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DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 401k Plan overview

Plan NameDONALD B. REMMEY, INC. GROUP MEDICAL PLAN
Plan identification number 502

DONALD B. REMMEY, INC. GROUP MEDICAL PLAN Benefits

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

401k Sponsoring company profile

DONALD B. REMMEY, INC. has sponsored the creation of one or more 401k plans.

Company Name:DONALD B. REMMEY, INC.
Employer identification number (EIN):231543293
NAIC Classification:321900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DONALD B. REMMEY, INC. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-01-01
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01
5022017-12-01KATHY STAUDER
5022016-12-01KATHY STAUDER

Plan Statistics for DONALD B. REMMEY, INC. GROUP MEDICAL PLAN

401k plan membership statisitcs for DONALD B. REMMEY, INC. GROUP MEDICAL PLAN

Measure Date Value
2023: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-0177
Total number of active participants reported on line 7a of the Form 55002023-01-0167
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-0167
2022: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0172
Total number of active participants reported on line 7a of the Form 55002022-01-0177
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0177
2021: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0169
Total number of active participants reported on line 7a of the Form 55002021-01-0169
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0169
2020: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0163
Total number of active participants reported on line 7a of the Form 55002020-01-0168
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0169
2019: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0164
Total number of active participants reported on line 7a of the Form 55002019-01-0162
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0163
2018: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0159
Total number of active participants reported on line 7a of the Form 55002018-01-0164
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0164
2017: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-0159
Total number of active participants reported on line 7a of the Form 55002017-12-0159
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-0159
2016: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-0159
Total number of active participants reported on line 7a of the Form 55002016-12-0159
Number of retired or separated participants receiving benefits2016-12-010
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-0159

Financial Data on DONALD B. REMMEY, INC. GROUP MEDICAL PLAN

Measure Date Value
2023 : DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2023 401k financial data
Total plan liabilities at end of year2023-12-31$89,882
Total plan liabilities at beginning of year2023-12-31$352,453
Total income from all sources2023-12-31$1,266,814
Expenses. Total of all expenses incurred2023-12-31$1,162,180
Benefits paid (including direct rollovers)2023-12-31$672,464
Total plan assets at end of year2023-12-31$206,527
Total plan assets at beginning of year2023-12-31$364,464
Value of fidelity bond covering the plan2023-12-31$300,000
Total contributions received or receivable from participants2023-12-31$243,271
Expenses. Other expenses not covered elsewhere2023-12-31$490,387
Contributions received from other sources (not participants or employers)2023-12-31$0
Other income received2023-12-31$8,785
Net income (gross income less expenses)2023-12-31$104,634
Net plan assets at end of year (total assets less liabilities)2023-12-31$116,645
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$12,011
Total contributions received or receivable from employer(s)2023-12-31$1,014,758
Value of corrective distributions2023-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$-671
2022 : DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$352,453
Total plan liabilities at beginning of year2022-12-31$248,753
Total income from all sources2022-12-31$1,080,945
Expenses. Total of all expenses incurred2022-12-31$1,051,348
Benefits paid (including direct rollovers)2022-12-31$623,818
Total plan assets at end of year2022-12-31$364,464
Total plan assets at beginning of year2022-12-31$231,167
Value of fidelity bond covering the plan2022-12-31$300,000
Total contributions received or receivable from participants2022-12-31$203,518
Expenses. Other expenses not covered elsewhere2022-12-31$428,061
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$1,763
Net income (gross income less expenses)2022-12-31$29,597
Net plan assets at end of year (total assets less liabilities)2022-12-31$12,011
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-17,586
Total contributions received or receivable from employer(s)2022-12-31$875,664
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$-531
2021 : DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$248,753
Total plan liabilities at beginning of year2021-12-31$43,238
Total income from all sources2021-12-31$212,051
Expenses. Total of all expenses incurred2021-12-31$1,172,069
Benefits paid (including direct rollovers)2021-12-31$785,856
Total plan assets at end of year2021-12-31$231,167
Total plan assets at beginning of year2021-12-31$985,670
Value of fidelity bond covering the plan2021-12-31$300,000
Total contributions received or receivable from participants2021-12-31$185,546
Expenses. Other expenses not covered elsewhere2021-12-31$370,954
Contributions received from other sources (not participants or employers)2021-12-31$635
Other income received2021-12-31$1,591
Net income (gross income less expenses)2021-12-31$-960,018
Net plan assets at end of year (total assets less liabilities)2021-12-31$-17,586
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$942,432
Total contributions received or receivable from employer(s)2021-12-31$24,279
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$15,259
2020 : DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$43,238
Total plan liabilities at beginning of year2020-12-31$51,465
Total income from all sources2020-12-31$989,453
Expenses. Total of all expenses incurred2020-12-31$784,553
Benefits paid (including direct rollovers)2020-12-31$408,586
Total plan assets at end of year2020-12-31$985,670
Total plan assets at beginning of year2020-12-31$788,997
Value of fidelity bond covering the plan2020-12-31$300,000
Total contributions received or receivable from participants2020-12-31$172,835
Expenses. Other expenses not covered elsewhere2020-12-31$341,736
Contributions received from other sources (not participants or employers)2020-12-31$3,443
Other income received2020-12-31$1,698
Net income (gross income less expenses)2020-12-31$204,900
Net plan assets at end of year (total assets less liabilities)2020-12-31$942,432
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$737,532
Total contributions received or receivable from employer(s)2020-12-31$811,477
Value of corrective distributions2020-12-31$19,458
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$14,773
2019 : DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$51,465
Total plan liabilities at beginning of year2019-12-31$48,692
Total income from all sources2019-12-31$1,014,262
Expenses. Total of all expenses incurred2019-12-31$876,135
Benefits paid (including direct rollovers)2019-12-31$448,815
Total plan assets at end of year2019-12-31$788,997
Total plan assets at beginning of year2019-12-31$648,097
Value of fidelity bond covering the plan2019-12-31$200,000
Total contributions received or receivable from participants2019-12-31$173,045
Expenses. Other expenses not covered elsewhere2019-12-31$331,781
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$1,192
Net income (gross income less expenses)2019-12-31$138,127
Net plan assets at end of year (total assets less liabilities)2019-12-31$737,532
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$599,405
Total contributions received or receivable from employer(s)2019-12-31$840,025
Value of corrective distributions2019-12-31$68,925
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$26,614
2018 : DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$48,692
Total plan liabilities at beginning of year2018-12-31$43,393
Total income from all sources2018-12-31$863,312
Expenses. Total of all expenses incurred2018-12-31$821,495
Benefits paid (including direct rollovers)2018-12-31$471,965
Total plan assets at end of year2018-12-31$648,097
Total plan assets at beginning of year2018-12-31$600,981
Value of fidelity bond covering the plan2018-12-31$200,000
Total contributions received or receivable from participants2018-12-31$142,538
Expenses. Other expenses not covered elsewhere2018-12-31$258,587
Other income received2018-12-31$974
Net income (gross income less expenses)2018-12-31$41,817
Net plan assets at end of year (total assets less liabilities)2018-12-31$599,405
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$557,588
Total contributions received or receivable from employer(s)2018-12-31$719,800
Value of corrective distributions2018-12-31$58,358
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$32,585
2017 : DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$43,393
Total plan liabilities at beginning of year2017-12-31$38,429
Total income from all sources2017-12-31$557,179
Expenses. Total of all expenses incurred2017-12-31$24,043
Benefits paid (including direct rollovers)2017-12-31$1,563
Total plan assets at end of year2017-12-31$600,981
Total plan assets at beginning of year2017-12-31$62,881
Value of fidelity bond covering the plan2017-12-31$200,000
Total contributions received or receivable from participants2017-12-31$12,277
Expenses. Other expenses not covered elsewhere2017-12-31$19,734
Other income received2017-12-31$33
Net income (gross income less expenses)2017-12-31$533,136
Net plan assets at end of year (total assets less liabilities)2017-12-31$557,588
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$24,452
Total contributions received or receivable from employer(s)2017-12-31$544,869
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$2,746
Total plan liabilities at end of year2017-11-30$38,429
Total plan liabilities at beginning of year2017-11-30$0
Total income from all sources2017-11-30$678,745
Expenses. Total of all expenses incurred2017-11-30$654,293
Benefits paid (including direct rollovers)2017-11-30$388,486
Total plan assets at end of year2017-11-30$62,881
Total plan assets at beginning of year2017-11-30$0
Value of fidelity bond covering the plan2017-11-30$200,000
Total contributions received or receivable from participants2017-11-30$92,986
Expenses. Other expenses not covered elsewhere2017-11-30$233,409
Other income received2017-11-30$122
Net income (gross income less expenses)2017-11-30$24,452
Net plan assets at end of year (total assets less liabilities)2017-11-30$24,452
Net plan assets at beginning of year (total assets less liabilities)2017-11-30$0
Total contributions received or receivable from employer(s)2017-11-30$585,637
Expenses. Administrative service providers (salaries,fees and commissions)2017-11-30$32,398

Form 5500 Responses for DONALD B. REMMEY, INC. GROUP MEDICAL PLAN

2023: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Submission has been amendedNo
2017-12-01This submission is the final filingNo
2017-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-12-01Plan is a collectively bargained planNo
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan funding arrangement – TrustYes
2017-12-01Plan benefit arrangement – InsuranceYes
2017-12-01Plan benefit arrangement - TrustYes
2016: DONALD B. REMMEY, INC. GROUP MEDICAL PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01First time form 5500 has been submittedYes
2016-12-01Submission has been amendedNo
2016-12-01This submission is the final filingNo
2016-12-01This return/report is a short plan year return/report (less than 12 months)No
2016-12-01Plan is a collectively bargained planNo
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan funding arrangement – TrustYes
2016-12-01Plan benefit arrangement – InsuranceYes
2016-12-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500241
Policy instance 1
Insurance contract or identification number30500241
Number of Individuals Covered67
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 $436,558
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 number30500241
Policy instance 1
Insurance contract or identification number30500241
Number of Individuals Covered77
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 $374,330
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 number30500241
Policy instance 1
Insurance contract or identification number30500241
Number of Individuals Covered69
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 $320,367
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 number30500241
Policy instance 1
Insurance contract or identification number30500241
Number of Individuals Covered68
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 $292,821
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 numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered62
Insurance policy start date2019-12-01
Insurance policy end date2019-12-31
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 $280,127
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 numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered64
Insurance policy start date2018-12-01
Insurance policy end date2018-12-31
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 $214,414
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 numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered59
Insurance policy start date2017-12-01
Insurance policy end date2017-12-31
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 $1,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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