OBI RETIREE VOLUNTARY EMPLOYEE BENEFITS ASSOCIATION has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2023 : OBI RETIREE BENEFIT PLAN 2023 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2023-12-31 | $31,672 |
| Total unrealized appreciation/depreciation of assets | 2023-12-31 | $31,672 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $0 |
| Total income from all sources (including contributions) | 2023-12-31 | $245,655 |
| Total loss/gain on sale of assets | 2023-12-31 | $20,160 |
| Total of all expenses incurred | 2023-12-31 | $202,503 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-12-31 | $92,092 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-12-31 | $0 |
| Value of total assets at end of year | 2023-12-31 | $2,859,569 |
| Value of total assets at beginning of year | 2023-12-31 | $2,816,417 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-12-31 | $110,411 |
| Total interest from all sources | 2023-12-31 | $78,697 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-12-31 | No |
| Was this plan covered by a fidelity bond | 2023-12-31 | Yes |
| Value of fidelity bond cover | 2023-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2023-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2023-12-31 | $51,299 |
| Assets. Other investments not covered elsewhere at beginning of year | 2023-12-31 | $51,230 |
| Other income not declared elsewhere | 2023-12-31 | $115,126 |
| Total non interest bearing cash at end of year | 2023-12-31 | $400 |
| Total non interest bearing cash at beginning of year | 2023-12-31 | $1,772 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-12-31 | No |
| Value of net income/loss | 2023-12-31 | $43,152 |
| Value of net assets at end of year (total assets less liabilities) | 2023-12-31 | $2,859,569 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-12-31 | $2,816,417 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-12-31 | No |
| Investment advisory and management fees | 2023-12-31 | $8,549 |
| Income. Interest from US Government securities | 2023-12-31 | $41,529 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-12-31 | $2,076,943 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-12-31 | $1,979,840 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-12-31 | $1,979,840 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-12-31 | $37,168 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-12-31 | $44,285 |
| Asset value of US Government securities at end of year | 2023-12-31 | $730,927 |
| Asset value of US Government securities at beginning of year | 2023-12-31 | $783,575 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-12-31 | $47,807 |
| Contract administrator fees | 2023-12-31 | $7,862 |
| Did the plan have assets held for investment | 2023-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-12-31 | No |
| Aggregate proceeds on sale of assets | 2023-12-31 | $20,160 |
| Opinion of an independent qualified public accountant for this plan | 2023-12-31 | Unqualified |
| Accountancy firm name | 2023-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2023-12-31 | 410746749 |
| 2022 : OBI RETIREE BENEFIT PLAN 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-9,384 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-9,384 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $0 |
| Total income from all sources (including contributions) | 2022-12-31 | $139,020 |
| Total loss/gain on sale of assets | 2022-12-31 | $-431 |
| Total of all expenses incurred | 2022-12-31 | $223,707 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $111,022 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $0 |
| Value of total assets at end of year | 2022-12-31 | $2,816,417 |
| Value of total assets at beginning of year | 2022-12-31 | $2,901,104 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $112,685 |
| Total interest from all sources | 2022-12-31 | $18,670 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Administrative expenses professional fees incurred | 2022-12-31 | $0 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2022-12-31 | $51,230 |
| Assets. Other investments not covered elsewhere at beginning of year | 2022-12-31 | $51,279 |
| Other income not declared elsewhere | 2022-12-31 | $130,165 |
| Administrative expenses (other) incurred | 2022-12-31 | $94,000 |
| Total non interest bearing cash at end of year | 2022-12-31 | $1,772 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $-84,687 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $2,816,417 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $2,901,104 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $8,655 |
| Income. Interest from US Government securities | 2022-12-31 | $8,363 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $1,979,840 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $1,850,525 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $1,850,525 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $10,307 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $43,782 |
| Asset value of US Government securities at end of year | 2022-12-31 | $783,575 |
| Asset value of US Government securities at beginning of year | 2022-12-31 | $999,300 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $67,240 |
| Contract administrator fees | 2022-12-31 | $10,030 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Aggregate proceeds on sale of assets | 2022-12-31 | $-431 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2022-12-31 | 410746749 |
| 2021 : OBI RETIREE BENEFIT PLAN 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $1,722 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $1,722 |
| Total income from all sources (including contributions) | 2021-12-31 | $165,540 |
| Total loss/gain on sale of assets | 2021-12-31 | $-8,713 |
| Total of all expenses incurred | 2021-12-31 | $275,315 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $137,446 |
| Value of total assets at end of year | 2021-12-31 | $2,901,104 |
| Value of total assets at beginning of year | 2021-12-31 | $3,010,879 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $137,869 |
| Total interest from all sources | 2021-12-31 | $11,777 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Administrative expenses professional fees incurred | 2021-12-31 | $23,000 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2021-12-31 | $51,279 |
| Assets. Other investments not covered elsewhere at beginning of year | 2021-12-31 | $51,279 |
| Other income not declared elsewhere | 2021-12-31 | $160,754 |
| Administrative expenses (other) incurred | 2021-12-31 | $94,000 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $-109,775 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $2,901,104 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $3,010,879 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Investment advisory and management fees | 2021-12-31 | $10,066 |
| Income. Interest from US Government securities | 2021-12-31 | $11,237 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $1,850,525 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $1,953,740 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $1,953,740 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $540 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $65,945 |
| Asset value of US Government securities at end of year | 2021-12-31 | $999,300 |
| Asset value of US Government securities at beginning of year | 2021-12-31 | $1,005,860 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $71,501 |
| Contract administrator fees | 2021-12-31 | $10,803 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-12-31 | No |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Aggregate proceeds on sale of assets | 2021-12-31 | $-8,713 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2021-12-31 | 043236498 |
| 2020 : OBI RETIREE BENEFIT PLAN 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $-2,853 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $-2,853 |
| Total income from all sources (including contributions) | 2020-12-31 | $211,594 |
| Total loss/gain on sale of assets | 2020-12-31 | $-5,772 |
| Total of all expenses incurred | 2020-12-31 | $322,654 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $163,458 |
| Value of total assets at end of year | 2020-12-31 | $3,010,879 |
| Value of total assets at beginning of year | 2020-12-31 | $3,121,939 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $159,196 |
| Total interest from all sources | 2020-12-31 | $43,475 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Administrative expenses professional fees incurred | 2020-12-31 | $33,000 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2020-12-31 | $51,279 |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-12-31 | $56,297 |
| Other income not declared elsewhere | 2020-12-31 | $176,744 |
| Administrative expenses (other) incurred | 2020-12-31 | $104,647 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $-111,060 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $3,010,879 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $3,121,939 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Investment advisory and management fees | 2020-12-31 | $10,773 |
| Income. Interest from US Government securities | 2020-12-31 | $38,086 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $1,953,740 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $959,870 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $959,870 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $5,389 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $99,963 |
| Asset value of US Government securities at end of year | 2020-12-31 | $1,005,860 |
| Asset value of US Government securities at beginning of year | 2020-12-31 | $2,105,772 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $63,495 |
| Contract administrator fees | 2020-12-31 | $10,776 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-12-31 | No |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Aggregate proceeds on sale of assets | 2020-12-31 | $-5,772 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Disclaimer |
| Accountancy firm name | 2020-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2020-12-31 | 043236498 |
| 2019 : OBI RETIREE BENEFIT PLAN 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $18,382 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $18,382 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $18,382 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $18,382 |
| Total income from all sources (including contributions) | 2019-12-31 | $302,010 |
| Total income from all sources (including contributions) | 2019-12-31 | $302,010 |
| Total loss/gain on sale of assets | 2019-12-31 | $964 |
| Total loss/gain on sale of assets | 2019-12-31 | $964 |
| Total of all expenses incurred | 2019-12-31 | $323,964 |
| Total of all expenses incurred | 2019-12-31 | $323,964 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $167,342 |
| Value of total assets at end of year | 2019-12-31 | $3,121,939 |
| Value of total assets at end of year | 2019-12-31 | $3,121,939 |
| Value of total assets at beginning of year | 2019-12-31 | $3,143,893 |
| Value of total assets at beginning of year | 2019-12-31 | $3,143,893 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $156,622 |
| Total interest from all sources | 2019-12-31 | $66,218 |
| Total interest from all sources | 2019-12-31 | $66,218 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Administrative expenses professional fees incurred | 2019-12-31 | $22,000 |
| Administrative expenses professional fees incurred | 2019-12-31 | $22,000 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $56,297 |
| Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $56,297 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $60,765 |
| Other income not declared elsewhere | 2019-12-31 | $216,446 |
| Other income not declared elsewhere | 2019-12-31 | $216,446 |
| Administrative expenses (other) incurred | 2019-12-31 | $107,794 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $-21,954 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $3,121,939 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $3,121,939 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $3,143,893 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $3,143,893 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Investment advisory and management fees | 2019-12-31 | $11,783 |
| Investment advisory and management fees | 2019-12-31 | $11,783 |
| Income. Interest from US Government securities | 2019-12-31 | $46,093 |
| Income. Interest from US Government securities | 2019-12-31 | $46,093 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $959,870 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $959,870 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $995,909 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $995,909 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $995,909 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $995,909 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $20,125 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $99,245 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $99,245 |
| Asset value of US Government securities at end of year | 2019-12-31 | $2,105,772 |
| Asset value of US Government securities at end of year | 2019-12-31 | $2,105,772 |
| Asset value of US Government securities at beginning of year | 2019-12-31 | $2,087,219 |
| Asset value of US Government securities at beginning of year | 2019-12-31 | $2,087,219 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $68,097 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $68,097 |
| Contract administrator fees | 2019-12-31 | $15,045 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-12-31 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-12-31 | No |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Aggregate proceeds on sale of assets | 2019-12-31 | $964 |
| Aggregate proceeds on sale of assets | 2019-12-31 | $964 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Accountancy firm name | 2019-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm name | 2019-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2019-12-31 | 043236498 |
| Accountancy firm EIN | 2019-12-31 | 043236498 |
| 2018 : OBI RETIREE BENEFIT PLAN 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $10,425 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $10,425 |
| Total income from all sources (including contributions) | 2018-12-31 | $327,255 |
| Total loss/gain on sale of assets | 2018-12-31 | $1,935 |
| Total of all expenses incurred | 2018-12-31 | $374,800 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $216,311 |
| Value of total assets at end of year | 2018-12-31 | $3,143,893 |
| Value of total assets at beginning of year | 2018-12-31 | $3,191,438 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $158,489 |
| Total interest from all sources | 2018-12-31 | $34,688 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Administrative expenses professional fees incurred | 2018-12-31 | $22,000 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2018-12-31 | $60,765 |
| Assets. Other investments not covered elsewhere at beginning of year | 2018-12-31 | $66,630 |
| Other income not declared elsewhere | 2018-12-31 | $280,207 |
| Administrative expenses (other) incurred | 2018-12-31 | $107,831 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $-47,545 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $3,143,893 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $3,191,438 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Investment advisory and management fees | 2018-12-31 | $12,623 |
| Income. Interest from US Government securities | 2018-12-31 | $17,526 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $995,909 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $957,871 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $957,871 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $17,162 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $133,961 |
| Asset value of US Government securities at end of year | 2018-12-31 | $2,087,219 |
| Asset value of US Government securities at beginning of year | 2018-12-31 | $2,166,937 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $82,350 |
| Contract administrator fees | 2018-12-31 | $16,035 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-12-31 | No |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Aggregate proceeds on sale of assets | 2018-12-31 | $1,935 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Disclaimer |
| Accountancy firm name | 2018-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2018-12-31 | 043236498 |
| 2017 : OBI RETIREE BENEFIT PLAN 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $-1,660 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $-1,660 |
| Total income from all sources (including contributions) | 2017-12-31 | $263,508 |
| Total loss/gain on sale of assets | 2017-12-31 | $-564 |
| Total of all expenses incurred | 2017-12-31 | $423,218 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $263,426 |
| Value of total assets at end of year | 2017-12-31 | $3,191,438 |
| Value of total assets at beginning of year | 2017-12-31 | $3,351,148 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $159,792 |
| Total interest from all sources | 2017-12-31 | $25,068 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Administrative expenses professional fees incurred | 2017-12-31 | $22,000 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2017-12-31 | $66,630 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-12-31 | $73,822 |
| Other income not declared elsewhere | 2017-12-31 | $240,664 |
| Administrative expenses (other) incurred | 2017-12-31 | $107,852 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $-159,710 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $3,191,438 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $3,351,148 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Investment advisory and management fees | 2017-12-31 | $12,910 |
| Income. Interest from US Government securities | 2017-12-31 | $17,871 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $957,871 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $1,105,354 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $1,105,354 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $7,197 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $142,373 |
| Asset value of US Government securities at end of year | 2017-12-31 | $2,166,937 |
| Asset value of US Government securities at beginning of year | 2017-12-31 | $2,171,972 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $121,053 |
| Contract administrator fees | 2017-12-31 | $17,030 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-12-31 | No |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Aggregate proceeds on sale of assets | 2017-12-31 | $-564 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Disclaimer |
| Accountancy firm name | 2017-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2017-12-31 | 043236498 |
| 2016 : OBI RETIREE BENEFIT PLAN 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $-3,500 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $-3,500 |
| Total income from all sources (including contributions) | 2016-12-31 | $384,488 |
| Total loss/gain on sale of assets | 2016-12-31 | $2,721 |
| Total of all expenses incurred | 2016-12-31 | $473,199 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $303,591 |
| Value of total assets at end of year | 2016-12-31 | $3,351,148 |
| Value of total assets at beginning of year | 2016-12-31 | $3,439,859 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $169,608 |
| Total interest from all sources | 2016-12-31 | $23,896 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Administrative expenses professional fees incurred | 2016-12-31 | $28,500 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2016-12-31 | $73,822 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-12-31 | $81,046 |
| Other income not declared elsewhere | 2016-12-31 | $361,371 |
| Administrative expenses (other) incurred | 2016-12-31 | $109,370 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $-88,711 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $3,351,148 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $3,439,859 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $12,738 |
| Income. Interest from US Government securities | 2016-12-31 | $21,113 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $1,105,354 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $1,286,536 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $1,286,536 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $2,783 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $160,667 |
| Asset value of US Government securities at end of year | 2016-12-31 | $2,171,972 |
| Asset value of US Government securities at beginning of year | 2016-12-31 | $2,072,277 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $142,924 |
| Contract administrator fees | 2016-12-31 | $19,000 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-12-31 | No |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Aggregate proceeds on sale of assets | 2016-12-31 | $2,721 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
| Accountancy firm name | 2016-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2016-12-31 | 043236498 |
| 2015 : OBI RETIREE BENEFIT PLAN 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $11,944 |
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $11,944 |
| Total income from all sources (including contributions) | 2015-12-31 | $428,785 |
| Total loss/gain on sale of assets | 2015-12-31 | $2,516 |
| Total of all expenses incurred | 2015-12-31 | $565,764 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $378,684 |
| Value of total assets at end of year | 2015-12-31 | $3,439,859 |
| Value of total assets at beginning of year | 2015-12-31 | $3,576,838 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $187,080 |
| Total interest from all sources | 2015-12-31 | $23,918 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Administrative expenses professional fees incurred | 2015-12-31 | $29,500 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2015-12-31 | $81,046 |
| Assets. Other investments not covered elsewhere at beginning of year | 2015-12-31 | $90,169 |
| Other income not declared elsewhere | 2015-12-31 | $390,407 |
| Administrative expenses (other) incurred | 2015-12-31 | $122,889 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $-136,979 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $3,439,859 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $3,576,838 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Investment advisory and management fees | 2015-12-31 | $12,735 |
| Income. Interest from US Government securities | 2015-12-31 | $22,746 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $1,286,536 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $656,084 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $656,084 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $1,172 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $207,513 |
| Asset value of US Government securities at end of year | 2015-12-31 | $2,072,277 |
| Asset value of US Government securities at beginning of year | 2015-12-31 | $2,830,585 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $171,171 |
| Contract administrator fees | 2015-12-31 | $21,956 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-12-31 | No |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Aggregate proceeds on sale of assets | 2015-12-31 | $2,516 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Disclaimer |
| Accountancy firm name | 2015-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2015-12-31 | 043236498 |
| 2014 : OBI RETIREE BENEFIT PLAN 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $21,886 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $21,886 |
| Total income from all sources (including contributions) | 2014-12-31 | $491,155 |
| Total of all expenses incurred | 2014-12-31 | $636,544 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $435,516 |
| Value of total assets at end of year | 2014-12-31 | $3,576,838 |
| Value of total assets at beginning of year | 2014-12-31 | $3,722,227 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $201,028 |
| Total interest from all sources | 2014-12-31 | $30,416 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Administrative expenses professional fees incurred | 2014-12-31 | $27,500 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2014-12-31 | $90,169 |
| Assets. Other investments not covered elsewhere at beginning of year | 2014-12-31 | $98,043 |
| Other income not declared elsewhere | 2014-12-31 | $438,853 |
| Administrative expenses (other) incurred | 2014-12-31 | $138,920 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $-145,389 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $3,576,838 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $3,722,227 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Investment advisory and management fees | 2014-12-31 | $12,663 |
| Income. Interest from US Government securities | 2014-12-31 | $30,052 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $656,084 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $565,503 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $565,503 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $364 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $235,845 |
| Asset value of US Government securities at end of year | 2014-12-31 | $2,830,585 |
| Asset value of US Government securities at beginning of year | 2014-12-31 | $3,058,681 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $199,671 |
| Contract administrator fees | 2014-12-31 | $21,945 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-12-31 | No |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Disclaimer |
| Accountancy firm name | 2014-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2014-12-31 | 043236498 |
| 2013 : OBI RETIREE BENEFIT PLAN 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $-59,295 |
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $-59,295 |
| Total income from all sources (including contributions) | 2013-12-31 | $437,225 |
| Total of all expenses incurred | 2013-12-31 | $698,184 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $495,429 |
| Value of total assets at end of year | 2013-12-31 | $3,722,227 |
| Value of total assets at beginning of year | 2013-12-31 | $3,983,186 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $202,755 |
| Total interest from all sources | 2013-12-31 | $35,414 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Administrative expenses professional fees incurred | 2013-12-31 | $27,500 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2013-12-31 | $98,043 |
| Assets. Other investments not covered elsewhere at beginning of year | 2013-12-31 | $128,898 |
| Other income not declared elsewhere | 2013-12-31 | $461,106 |
| Administrative expenses (other) incurred | 2013-12-31 | $138,777 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $-260,959 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $3,722,227 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $3,983,186 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Investment advisory and management fees | 2013-12-31 | $12,856 |
| Income. Interest from US Government securities | 2013-12-31 | $34,520 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $565,503 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $736,312 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $736,312 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $894 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $278,506 |
| Asset value of US Government securities at end of year | 2013-12-31 | $3,058,681 |
| Asset value of US Government securities at beginning of year | 2013-12-31 | $3,117,976 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $216,923 |
| Contract administrator fees | 2013-12-31 | $23,622 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-12-31 | No |
| Did the plan have assets held for investment | 2013-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
| Accountancy firm name | 2013-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2013-12-31 | 043236498 |
| 2012 : OBI RETIREE BENEFIT PLAN 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $1,363 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $1,363 |
| Total income from all sources (including contributions) | 2012-12-31 | $521,114 |
| Total loss/gain on sale of assets | 2012-12-31 | $-1,840 |
| Total of all expenses incurred | 2012-12-31 | $812,546 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $611,844 |
| Value of total assets at end of year | 2012-12-31 | $3,983,186 |
| Value of total assets at beginning of year | 2012-12-31 | $4,274,618 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $200,702 |
| Total interest from all sources | 2012-12-31 | $33,660 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $2 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $2 |
| Administrative expenses professional fees incurred | 2012-12-31 | $26,500 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2012-12-31 | $128,898 |
| Assets. Other investments not covered elsewhere at beginning of year | 2012-12-31 | $133,680 |
| Other income not declared elsewhere | 2012-12-31 | $487,929 |
| Administrative expenses (other) incurred | 2012-12-31 | $137,000 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-291,432 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $3,983,186 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $4,274,618 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Investment advisory and management fees | 2012-12-31 | $13,112 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $80,729 |
| Income. Interest from US Government securities | 2012-12-31 | $31,924 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $736,312 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $287,877 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $287,877 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $1,736 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $277,417 |
| Asset value of US Government securities at end of year | 2012-12-31 | $3,117,976 |
| Asset value of US Government securities at beginning of year | 2012-12-31 | $3,772,332 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $334,427 |
| Contract administrator fees | 2012-12-31 | $24,090 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-12-31 | No |
| Did the plan have assets held for investment | 2012-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Aggregate proceeds on sale of assets | 2012-12-31 | $-1,840 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
| Accountancy firm name | 2012-12-31 | WALTER & SHUFFAIN, P.C. |
| Accountancy firm EIN | 2012-12-31 | 043236498 |
| 2011 : OBI RETIREE BENEFIT PLAN 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $11,670 |
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $11,670 |
| Total income from all sources (including contributions) | 2011-12-31 | $572,980 |
| Total loss/gain on sale of assets | 2011-12-31 | $11,875 |
| Total of all expenses incurred | 2011-12-31 | $1,074,967 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $862,372 |
| Value of total assets at end of year | 2011-12-31 | $4,274,618 |
| Value of total assets at beginning of year | 2011-12-31 | $4,776,605 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $212,595 |
| Total interest from all sources | 2011-12-31 | $22,317 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $885 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-12-31 | $885 |
| Administrative expenses professional fees incurred | 2011-12-31 | $26,500 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2011-12-31 | $133,680 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-12-31 | $155,882 |
| Other income not declared elsewhere | 2011-12-31 | $526,233 |
| Administrative expenses (other) incurred | 2011-12-31 | $135,000 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $-501,987 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $4,274,618 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $4,776,605 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Investment advisory and management fees | 2011-12-31 | $17,200 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $80,729 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $2,011,481 |
| Income. Interest from US Government securities | 2011-12-31 | $19,708 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $287,877 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $2,609,242 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $2,609,242 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $2,609 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $372,501 |
| Asset value of US Government securities at end of year | 2011-12-31 | $3,772,332 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $489,871 |
| Contract administrator fees | 2011-12-31 | $33,895 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-12-31 | No |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Aggregate proceeds on sale of assets | 2011-12-31 | $11,875 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
| Accountancy firm name | 2011-12-31 | WALTER & SHUFFAIN, PC |
| Accountancy firm EIN | 2011-12-31 | 043236498 |
| 2010 : OBI RETIREE BENEFIT PLAN 2010 401k financial data |
|---|
| Total income from all sources (including contributions) | 2010-12-31 | $550,673 |
| Total of all expenses incurred | 2010-12-31 | $1,436,619 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $1,204,647 |
| Value of total assets at end of year | 2010-12-31 | $4,776,605 |
| Value of total assets at beginning of year | 2010-12-31 | $5,662,551 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $231,972 |
| Total interest from all sources | 2010-12-31 | $9,356 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $2,623 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2010-12-31 | $2,623 |
| Administrative expenses professional fees incurred | 2010-12-31 | $25,800 |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2010-12-31 | $155,882 |
| Assets. Other investments not covered elsewhere at beginning of year | 2010-12-31 | $208,913 |
| Other income not declared elsewhere | 2010-12-31 | $538,694 |
| Administrative expenses (other) incurred | 2010-12-31 | $149,767 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $-885,946 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $4,776,605 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $5,662,551 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Investment advisory and management fees | 2010-12-31 | $19,789 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $2,011,481 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $2,008,858 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $2,609,242 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $3,444,780 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $3,444,780 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $9,356 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $381,789 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $822,858 |
| Contract administrator fees | 2010-12-31 | $36,616 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2010-12-31 | No |
| Did the plan have assets held for investment | 2010-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
| Accountancy firm name | 2010-12-31 | WALTER & SHUFFAIN, PC |
| Accountancy firm EIN | 2010-12-31 | 043236498 |
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0000A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0000A | | Number of Individuals Covered | 261 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $103,443 | | 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 | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | 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 $557,267 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4253 |
| Policy instance | 2 |
| Insurance contract or identification number | 4253 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $12,486 | | 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 | No | | 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 $142,555 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,817 | | Total amount of fees paid to insurance company | USD $34 | | 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 | Yes | | Vision Insurance Welfare Benefit | No | | 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 $56,425 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,117 | | 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 | Yes | | Vision Insurance Welfare Benefit | No | | 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 $61,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,117 | | Insurance broker organization code? | 3 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4253 |
| Policy instance | 2 |
| Insurance contract or identification number | 4253 | | Number of Individuals Covered | 273 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $14,366 | | 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 | No | | 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 $164,265 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,987 | | Insurance broker organization code? | 5 |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0000A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0000A | | Number of Individuals Covered | 304 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $120,841 | | 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 | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | 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 $649,015 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,377 | | Insurance broker organization code? | 5 |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 353 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $132,677 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $765,926 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $64,500 | | Insurance broker organization code? | 5 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4253 |
| Policy instance | 2 |
| Insurance contract or identification number | 4253 | | Number of Individuals Covered | 319 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $16,881 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $191,330 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,561 | | Insurance broker organization code? | 5 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,296 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $65,634 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,296 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $3,648 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $71,716 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,648 | | Insurance broker organization code? | 3 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4252, 4253 |
| Policy instance | 2 |
| Insurance contract or identification number | 4252, 4253 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $25,224 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $285,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,765 | | Insurance broker organization code? | 5 |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 403 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $158,145 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $849,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,738 | | Insurance broker organization code? | 5 |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 459 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $180,480 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $883,464 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $86,459 | | Insurance broker organization code? | 5 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4252, 4253 |
| Policy instance | 2 |
| Insurance contract or identification number | 4252, 4253 | | Number of Individuals Covered | 425 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $28,588 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $324,354 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,839 | | Insurance broker organization code? | 5 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,304 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,304 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $4,699 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $92,701 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,699 | | Insurance broker organization code? | 3 |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 523 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $188,054 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $919,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $86,384 | | Insurance broker organization code? | 5 |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4252, 4253 |
| Policy instance | 2 |
| Insurance contract or identification number | 4252, 4253 | | Number of Individuals Covered | 484 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $32,205 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $366,760 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,123 | | Insurance broker organization code? | 5 |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 583 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $205,772 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,004,285 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $94,694 | | Insurance broker organization code? | 5 | | Insurance broker name | WEB TPA |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | 4252, 4253 |
| Policy instance | 2 |
| Insurance contract or identification number | 4252, 4253 | | Number of Individuals Covered | 548 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $33,375 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $386,062 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,874 | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $4,987 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,772 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,987 | | Insurance broker organization code? | 3 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $4,061 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,754 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,061 | | Insurance broker organization code? | 3 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 ) |
| Policy contract number | D2734, D2735 |
| Policy instance | 2 |
| Insurance contract or identification number | D2734, D2735 | | Number of Individuals Covered | 662 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $41,644 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $374,823 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,485 | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 699 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $250,690 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,142,033 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $120,665 | | Insurance broker organization code? | 5 | | Insurance broker name | WEB TPA |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 771 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $280,471 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,277,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $134,998 | | Insurance broker organization code? | 5 | | Insurance broker name | WEB TPA |
|
| STONEBRIDGE LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 65021 ) |
| Policy contract number | S9579007 |
| Policy instance | 2 |
| Insurance contract or identification number | S9579007 | | Number of Individuals Covered | 728 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $57,344 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $516,127 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $42,860 | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $5,412 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,412 | | Insurance broker organization code? | 3 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 1 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $4,523 | | Total amount of fees paid to insurance company | USD $13 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $86,286 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,523 | | Amount paid for insurance broker fees | 13 | | Insurance broker organization code? | 3 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 3 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 849 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $322,865 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,470,827 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $159,302 | | Insurance broker organization code? | 5 | | Insurance broker name | WEB TPA |
|
| STONEBRIDGE LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 65021 ) |
| Policy contract number | S9579007 |
| Policy instance | 2 |
| Insurance contract or identification number | S9579007 | | Number of Individuals Covered | 801 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $59,681 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $537,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,389 | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| MONUMENTAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | MZ0926153H0001A |
| Policy instance | 5 |
| Insurance contract or identification number | MZ0926153H0001A | | Number of Individuals Covered | 942 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $348,686 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,589,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $169,744 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 5 | | Insurance broker name | WEB TPA |
|
| STONEBRIDGE LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 65021 ) |
| Policy contract number | S9579007 |
| Policy instance | 4 |
| Insurance contract or identification number | S9579007 | | Number of Individuals Covered | 886 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $63,903 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $575,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,121 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 ) |
| Policy contract number | 2734 |
| Policy instance | 3 |
| Insurance contract or identification number | 2734 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $-477 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $-2,703 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $-159 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker name | NEBCO |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 2 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,422 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $89,013 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,422 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| STERLING LIFE (National Association of Insurance Commissioners NAIC id number: 77399 ) |
| Policy contract number | S 4802 |
| Policy instance | 1 |
| Insurance contract or identification number | S 4802 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $11 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $-216 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| STERLING LIFE (National Association of Insurance Commissioners NAIC id number: 77399 ) |
| Policy contract number | S 4802 |
| Policy instance | 1 |
| Insurance contract or identification number | S 4802 | | Number of Individuals Covered | 992 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $141,753 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,335,825 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 2 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 219 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $4,756 | | Total amount of fees paid to insurance company | USD $511 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,492 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 ) |
| Policy contract number | 2734 |
| Policy instance | 3 |
| Insurance contract or identification number | 2734 | | Number of Individuals Covered | 1054 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $311,363 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,764,388 | | 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 number | AGP 002427 |
| Policy instance | 1 |
| Insurance contract or identification number | AGP 002427 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $21 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $130 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0135705 |
| Policy instance | 3 |
| Insurance contract or identification number | 0135705 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $4,788 | | Total amount of fees paid to insurance company | USD $387 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $92,840 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,788 | | Amount paid for insurance broker fees | 387 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| STERLING LIFE (National Association of Insurance Commissioners NAIC id number: 77399 ) |
| Policy contract number | S 4802 |
| Policy instance | 2 |
| Insurance contract or identification number | S 4802 | | Number of Individuals Covered | 1086 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $162,987 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $773,941 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $135,234 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
| UNITED AMERICAN INSURANCE (National Association of Insurance Commissioners NAIC id number: 92916 ) |
| Policy contract number | 2734 |
| Policy instance | 4 |
| Insurance contract or identification number | 2734 | | Number of Individuals Covered | 1154 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $331,439 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,878,153 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $220,959 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 5 | | Insurance broker name | DIETRICH & ASSOCIATES |
|
