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PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 401k Plan overview

Plan NamePENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN
Plan identification number 501

PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN Benefits

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

401k Sponsoring company profile

PENNSYLVANIA TRUCK CENTERS, INC. has sponsored the creation of one or more 401k plans.

Company Name:PENNSYLVANIA TRUCK CENTERS, INC.
Employer identification number (EIN):231336462
NAIC Classification:441228
NAIC Description:Motorcycle, ATV, and All Other Motor Vehicle Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-04-01
5012018-04-01
5012017-04-01DREW BEHMER
5012016-04-01DREW BEHMER
5012015-04-01DREW BEHMER
5012014-04-01DREW BEHMER
5012013-04-01DREW BEHMER
5012012-04-01DREW BEHMER
5012012-03-01DREW BEHMER
5012011-03-01DREW BEHMER

Plan Statistics for PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN

401k plan membership statisitcs for PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN

Measure Date Value
2019: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-010
Total number of active participants reported on line 7a of the Form 55002019-04-010
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-010
2018: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-0173
Total number of active participants reported on line 7a of the Form 55002018-04-0167
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-0167
2017: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-0177
Total number of active participants reported on line 7a of the Form 55002017-04-0172
Number of retired or separated participants receiving benefits2017-04-011
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-0173
2016: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-0174
Total number of active participants reported on line 7a of the Form 55002016-04-0177
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-0177
2015: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-0167
Total number of active participants reported on line 7a of the Form 55002015-04-0174
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-0174
2014: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-0170
Total number of active participants reported on line 7a of the Form 55002014-04-0167
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-0167
2013: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-0164
Total number of active participants reported on line 7a of the Form 55002013-04-0170
Number of retired or separated participants receiving benefits2013-04-010
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-0170
2012: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-0163
Total number of active participants reported on line 7a of the Form 55002012-04-0164
Number of retired or separated participants receiving benefits2012-04-010
Number of other retired or separated participants entitled to future benefits2012-04-010
Total of all active and inactive participants2012-04-0164
Total participants, beginning-of-year2012-03-0163
Total number of active participants reported on line 7a of the Form 55002012-03-0163
Number of retired or separated participants receiving benefits2012-03-010
Number of other retired or separated participants entitled to future benefits2012-03-010
Total of all active and inactive participants2012-03-0163
2011: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-03-0160
Total number of active participants reported on line 7a of the Form 55002011-03-0163
Number of retired or separated participants receiving benefits2011-03-010
Number of other retired or separated participants entitled to future benefits2011-03-010
Total of all active and inactive participants2011-03-0163

Financial Data on PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN

Measure Date Value
2020 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2020 401k financial data
Total plan liabilities at end of year2020-03-31$0
Total plan liabilities at beginning of year2020-03-31$0
Total income from all sources2020-03-31$742,748
Expenses. Total of all expenses incurred2020-03-31$663,944
Benefits paid (including direct rollovers)2020-03-31$661,063
Total plan assets at end of year2020-03-31$131,278
Total plan assets at beginning of year2020-03-31$52,474
Value of fidelity bond covering the plan2020-03-31$500,000
Other income received2020-03-31$88,080
Net income (gross income less expenses)2020-03-31$78,804
Net plan assets at end of year (total assets less liabilities)2020-03-31$131,278
Net plan assets at beginning of year (total assets less liabilities)2020-03-31$52,474
Total contributions received or receivable from employer(s)2020-03-31$654,668
Expenses. Administrative service providers (salaries,fees and commissions)2020-03-31$2,881
2019 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2019 401k financial data
Total plan liabilities at end of year2019-03-31$0
Total plan liabilities at beginning of year2019-03-31$0
Total income from all sources2019-03-31$713,504
Expenses. Total of all expenses incurred2019-03-31$773,809
Benefits paid (including direct rollovers)2019-03-31$773,021
Total plan assets at end of year2019-03-31$52,474
Total plan assets at beginning of year2019-03-31$112,779
Value of fidelity bond covering the plan2019-03-31$500,000
Other income received2019-03-31$82,274
Net income (gross income less expenses)2019-03-31$-60,305
Net plan assets at end of year (total assets less liabilities)2019-03-31$52,474
Net plan assets at beginning of year (total assets less liabilities)2019-03-31$112,779
Total contributions received or receivable from employer(s)2019-03-31$631,230
Expenses. Administrative service providers (salaries,fees and commissions)2019-03-31$788
2018 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2018 401k financial data
Total income from all sources2018-03-31$613,013
Expenses. Total of all expenses incurred2018-03-31$570,041
Benefits paid (including direct rollovers)2018-03-31$569,291
Total plan assets at end of year2018-03-31$112,779
Total plan assets at beginning of year2018-03-31$69,807
Value of fidelity bond covering the plan2018-03-31$500,000
Other income received2018-03-31$31,697
Net income (gross income less expenses)2018-03-31$42,972
Net plan assets at end of year (total assets less liabilities)2018-03-31$112,779
Net plan assets at beginning of year (total assets less liabilities)2018-03-31$69,807
Total contributions received or receivable from employer(s)2018-03-31$581,316
Expenses. Administrative service providers (salaries,fees and commissions)2018-03-31$750
2017 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2017 401k financial data
Total income from all sources2017-03-31$500,314
Expenses. Total of all expenses incurred2017-03-31$562,150
Benefits paid (including direct rollovers)2017-03-31$561,400
Total plan assets at end of year2017-03-31$69,807
Total plan assets at beginning of year2017-03-31$131,643
Value of fidelity bond covering the plan2017-03-31$500,000
Other income received2017-03-31$41,084
Net income (gross income less expenses)2017-03-31$-61,836
Net plan assets at end of year (total assets less liabilities)2017-03-31$69,807
Net plan assets at beginning of year (total assets less liabilities)2017-03-31$131,643
Total contributions received or receivable from employer(s)2017-03-31$459,230
Expenses. Administrative service providers (salaries,fees and commissions)2017-03-31$750
2016 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2016 401k financial data
Total income from all sources2016-03-31$280,522
Expenses. Total of all expenses incurred2016-03-31$463,907
Benefits paid (including direct rollovers)2016-03-31$463,157
Total plan assets at end of year2016-03-31$131,643
Total plan assets at beginning of year2016-03-31$315,028
Value of fidelity bond covering the plan2016-03-31$500,000
Other income received2016-03-31$105
Net income (gross income less expenses)2016-03-31$-183,385
Net plan assets at end of year (total assets less liabilities)2016-03-31$131,643
Net plan assets at beginning of year (total assets less liabilities)2016-03-31$315,028
Total contributions received or receivable from employer(s)2016-03-31$280,417
Expenses. Administrative service providers (salaries,fees and commissions)2016-03-31$750
2015 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2015 401k financial data
Total income from all sources2015-03-31$261,006
Expenses. Total of all expenses incurred2015-03-31$270,811
Benefits paid (including direct rollovers)2015-03-31$270,061
Total plan assets at end of year2015-03-31$315,028
Total plan assets at beginning of year2015-03-31$324,833
Value of fidelity bond covering the plan2015-03-31$500,000
Other income received2015-03-31$38
Net income (gross income less expenses)2015-03-31$-9,805
Net plan assets at end of year (total assets less liabilities)2015-03-31$315,028
Net plan assets at beginning of year (total assets less liabilities)2015-03-31$324,833
Total contributions received or receivable from employer(s)2015-03-31$260,968
Expenses. Administrative service providers (salaries,fees and commissions)2015-03-31$750
2014 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2014 401k financial data
Total income from all sources2014-03-31$606,788
Expenses. Total of all expenses incurred2014-03-31$389,888
Benefits paid (including direct rollovers)2014-03-31$389,138
Total plan assets at end of year2014-03-31$324,833
Total plan assets at beginning of year2014-03-31$107,933
Value of fidelity bond covering the plan2014-03-31$500,000
Other income received2014-03-31$30
Net income (gross income less expenses)2014-03-31$216,900
Net plan assets at end of year (total assets less liabilities)2014-03-31$324,833
Net plan assets at beginning of year (total assets less liabilities)2014-03-31$107,933
Total contributions received or receivable from employer(s)2014-03-31$606,758
Expenses. Administrative service providers (salaries,fees and commissions)2014-03-31$750
2013 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2013 401k financial data
Total income from all sources2013-03-31$577,163
Expenses. Total of all expenses incurred2013-03-31$469,449
Benefits paid (including direct rollovers)2013-03-31$468,704
Total plan assets at end of year2013-03-31$107,933
Total plan assets at beginning of year2013-03-31$219
Other income received2013-03-31$28
Net income (gross income less expenses)2013-03-31$107,714
Net plan assets at end of year (total assets less liabilities)2013-03-31$107,933
Net plan assets at beginning of year (total assets less liabilities)2013-03-31$219
Total contributions received or receivable from employer(s)2013-03-31$577,135
Expenses. Administrative service providers (salaries,fees and commissions)2013-03-31$745
2012 : PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2012 401k financial data
Total income from all sources2012-03-31$114,249
Expenses. Total of all expenses incurred2012-03-31$126,322
Benefits paid (including direct rollovers)2012-03-31$125,801
Total plan assets at end of year2012-03-31$219
Total plan assets at beginning of year2012-03-31$12,292
Net income (gross income less expenses)2012-03-31$-12,073
Net plan assets at end of year (total assets less liabilities)2012-03-31$219
Net plan assets at beginning of year (total assets less liabilities)2012-03-31$12,292
Total contributions received or receivable from employer(s)2012-03-31$114,249
Expenses. Administrative service providers (salaries,fees and commissions)2012-03-31$521
Total income from all sources2012-02-29$476,717
Expenses. Total of all expenses incurred2012-02-29$464,425
Benefits paid (including direct rollovers)2012-02-29$464,174
Total plan assets at end of year2012-02-29$12,292
Other income received2012-02-29$8
Net income (gross income less expenses)2012-02-29$12,292
Net plan assets at end of year (total assets less liabilities)2012-02-29$12,292
Net plan assets at beginning of year (total assets less liabilities)2012-02-29$0
Total contributions received or receivable from employer(s)2012-02-29$476,709
Expenses. Administrative service providers (salaries,fees and commissions)2012-02-29$251

Form 5500 Responses for PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN

2019: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes
2018: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement - TrustYes
2017: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – TrustYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement - TrustYes
2016: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – TrustYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement - TrustYes
2015: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – TrustYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement - TrustYes
2014: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – TrustYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement - TrustYes
2013: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan funding arrangement – TrustYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement - TrustYes
2012: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – TrustYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement - TrustYes
2012-03-01Type of plan entitySingle employer plan
2012-03-01Submission has been amendedNo
2012-03-01This submission is the final filingNo
2012-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-03-01Plan is a collectively bargained planNo
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan funding arrangement – TrustYes
2012-03-01Plan benefit arrangement – InsuranceYes
2012-03-01Plan benefit arrangement - TrustYes
2011: PENNSYLVANIA TRUCK CENTERS, INC. GROUP HEALTH PLAN 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Submission has been amendedNo
2011-03-01This submission is the final filingNo
2011-03-01This return/report is a short plan year return/report (less than 12 months)No
2011-03-01Plan is a collectively bargained planNo
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan funding arrangement – TrustYes
2011-03-01Plan benefit arrangement – InsuranceYes
2011-03-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered68
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $186,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered67
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $196,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered73
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $193,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered74
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $139,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered67
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $137,811
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered70
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $145,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered64
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $168,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered63
Insurance policy start date2012-03-01
Insurance policy end date2012-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $13,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered63
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $152,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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