,375
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$157,424
Expenses. Total of all expenses incurred2013-12-31$42,988
Benefits paid (including direct rollovers)2013-12-31$35,000
Total plan assets at end of year2013-12-31$657,653
Total plan assets at beginning of year2013-12-31$543,217
Value of fidelity bond covering the plan2013-12-31$100,000
Total contributions received or receivable from participants2013-12-31$58,098
Expenses. Other expenses not covered elsewhere2013-12-31$16
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$99,326
Net income (gross income less expenses)2013-12-31$114,436
Net plan assets at end of year (total assets less liabilities)2013-12-31$657,653
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$543,217
Assets. Value of participant loans2013-12-31$3,439
Total contributions received or receivable from employer(s)2013-12-31$0
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$7,972
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$126,812
Expenses. Total of all expenses incurred2012-12-31$10,420
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$543,217
Total plan assets at beginning of year2012-12-31$426,825
Value of fidelity bond covering the plan2012-12-31$100,000
Total contributions received or receivable from participants2012-12-31$57,410
Expenses. Other expenses not covered elsewhere2012-12-31$16
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$69,402
Net income (gross income less expenses)2012-12-31$116,392
Net plan assets at end of year (total assets less liabilities)2012-12-31$543,217
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$426,825
Assets. Value of participant loans2012-12-31$6,761
Total contributions received or receivable from employer(s)2012-12-31$0
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$10,404
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$36,750
Expenses. Total of all expenses incurred2011-12-31$9,034
Benefits paid (including direct rollovers)2011-12-31$5,217
Total plan assets at end of year2011-12-31$426,825
Total plan assets at beginning of year2011-12-31$399,109
Value of fidelity bond covering the plan2011-12-31$100,000
Total contributions received or receivable from participants2011-12-31$58,422
Expenses. Other expenses not covered elsewhere2011-12-31$16
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-21,672
Net income (gross income less expenses)2011-12-31$27,716
Net plan assets at end of year (total assets less liabilities)2011-12-31$426,825
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$399,109
Assets. Value of participant loans2011-12-31$9,517
Total contributions received or receivable from employer(s)2011-12-31$0
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$3,801
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$113,848
Expenses. Total of all expenses incurred2010-12-31$296,938
Benefits paid (including direct rollovers)2010-12-31$296,922
Total plan assets at end of year2010-12-31$399,109
Total plan assets at beginning of year2010-12-31$582,199
Value of fidelity bond covering the plan2010-12-31$100,000
Total contributions received or receivable from participants2010-12-31$61,027
Expenses. Other expenses not covered elsewhere2010-12-31$16
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$52,821
Net income (gross income less expenses)2010-12-31$-183,090
Net plan assets at end of year (total assets less liabilities)2010-12-31$399,109
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$582,199
Assets. Value of participant loans2010-12-31$12,192
Total contributions received or receivable from employer(s)2010-12-31$0
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP

2014: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2014 form 5500 responses
2014-01-01Type of plan entitySingle 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
2013: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2013 form 5500 responses
2013-01-01Type of plan entitySingle 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
2012: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2012 form 5500 responses
2012-01-01Type of plan entitySingle 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
2011: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
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
2010: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2010 form 5500 responses
2010-01-01Type of plan entitySingle 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
2009: BOULDER HILL DENTAL, LTD EMPLOYEES 401(K) PSP 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-813052
Policy instance 1
Insurance contract or identification numberGA-813052
Number of Individuals Covered7
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,514
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?Yes
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
Commission paid to Insurance BrokerUSD $2,514
Insurance broker organization code?3
Insurance broker nameWOODBURY FIN SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-813052
Policy instance 1
Insurance contract or identification numberGA-813052
Number of Individuals Covered9
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,128
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?Yes
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
Commission paid to Insurance BrokerUSD $2,128
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-813052
Policy instance 1
Insurance contract or identification numberGA-813052
Number of Individuals Covered10
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,766
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?Yes
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
Commission paid to Insurance BrokerUSD $1,766
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-813052
Policy instance 1
Insurance contract or identification numberGA-813052
Number of Individuals Covered9
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,596
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?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-813052
Policy instance 1
Insurance contract or identification numberGA-813052
Number of Individuals Covered9
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,450
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?Yes
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

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