401k Plan data: LOCAL 837 HEALTH AND WELFARE PLAN plan

LOCAL 837 HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	LOCAL 837 HEALTH AND WELFARE PLAN
Plan identification number	501

LOCAL 837 HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

LOCAL 837 HEALTH AND WELFARE PLAN BOARD OF TRUSTEES has sponsored the creation of one or more 401k plans.

Company Name: LOCAL 837 HEALTH AND WELFARE PLAN BOARD OF TRUSTEES

Employer identification number (EIN): 231685740

NAIC Classification: 493100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LOCAL 837 HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01
501 2022-01-01
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2019-01-01
501 2018-01-01
501 2017-01-01 PAMELA PALMER DOMINIC MARANO 2018-10-11
501 2016-01-01 PAMELA PALMER DOMINIC MARANO 2017-10-11
501 2015-01-01 PAMELA PALMER DOMINIC MARANO 2016-10-14
501 2014-01-01 PAMELA PALMER DOMINIC MARANO 2015-10-15
501 2013-01-01 PAMELA PALMER DOMINIC MARANO 2014-10-10
501 2012-01-01 PAMELA PALMER DOMINIC MARANO 2013-10-15
501 2011-01-01 JOHN DULCZAK DOMINIC MARANO 2012-10-15
501 2010-01-01 JOHN DULCZAK DOMINIC MARANO 2011-10-17
501 2009-01-01 JOHN DULCZAK DOMINIC MARANO 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01
501	2022-01-01
501	2021-01-01
501	2020-01-01
501	2019-01-01
501	2019-01-01
501	2018-01-01
501	2017-01-01	PAMELA PALMER	DOMINIC MARANO	2018-10-11
501	2016-01-01	PAMELA PALMER	DOMINIC MARANO	2017-10-11
501	2015-01-01	PAMELA PALMER	DOMINIC MARANO	2016-10-14
501	2014-01-01	PAMELA PALMER	DOMINIC MARANO	2015-10-15
501	2013-01-01	PAMELA PALMER	DOMINIC MARANO	2014-10-10
501	2012-01-01	PAMELA PALMER	DOMINIC MARANO	2013-10-15
501	2011-01-01	JOHN DULCZAK	DOMINIC MARANO	2012-10-15
501	2010-01-01	JOHN DULCZAK	DOMINIC MARANO	2011-10-17
501	2009-01-01	JOHN DULCZAK	DOMINIC MARANO	2010-10-14

Plan Statistics for LOCAL 837 HEALTH AND WELFARE PLAN

401k plan membership statisitcs for LOCAL 837 HEALTH AND WELFARE PLAN

Measure Date Value
2023: LOCAL 837 HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 115
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 115
Number of employers contributing to the scheme 2023-01-01 4
2022: LOCAL 837 HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 191
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 191
Number of employers contributing to the scheme 2022-01-01 6
2021: LOCAL 837 HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 201
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 196
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 196
Number of employers contributing to the scheme 2021-01-01 6
2020: LOCAL 837 HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 229
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 201
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 201
Number of employers contributing to the scheme 2020-01-01 6
2019: LOCAL 837 HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 282
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 229
Total of all active and inactive participants 2019-01-01 229
Number of employers contributing to the scheme 2019-01-01 6
2018: LOCAL 837 HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 308
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 282
Total of all active and inactive participants 2018-01-01 282
Number of employers contributing to the scheme 2018-01-01 5
2017: LOCAL 837 HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 303
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 308
Total of all active and inactive participants 2017-01-01 308
Number of employers contributing to the scheme 2017-01-01 5
2016: LOCAL 837 HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 292
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 303
Total of all active and inactive participants 2016-01-01 303
Number of employers contributing to the scheme 2016-01-01 6
2015: LOCAL 837 HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 348
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 292
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 292
2014: LOCAL 837 HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 360
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 348
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 348
2013: LOCAL 837 HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 354
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 360
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 360
2012: LOCAL 837 HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 427
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 354
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 354
2011: LOCAL 837 HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 446
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 427
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 427
2010: LOCAL 837 HEALTH AND WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 499
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 446
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 446
Total participants 2010-01-01 446
2009: LOCAL 837 HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,225
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 499
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 499

Measure	Date	Value
2023: LOCAL 837 HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	115
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	115
Number of employers contributing to the scheme	2023-01-01	4
2022: LOCAL 837 HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	191
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	191
Number of employers contributing to the scheme	2022-01-01	6
2021: LOCAL 837 HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	201
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	196
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	196
Number of employers contributing to the scheme	2021-01-01	6
2020: LOCAL 837 HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	229
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	201
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	201
Number of employers contributing to the scheme	2020-01-01	6
2019: LOCAL 837 HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	282
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	229
Total of all active and inactive participants	2019-01-01	229
Number of employers contributing to the scheme	2019-01-01	6
2018: LOCAL 837 HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	308
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	282
Total of all active and inactive participants	2018-01-01	282
Number of employers contributing to the scheme	2018-01-01	5
2017: LOCAL 837 HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	303
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	308
Total of all active and inactive participants	2017-01-01	308
Number of employers contributing to the scheme	2017-01-01	5
2016: LOCAL 837 HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	292
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	303
Total of all active and inactive participants	2016-01-01	303
Number of employers contributing to the scheme	2016-01-01	6
2015: LOCAL 837 HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	348
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	292
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	292
2014: LOCAL 837 HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	360
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	348
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	348
2013: LOCAL 837 HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	354
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	360
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	360
2012: LOCAL 837 HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	427
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	354
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	354
2011: LOCAL 837 HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	446
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	427
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	427
2010: LOCAL 837 HEALTH AND WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	499
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	446
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	446
Total participants	2010-01-01	446
2009: LOCAL 837 HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,225
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	499
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	499

Financial Data on LOCAL 837 HEALTH AND WELFARE PLAN

Measure	Date	Value
2023 : LOCAL 837 HEALTH AND WELFARE PLAN 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2023-12-31	$203,189
Total unrealized appreciation/depreciation of assets	2023-12-31	$203,189
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$377,002
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$406,187
Total income from all sources (including contributions)	2023-12-31	$1,552,412
Total loss/gain on sale of assets	2023-12-31	$-48,187
Total of all expenses incurred	2023-12-31	$1,565,855
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$643,604
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$714,891
Value of total assets at end of year	2023-12-31	$8,658,525
Value of total assets at beginning of year	2023-12-31	$8,701,153
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$922,251
Total interest from all sources	2023-12-31	$112,878
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$99,750
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-12-31	$79,557
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$41,496
Value of other receiveables (less allowance for doubtful accounts) at end of year	2023-12-31	$95,235
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2023-12-31	$162,754
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2023-12-31	$235,317
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2023-12-31	$268,116
Administrative expenses (other) incurred	2023-12-31	$348,002
Liabilities. Value of operating payables at end of year	2023-12-31	$35,136
Liabilities. Value of operating payables at beginning of year	2023-12-31	$54,847
Total non interest bearing cash at end of year	2023-12-31	$225
Total non interest bearing cash at beginning of year	2023-12-31	$225
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	$-13,443
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$8,281,523
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$8,294,966
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	$45,056
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$3,252,608
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$3,743,831
Income. Interest from US Government securities	2023-12-31	$15,613
Income. Interest from corporate debt instruments	2023-12-31	$90,047
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2023-12-31	$184,833
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2023-12-31	$830,655
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2023-12-31	$830,655
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2023-12-31	$7,218
Expenses. Payments to insurance carriers foe the provision of benefits	2023-12-31	$150,813
Asset value of US Government securities at end of year	2023-12-31	$1,126,043
Asset value of US Government securities at beginning of year	2023-12-31	$909,950
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$469,891
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
Assets. Value of employer real property at end of year	2023-12-31	$235,317
Assets. Value of employer real property at beginning of year	2023-12-31	$268,116
Contributions received in cash from employer	2023-12-31	$673,395
Employer contributions (assets) at end of year	2023-12-31	$638,966
Employer contributions (assets) at beginning of year	2023-12-31	$650,572
Income. Dividends from common stock	2023-12-31	$20,193
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$492,791
Asset. Corporate debt instrument debt (other) at end of year	2023-12-31	$2,070,630
Asset. Corporate debt instrument debt (other) at beginning of year	2023-12-31	$2,127,305
Contract administrator fees	2023-12-31	$41,215
Assets. Corporate common stocks other than exployer securities at end of year	2023-12-31	$1,048,678
Liabilities. Value of benefit claims payable at end of year	2023-12-31	$106,549
Liabilities. Value of benefit claims payable at beginning of year	2023-12-31	$83,224
Assets. Value of buildings and other operty used in plan operation at end of year	2023-12-31	$5,990
Assets. Value of buildings and other operty used in plan operation at beginning of year	2023-12-31	$7,745
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	$1,237,290
Aggregate carrying amount (costs) on sale of assets	2023-12-31	$1,285,477
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	FISCHER DORWART
Accountancy firm EIN	2023-12-31	232247478
2022 : LOCAL 837 HEALTH AND WELFARE PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$-137,996
Total unrealized appreciation/depreciation of assets	2022-12-31	$-137,996
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$406,187
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$330,158
Total income from all sources (including contributions)	2022-12-31	$-139,399
Total loss/gain on sale of assets	2022-12-31	$100,850
Total of all expenses incurred	2022-12-31	$1,231,124
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$356,684
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$419,461
Value of total assets at end of year	2022-12-31	$8,701,153
Value of total assets at beginning of year	2022-12-31	$9,995,647
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$874,440
Total interest from all sources	2022-12-31	$100,730
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$92,546
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$92,546
Administrative expenses professional fees incurred	2022-12-31	$21,577
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$54,962
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$162,754
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$191,779
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$268,116
Administrative expenses (other) incurred	2022-12-31	$793,121
Liabilities. Value of operating payables at end of year	2022-12-31	$54,847
Liabilities. Value of operating payables at beginning of year	2022-12-31	$73,497
Total non interest bearing cash at end of year	2022-12-31	$225
Total non interest bearing cash at beginning of year	2022-12-31	$225
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	$-1,370,523
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$8,294,966
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$9,665,489
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	$22,416
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,743,831
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$4,165,771
Income. Interest from US Government securities	2022-12-31	$12,607
Income. Interest from corporate debt instruments	2022-12-31	$82,920
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$830,655
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$1,336,758
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$1,336,758
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$5,203
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$356,684
Asset value of US Government securities at end of year	2022-12-31	$909,950
Asset value of US Government securities at beginning of year	2022-12-31	$962,614
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-714,990
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
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
Assets. Value of employer real property at end of year	2022-12-31	$268,116
Contributions received in cash from employer	2022-12-31	$364,499
Employer contributions (assets) at end of year	2022-12-31	$650,572
Employer contributions (assets) at beginning of year	2022-12-31	$1,187,051
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$2,127,305
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$2,141,903
Contract administrator fees	2022-12-31	$37,326
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$83,224
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$256,661
Assets. Value of buildings and other operty used in plan operation at end of year	2022-12-31	$7,745
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-12-31	$9,546
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	$3,972,029
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$3,871,179
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	FISCHER DORWART PC
Accountancy firm EIN	2022-12-31	232247478
2021 : LOCAL 837 HEALTH AND WELFARE PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$-97,806
Total unrealized appreciation/depreciation of assets	2021-12-31	$-97,806
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$330,158
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$413,496
Total income from all sources (including contributions)	2021-12-31	$1,381,759
Total loss/gain on sale of assets	2021-12-31	$5,884
Total of all expenses incurred	2021-12-31	$2,034,351
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,161,162
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$736,786
Value of total assets at end of year	2021-12-31	$9,995,647
Value of total assets at beginning of year	2021-12-31	$10,731,577
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$873,189
Total interest from all sources	2021-12-31	$102,051
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$239,553
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$239,553
Administrative expenses professional fees incurred	2021-12-31	$20,439
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$66,871
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$191,779
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$214,650
Administrative expenses (other) incurred	2021-12-31	$758,290
Liabilities. Value of operating payables at end of year	2021-12-31	$73,497
Liabilities. Value of operating payables at beginning of year	2021-12-31	$36,130
Total non interest bearing cash at end of year	2021-12-31	$225
Total non interest bearing cash at beginning of year	2021-12-31	$225
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	$-652,592
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$9,665,489
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$10,318,081
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	$49,388
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$4,165,771
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$3,560,928
Income. Interest from US Government securities	2021-12-31	$14,398
Income. Interest from corporate debt instruments	2021-12-31	$84,572
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$1,336,758
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$1,529,008
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$1,529,008
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$3,081
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$1,161,162
Asset value of US Government securities at end of year	2021-12-31	$962,614
Asset value of US Government securities at beginning of year	2021-12-31	$941,388
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$395,291
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
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
Contributions received in cash from employer	2021-12-31	$669,915
Employer contributions (assets) at end of year	2021-12-31	$1,187,051
Employer contributions (assets) at beginning of year	2021-12-31	$2,226,283
Asset. Corporate debt instrument debt (other) at end of year	2021-12-31	$2,141,903
Asset. Corporate debt instrument debt (other) at beginning of year	2021-12-31	$2,247,748
Contract administrator fees	2021-12-31	$45,072
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$256,661
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$377,366
Assets. Value of buildings and other operty used in plan operation at end of year	2021-12-31	$9,546
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-12-31	$11,347
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	$2,921,627
Aggregate carrying amount (costs) on sale of assets	2021-12-31	$2,915,743
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2021-12-31	232247478
2020 : LOCAL 837 HEALTH AND WELFARE PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$33,996
Total unrealized appreciation/depreciation of assets	2020-12-31	$33,996
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$413,496
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$570,370
Total income from all sources (including contributions)	2020-12-31	$2,891,256
Total loss/gain on sale of assets	2020-12-31	$-1,962
Total of all expenses incurred	2020-12-31	$2,624,100
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,718,951
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$2,498,172
Value of total assets at end of year	2020-12-31	$10,731,577
Value of total assets at beginning of year	2020-12-31	$10,621,295
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$905,149
Total interest from all sources	2020-12-31	$104,494
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$97,336
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$97,336
Administrative expenses professional fees incurred	2020-12-31	$20,473
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$21,749
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$214,650
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$184,840
Administrative expenses (other) incurred	2020-12-31	$820,289
Liabilities. Value of operating payables at end of year	2020-12-31	$36,130
Liabilities. Value of operating payables at beginning of year	2020-12-31	$54,174
Total non interest bearing cash at end of year	2020-12-31	$225
Total non interest bearing cash at beginning of year	2020-12-31	$225
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	$267,156
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$10,318,081
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$10,050,925
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	$38,184
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$3,560,928
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,312,492
Income. Interest from US Government securities	2020-12-31	$14,426
Income. Interest from corporate debt instruments	2020-12-31	$81,898
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$1,529,008
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$2,590,074
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$2,590,074
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$8,170
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$1,718,951
Asset value of US Government securities at end of year	2020-12-31	$941,388
Asset value of US Government securities at beginning of year	2020-12-31	$904,701
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$159,220
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
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
Contributions received in cash from employer	2020-12-31	$2,476,423
Employer contributions (assets) at end of year	2020-12-31	$2,226,283
Employer contributions (assets) at beginning of year	2020-12-31	$1,488,253
Asset. Corporate debt instrument debt (other) at end of year	2020-12-31	$2,247,748
Asset. Corporate debt instrument debt (other) at beginning of year	2020-12-31	$2,126,773
Contract administrator fees	2020-12-31	$26,203
Liabilities. Value of benefit claims payable at end of year	2020-12-31	$377,366
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$516,196
Assets. Value of buildings and other operty used in plan operation at end of year	2020-12-31	$11,347
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-12-31	$13,937
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	$4,624,174
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$4,626,136
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2020-12-31	232247478
2019 : LOCAL 837 HEALTH AND WELFARE PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$429,903
Total unrealized appreciation/depreciation of assets	2019-12-31	$429,903
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$570,370
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$601,731
Total income from all sources (including contributions)	2019-12-31	$4,198,873
Total loss/gain on sale of assets	2019-12-31	$-31,400
Total of all expenses incurred	2019-12-31	$3,709,126
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,782,073
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$3,451,871
Value of total assets at end of year	2019-12-31	$10,621,295
Value of total assets at beginning of year	2019-12-31	$10,162,909
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$927,053
Total interest from all sources	2019-12-31	$127,211
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$131,877
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$131,877
Administrative expenses professional fees incurred	2019-12-31	$28,376
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$155,556
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$12,466
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$184,840
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$196,961
Administrative expenses (other) incurred	2019-12-31	$811,698
Liabilities. Value of operating payables at end of year	2019-12-31	$54,174
Liabilities. Value of operating payables at beginning of year	2019-12-31	$41,058
Total non interest bearing cash at end of year	2019-12-31	$225
Total non interest bearing cash at beginning of year	2019-12-31	$225
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	$489,747
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$10,050,925
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$9,561,178
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 leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$37,595
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,312,492
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,776,233
Income. Interest from US Government securities	2019-12-31	$15,362
Income. Interest from corporate debt instruments	2019-12-31	$77,364
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$2,590,074
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$2,534,708
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$2,534,708
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$34,485
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$2,782,073
Asset value of US Government securities at end of year	2019-12-31	$904,701
Asset value of US Government securities at beginning of year	2019-12-31	$873,672
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$89,411
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	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
Contributions received in cash from employer	2019-12-31	$3,283,849
Employer contributions (assets) at end of year	2019-12-31	$1,488,253
Employer contributions (assets) at beginning of year	2019-12-31	$1,729,535
Asset. Corporate debt instrument debt (other) at end of year	2019-12-31	$2,126,773
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$2,034,483
Contract administrator fees	2019-12-31	$49,384
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$516,196
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$560,673
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$13,937
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$17,092
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
Aggregate proceeds on sale of assets	2019-12-31	$2,978,434
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$3,009,834
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Accountancy firm name	2019-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2019-12-31	232247478
2018 : LOCAL 837 HEALTH AND WELFARE PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$-337,480
Total unrealized appreciation/depreciation of assets	2018-12-31	$-337,480
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$601,731
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$573,427
Total income from all sources (including contributions)	2018-12-31	$5,357,118
Total loss/gain on sale of assets	2018-12-31	$-48,214
Total of all expenses incurred	2018-12-31	$3,846,151
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$2,924,616
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$5,444,451
Value of total assets at end of year	2018-12-31	$10,162,909
Value of total assets at beginning of year	2018-12-31	$8,623,638
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$921,535
Total interest from all sources	2018-12-31	$124,826
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$197,499
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$197,499
Administrative expenses professional fees incurred	2018-12-31	$31,500
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$220,512
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$22,636
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$196,961
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$144,321
Administrative expenses (other) incurred	2018-12-31	$802,626
Liabilities. Value of operating payables at end of year	2018-12-31	$41,058
Liabilities. Value of operating payables at beginning of year	2018-12-31	$62,690
Total non interest bearing cash at end of year	2018-12-31	$225
Total non interest bearing cash at beginning of year	2018-12-31	$225
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	$1,510,967
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$9,561,178
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$8,050,211
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	$39,637
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,776,233
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,958,164
Income. Interest from US Government securities	2018-12-31	$12,548
Income. Interest from corporate debt instruments	2018-12-31	$75,468
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$2,534,708
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$2,204,771
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$2,204,771
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$36,810
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$2,924,616
Asset value of US Government securities at end of year	2018-12-31	$873,672
Asset value of US Government securities at beginning of year	2018-12-31	$942,720
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-23,964
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
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
Contributions received in cash from employer	2018-12-31	$5,201,303
Employer contributions (assets) at end of year	2018-12-31	$1,729,535
Employer contributions (assets) at beginning of year	2018-12-31	$442,804
Asset. Corporate debt instrument debt (other) at end of year	2018-12-31	$2,034,483
Asset. Corporate debt instrument debt (other) at beginning of year	2018-12-31	$1,910,387
Contract administrator fees	2018-12-31	$47,772
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$560,673
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$510,737
Assets. Value of buildings and other operty used in plan operation at end of year	2018-12-31	$17,092
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-12-31	$20,246
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	$2,442,885
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$2,491,099
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	No
Opinion of an independent qualified public accountant for this plan	2018-12-31	Unqualified
Accountancy firm name	2018-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2018-12-31	232247478
2017 : LOCAL 837 HEALTH AND WELFARE PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$314,696
Total unrealized appreciation/depreciation of assets	2017-12-31	$314,696
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$573,427
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$567,301
Total income from all sources (including contributions)	2017-12-31	$5,592,123
Total loss/gain on sale of assets	2017-12-31	$-127,912
Total of all expenses incurred	2017-12-31	$4,046,423
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$3,198,342
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$5,149,839
Value of total assets at end of year	2017-12-31	$8,623,638
Value of total assets at beginning of year	2017-12-31	$7,071,812
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$848,081
Total interest from all sources	2017-12-31	$135,836
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$119,664
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$119,664
Administrative expenses professional fees incurred	2017-12-31	$32,307
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$210,525
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$12,343
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$144,321
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$122,112
Administrative expenses (other) incurred	2017-12-31	$722,758
Liabilities. Value of operating payables at end of year	2017-12-31	$62,690
Liabilities. Value of operating payables at beginning of year	2017-12-31	$52,700
Total non interest bearing cash at end of year	2017-12-31	$225
Total non interest bearing cash at beginning of year	2017-12-31	$225
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	$1,545,700
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$8,050,211
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$6,504,511
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	$35,599
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$2,958,164
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,598,180
Income. Interest from US Government securities	2017-12-31	$37,861
Income. Interest from corporate debt instruments	2017-12-31	$76,724
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$2,204,771
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$1,234,633
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$1,234,633
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$21,251
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$3,198,342
Asset value of US Government securities at end of year	2017-12-31	$942,720
Asset value of US Government securities at beginning of year	2017-12-31	$984,115
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
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
Contributions received in cash from employer	2017-12-31	$4,926,971
Employer contributions (assets) at end of year	2017-12-31	$442,804
Employer contributions (assets) at beginning of year	2017-12-31	$413,560
Asset. Corporate debt instrument debt (other) at end of year	2017-12-31	$1,910,387
Asset. Corporate debt instrument debt (other) at beginning of year	2017-12-31	$1,695,586
Contract administrator fees	2017-12-31	$57,417
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$510,737
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$514,601
Assets. Value of buildings and other operty used in plan operation at end of year	2017-12-31	$20,246
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-12-31	$23,401
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	$3,095,587
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$3,223,499
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2017-12-31	232247478
2016 : LOCAL 837 HEALTH AND WELFARE PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$32,396
Total unrealized appreciation/depreciation of assets	2016-12-31	$32,396
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$567,301
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$536,154
Total income from all sources (including contributions)	2016-12-31	$4,408,627
Total loss/gain on sale of assets	2016-12-31	$-104,321
Total of all expenses incurred	2016-12-31	$4,168,840
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$3,341,114
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$4,096,416
Value of total assets at end of year	2016-12-31	$7,071,812
Value of total assets at beginning of year	2016-12-31	$6,800,878
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$827,726
Total interest from all sources	2016-12-31	$93,736
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$75,177
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$75,177
Administrative expenses professional fees incurred	2016-12-31	$43,327
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$182,488
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$26,216
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$122,112
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$123,313
Administrative expenses (other) incurred	2016-12-31	$712,333
Liabilities. Value of operating payables at end of year	2016-12-31	$52,700
Liabilities. Value of operating payables at beginning of year	2016-12-31	$78,349
Total non interest bearing cash at end of year	2016-12-31	$225
Total non interest bearing cash at beginning of year	2016-12-31	$225
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	$239,787
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$6,504,511
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$6,264,724
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	$38,518
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$2,598,180
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,393,585
Income. Interest from US Government securities	2016-12-31	$23,572
Income. Interest from corporate debt instruments	2016-12-31	$54,231
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$1,234,633
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$876,861
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$876,861
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$15,933
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$3,341,114
Asset value of US Government securities at end of year	2016-12-31	$984,115
Asset value of US Government securities at beginning of year	2016-12-31	$674,891
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$215,223
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
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
Contributions received in cash from employer	2016-12-31	$3,887,712
Employer contributions (assets) at end of year	2016-12-31	$413,560
Employer contributions (assets) at beginning of year	2016-12-31	$584,412
Asset. Corporate debt instrument debt (other) at end of year	2016-12-31	$1,695,586
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$2,121,036
Contract administrator fees	2016-12-31	$33,548
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$514,601
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$457,805
Assets. Value of buildings and other operty used in plan operation at end of year	2016-12-31	$23,401
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$26,555
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	$4,367,304
Aggregate carrying amount (costs) on sale of assets	2016-12-31	$4,471,625
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	FISCHER DORWART, PC
Accountancy firm EIN	2016-12-31	232247478
2015 : LOCAL 837 HEALTH AND WELFARE PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$-196,444
Total unrealized appreciation/depreciation of assets	2015-12-31	$-196,444
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$536,154
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$474,247
Total income from all sources (including contributions)	2015-12-31	$3,838,116
Total loss/gain on sale of assets	2015-12-31	$-59,570
Total of all expenses incurred	2015-12-31	$3,409,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,542,874
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$3,906,969
Value of total assets at end of year	2015-12-31	$6,800,878
Value of total assets at beginning of year	2015-12-31	$6,310,812
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$867,083
Total interest from all sources	2015-12-31	$96,728
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$90,433
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$89,692
Administrative expenses professional fees incurred	2015-12-31	$42,074
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
Contributions received from participants	2015-12-31	$168,121
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$33,319
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$123,313
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$114,305
Administrative expenses (other) incurred	2015-12-31	$709,645
Liabilities. Value of operating payables at end of year	2015-12-31	$78,349
Liabilities. Value of operating payables at beginning of year	2015-12-31	$32,729
Total non interest bearing cash at end of year	2015-12-31	$225
Total non interest bearing cash at beginning of year	2015-12-31	$225
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	$428,159
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$6,264,724
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,836,565
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	$42,928
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$2,393,585
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,515,342
Income. Interest from US Government securities	2015-12-31	$10,227
Income. Interest from corporate debt instruments	2015-12-31	$72,990
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$876,861
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$635,689
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$635,689
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$13,511
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$2,542,874
Asset value of US Government securities at end of year	2015-12-31	$674,891
Asset value of US Government securities at beginning of year	2015-12-31	$676,905
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
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
Contributions received in cash from employer	2015-12-31	$3,705,529
Employer contributions (assets) at end of year	2015-12-31	$584,412
Employer contributions (assets) at beginning of year	2015-12-31	$282,338
Income. Dividends from common stock	2015-12-31	$741
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$2,121,036
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$2,063,857
Contract administrator fees	2015-12-31	$72,436
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$457,805
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$441,518
Assets. Value of buildings and other operty used in plan operation at end of year	2015-12-31	$26,555
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-12-31	$22,151
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	$3,348,844
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$3,408,414
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2015-12-31	232247478
2014 : LOCAL 837 HEALTH AND WELFARE PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$11,321
Total unrealized appreciation/depreciation of assets	2014-12-31	$11,321
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$474,247
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$735,749
Total income from all sources (including contributions)	2014-12-31	$3,366,161
Total loss/gain on sale of assets	2014-12-31	$-83,864
Total of all expenses incurred	2014-12-31	$3,617,832
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$2,783,222
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$3,188,179
Value of total assets at end of year	2014-12-31	$6,310,812
Value of total assets at beginning of year	2014-12-31	$6,823,985
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$834,610
Total interest from all sources	2014-12-31	$106,137
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$89,552
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$89,552
Administrative expenses professional fees incurred	2014-12-31	$32,214
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
Contributions received from participants	2014-12-31	$119,323
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$26,565
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$114,305
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$91,178
Administrative expenses (other) incurred	2014-12-31	$694,633
Liabilities. Value of operating payables at end of year	2014-12-31	$32,729
Liabilities. Value of operating payables at beginning of year	2014-12-31	$79,007
Total non interest bearing cash at end of year	2014-12-31	$225
Total non interest bearing cash at beginning of year	2014-12-31	$225
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	$-251,671
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,836,565
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$6,088,236
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	$40,666
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$2,515,342
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$762,585
Income. Interest from US Government securities	2014-12-31	$16,624
Income. Interest from corporate debt instruments	2014-12-31	$83,965
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$635,689
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$1,856,759
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$1,856,759
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$5,548
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$2,783,222
Asset value of US Government securities at end of year	2014-12-31	$676,905
Asset value of US Government securities at beginning of year	2014-12-31	$865,452
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$54,836
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
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
Contributions received in cash from employer	2014-12-31	$3,042,291
Employer contributions (assets) at end of year	2014-12-31	$282,338
Employer contributions (assets) at beginning of year	2014-12-31	$449,389
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$2,063,857
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$2,763,502
Contract administrator fees	2014-12-31	$67,097
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$10,271
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$441,518
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$656,742
Assets. Value of buildings and other operty used in plan operation at end of year	2014-12-31	$22,151
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-12-31	$24,624
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
Aggregate proceeds on sale of assets	2014-12-31	$5,610,084
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$5,693,948
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2014-12-31	232247478
2013 : LOCAL 837 HEALTH AND WELFARE PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$56,436
Total unrealized appreciation/depreciation of assets	2013-12-31	$56,436
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$735,749
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$560,702
Total income from all sources (including contributions)	2013-12-31	$3,212,840
Total loss/gain on sale of assets	2013-12-31	$-212,629
Total of all expenses incurred	2013-12-31	$4,795,724
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$3,933,954
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$3,131,596
Value of total assets at end of year	2013-12-31	$6,823,985
Value of total assets at beginning of year	2013-12-31	$8,231,822
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$861,770
Total interest from all sources	2013-12-31	$224,307
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$931
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$768
Administrative expenses professional fees incurred	2013-12-31	$30,600
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
Contributions received from participants	2013-12-31	$38,896
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$70,456
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$91,178
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$126,618
Administrative expenses (other) incurred	2013-12-31	$701,159
Liabilities. Value of operating payables at end of year	2013-12-31	$79,007
Liabilities. Value of operating payables at beginning of year	2013-12-31	$47,395
Total non interest bearing cash at end of year	2013-12-31	$225
Total non interest bearing cash at beginning of year	2013-12-31	$225
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	$-1,582,884
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$6,088,236
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$7,671,120
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	$40,912
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$762,585
Income. Interest from US Government securities	2013-12-31	$55,782
Income. Interest from corporate debt instruments	2013-12-31	$164,906
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$1,856,759
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$744,884
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$744,884
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$3,619
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$3,933,954
Asset value of US Government securities at end of year	2013-12-31	$865,452
Asset value of US Government securities at beginning of year	2013-12-31	$1,967,017
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$12,199
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
Contributions received in cash from employer	2013-12-31	$3,022,244
Employer contributions (assets) at end of year	2013-12-31	$449,389
Employer contributions (assets) at beginning of year	2013-12-31	$449,692
Income. Dividends from common stock	2013-12-31	$163
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$2,763,502
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$4,916,172
Contract administrator fees	2013-12-31	$89,099
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$10,271
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$656,742
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$513,307
Assets. Value of buildings and other operty used in plan operation at end of year	2013-12-31	$24,624
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-12-31	$27,214
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
Aggregate proceeds on sale of assets	2013-12-31	$7,060,518
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$7,273,147
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2013-12-31	232247478
2012 : LOCAL 837 HEALTH AND WELFARE PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$-13,800
Total unrealized appreciation/depreciation of assets	2012-12-31	$-13,800
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$560,702
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$775,800
Total income from all sources (including contributions)	2012-12-31	$4,186,296
Total loss/gain on sale of assets	2012-12-31	$-96,106
Total of all expenses incurred	2012-12-31	$4,975,786
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$4,100,676
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$4,029,156
Value of total assets at end of year	2012-12-31	$8,231,822
Value of total assets at beginning of year	2012-12-31	$9,236,410
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$875,110
Total interest from all sources	2012-12-31	$267,046
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$31,821
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
Contributions received from participants	2012-12-31	$26,708
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$48,892
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$126,618
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$205,462
Administrative expenses (other) incurred	2012-12-31	$726,512
Liabilities. Value of operating payables at end of year	2012-12-31	$47,395
Liabilities. Value of operating payables at beginning of year	2012-12-31	$55,461
Total non interest bearing cash at end of year	2012-12-31	$225
Total non interest bearing cash at beginning of year	2012-12-31	$225
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	$-789,490
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$7,671,120
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$8,460,610
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	$45,284
Income. Interest from US Government securities	2012-12-31	$44,773
Income. Interest from corporate debt instruments	2012-12-31	$213,298
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$744,884
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$604,440
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$604,440
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$8,975
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$4,100,676
Asset value of US Government securities at end of year	2012-12-31	$1,967,017
Asset value of US Government securities at beginning of year	2012-12-31	$2,649,290
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
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
Contributions received in cash from employer	2012-12-31	$3,953,556
Employer contributions (assets) at end of year	2012-12-31	$449,692
Employer contributions (assets) at beginning of year	2012-12-31	$486,913
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$4,916,172
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$5,284,449
Contract administrator fees	2012-12-31	$71,493
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$513,307
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$720,339
Assets. Value of buildings and other operty used in plan operation at end of year	2012-12-31	$27,214
Assets. Value of buildings and other operty used in plan operation at beginning of year	2012-12-31	$5,631
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	$8,983,279
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$9,079,385
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2012-12-31	232247478
2011 : LOCAL 837 HEALTH AND WELFARE PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-112,989
Total unrealized appreciation/depreciation of assets	2011-12-31	$-112,989
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$775,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$469,490
Total income from all sources (including contributions)	2011-12-31	$4,164,925
Total loss/gain on sale of assets	2011-12-31	$-43,115
Total of all expenses incurred	2011-12-31	$4,613,919
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$3,860,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$4,062,604
Value of total assets at end of year	2011-12-31	$9,236,410
Value of total assets at beginning of year	2011-12-31	$9,379,094
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$753,690
Total interest from all sources	2011-12-31	$258,425
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$36,875
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
Contributions received from participants	2011-12-31	$17,981
Participant contributions at beginning of year	2011-12-31	$1,280
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$27,365
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$205,462
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$172,114
Administrative expenses (other) incurred	2011-12-31	$648,331
Liabilities. Value of operating payables at end of year	2011-12-31	$55,461
Liabilities. Value of operating payables at beginning of year	2011-12-31	$39,450
Total non interest bearing cash at end of year	2011-12-31	$225
Total non interest bearing cash at beginning of year	2011-12-31	$225
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	$-448,994
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$8,460,610
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$8,909,604
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	$26,489
Income. Interest from US Government securities	2011-12-31	$63,437
Income. Interest from corporate debt instruments	2011-12-31	$179,541
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$604,440
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$569,824
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$569,824
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$15,447
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$3,860,229
Asset value of US Government securities at end of year	2011-12-31	$2,649,290
Asset value of US Government securities at beginning of year	2011-12-31	$4,689,511
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
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
Contributions received in cash from employer	2011-12-31	$4,017,258
Employer contributions (assets) at end of year	2011-12-31	$486,913
Employer contributions (assets) at beginning of year	2011-12-31	$559,072
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$5,284,449
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$3,378,553
Contract administrator fees	2011-12-31	$41,995
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$720,339
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$430,040
Assets. Value of buildings and other operty used in plan operation at end of year	2011-12-31	$5,631
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-31	$8,515
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	$16,218,081
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$16,261,196
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2011-12-31	232247478
2010 : LOCAL 837 HEALTH AND WELFARE PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$-24,877
Total unrealized appreciation/depreciation of assets	2010-12-31	$-24,877
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$469,490
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$661,123
Total income from all sources (including contributions)	2010-12-31	$4,574,539
Total loss/gain on sale of assets	2010-12-31	$-25,644
Total of all expenses incurred	2010-12-31	$4,101,755
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$3,577,259
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$4,363,998
Value of total assets at end of year	2010-12-31	$9,379,094
Value of total assets at beginning of year	2010-12-31	$9,097,943
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$524,496
Total interest from all sources	2010-12-31	$261,062
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$38,507
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
Contributions received from participants	2010-12-31	$31,760
Participant contributions at end of year	2010-12-31	$1,280
Participant contributions at beginning of year	2010-12-31	$3,920
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$59,586
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$172,114
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$193,244
Administrative expenses (other) incurred	2010-12-31	$428,100
Liabilities. Value of operating payables at end of year	2010-12-31	$39,450
Liabilities. Value of operating payables at beginning of year	2010-12-31	$35,407
Total non interest bearing cash at end of year	2010-12-31	$225
Total non interest bearing cash at beginning of year	2010-12-31	$225
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	$472,784
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$8,909,604
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$8,436,820
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	$26,896
Income. Interest from US Government securities	2010-12-31	$95,976
Income. Interest from corporate debt instruments	2010-12-31	$147,959
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$569,824
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$488,707
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$488,707
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$17,127
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$3,577,259
Asset value of US Government securities at end of year	2010-12-31	$4,689,511
Asset value of US Government securities at beginning of year	2010-12-31	$5,074,790
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
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
Contributions received in cash from employer	2010-12-31	$4,272,652
Employer contributions (assets) at end of year	2010-12-31	$559,072
Employer contributions (assets) at beginning of year	2010-12-31	$435,574
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$3,378,553
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$2,889,730
Contract administrator fees	2010-12-31	$30,993
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$430,040
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$625,716
Assets. Value of buildings and other operty used in plan operation at end of year	2010-12-31	$8,515
Assets. Value of buildings and other operty used in plan operation at beginning of year	2010-12-31	$11,753
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
Aggregate proceeds on sale of assets	2010-12-31	$3,941,466
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$3,967,110
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	FISCHER DORWART, P.C.
Accountancy firm EIN	2010-12-31	232247478

Form 5500 Responses for LOCAL 837 HEALTH AND WELFARE PLAN

2023: LOCAL 837 HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Multi-employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: LOCAL 837 HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Multi-employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: LOCAL 837 HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Multi-employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	Yes
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: LOCAL 837 HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Multi-employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: LOCAL 837 HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Multi-employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: LOCAL 837 HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Multi-employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: LOCAL 837 HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Multi-employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: LOCAL 837 HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Multi-employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: LOCAL 837 HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Multi-employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: LOCAL 837 HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Multi-employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: LOCAL 837 HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Multi-employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: LOCAL 837 HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Multi-employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: LOCAL 837 HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Multi-employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: LOCAL 837 HEALTH AND WELFARE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Multi-employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	Yes
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: LOCAL 837 HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Multi-employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	Yes
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

418206

Policy instance

Insurance contract or identification number	418206
Number of Individuals Covered	20
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $583
Total amount of fees paid to insurance company	USD $73
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $5,784
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )

Policy contract number

GL-0032-VU

Policy instance

Insurance contract or identification number	GL-0032-VU
Number of Individuals Covered	115
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $17,233
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 $143,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

418206

Policy instance

Insurance contract or identification number	418206
Number of Individuals Covered	19
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $527
Total amount of fees paid to insurance company	USD $66
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $5,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $527
Insurance broker organization code?	3
Amount paid for insurance broker fees	66
Additional information about fees paid to insurance broker	COMPENSATION

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

GL-0032-VU

Policy instance

Insurance contract or identification number	GL-0032-VU
Number of Individuals Covered	191
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $17,725
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 $146,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,725
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

GL-0032-VU

Policy instance

Insurance contract or identification number	GL-0032-VU
Number of Individuals Covered	196
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $22,840
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 $190,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,840
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

418206

Policy instance

Insurance contract or identification number	418206
Number of Individuals Covered	55
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $849
Total amount of fees paid to insurance company	USD $106
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $8,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $849
Insurance broker organization code?	3
Amount paid for insurance broker fees	106

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

418206

Policy instance

Insurance contract or identification number	418206
Number of Individuals Covered	59
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,298
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $11,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,298
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

GL-0032-VU

Policy instance

Insurance contract or identification number	GL-0032-VU
Number of Individuals Covered	201
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $22,727
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 $189,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,727
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

GL-0032-VU

Policy instance

Insurance contract or identification number	GL-0032-VU
Number of Individuals Covered	226
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $43,036
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 $358,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $43,036
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

418206

Policy instance

Insurance contract or identification number	418206
Number of Individuals Covered	217
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,143
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $25,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,143
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

418206

Policy instance

Insurance contract or identification number	418206
Number of Individuals Covered	282
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,292
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $25,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,292
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

GL-0032-VU

Policy instance

Insurance contract or identification number	GL-0032-VU
Number of Individuals Covered	279
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $49,019
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 $408,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $49,019
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

GL0032VU

Policy instance

Insurance contract or identification number	GL0032VU
Number of Individuals Covered	257
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $50,397
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 $419,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $50,397
Insurance broker organization code?	3
Insurance broker name	LABOR FIRST LLC

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

418206

Policy instance

Insurance contract or identification number	418206
Number of Individuals Covered	257
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,072
Total amount of fees paid to insurance company	USD $275
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $23,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,072
Amount paid for insurance broker fees	275
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES INC.

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

418206

Policy instance

Insurance contract or identification number	418206
Number of Individuals Covered	217
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $2,597
Total amount of fees paid to insurance company	USD $524
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $20,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,597
Amount paid for insurance broker fees	524
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES INC.

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )

Policy contract number

SL10247

Policy instance

Insurance contract or identification number	SL10247
Number of Individuals Covered	284
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $46,948
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	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 $362,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $39,697
Insurance broker organization code?	3
Insurance broker name	UPSTATE FINANCIAL SERVICES

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

SE3E50038

Policy instance

Insurance contract or identification number	SE3E50038
Number of Individuals Covered	256
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $36,547
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	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 $282,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,547
Insurance broker organization code?	3
Insurance broker name	LABOR FIRST LLC

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3064

Policy instance

Insurance contract or identification number	PA3064
Number of Individuals Covered	348
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $389
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $77,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $389
Insurance broker organization code?	4
Insurance broker name	DE VALLEY HEALTH CARE COALITION

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )

Policy contract number

8386-4EL

Policy instance

Insurance contract or identification number	8386-4EL
Number of Individuals Covered	196
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,609
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $14,701
Commission paid to Insurance Broker	USD $1,609
Insurance broker organization code?	3
Insurance broker name	LABOR FIRST, LLC

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

6130

Policy instance

Insurance contract or identification number	6130
Number of Individuals Covered	5
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $276
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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 $9,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $276
Insurance broker organization code?	3
Insurance broker name	EMERSON REID DBA TRA BENEFIT

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

6130

Policy instance

Insurance contract or identification number	6130
Number of Individuals Covered	198
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $10,672
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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 $260,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,672
Insurance broker organization code?	3
Insurance broker name	EMERSON REID DBA TRA BENEFIT

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )

Policy contract number

8386-4EL

Policy instance

Insurance contract or identification number	8386-4EL
Number of Individuals Covered	153
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,234
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
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 $27,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,234
Insurance broker organization code?	3
Insurance broker name	LABOR FIRST LLC

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

6130

Policy instance

Insurance contract or identification number	6130
Number of Individuals Covered	199
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $74,056
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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 $1,457,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $61,876
Insurance broker organization code?	3
Insurance broker name	EMERSON REID

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3064

Policy instance

Insurance contract or identification number	PA3064
Number of Individuals Covered	357
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $623
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $132,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $623
Insurance broker organization code?	4
Insurance broker name	DE VALLEY HEALTH CARE COALITION

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

SE450038

Policy instance

Insurance contract or identification number	SE450038
Number of Individuals Covered	117
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $15,559
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	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 $130,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,559
Insurance broker organization code?	3
Insurance broker name

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3072

Policy instance

Insurance contract or identification number	PA3072
Number of Individuals Covered	169
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $70
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $14,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $70
Insurance broker organization code?	4
Insurance broker name	DE VALLEY HEALTH CARE COALITION

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

6130

Policy instance

Insurance contract or identification number	6130
Number of Individuals Covered	3
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,266
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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 $37,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $954
Insurance broker organization code?	3
Insurance broker name	EMERSON REID

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3064

Policy instance

Insurance contract or identification number	PA3064
Number of Individuals Covered	234
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $700
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $152,204
Commission paid to Insurance Broker	USD $700
Insurance broker organization code?	4
Insurance broker name	DE VALLEY HEALTH CARE COALITION

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

6130

Policy instance

Insurance contract or identification number	6130
Number of Individuals Covered	2
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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 $32,794

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3072

Policy instance

Insurance contract or identification number	PA3072
Number of Individuals Covered	64
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $60
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $18,816
Commission paid to Insurance Broker	USD $60
Insurance broker organization code?	4
Insurance broker name	DE VALLEY HEALTH CARE COALITION

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

6130

Policy instance

Insurance contract or identification number	6130
Number of Individuals Covered	136
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $102,170
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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 $1,623,220
Commission paid to Insurance Broker	USD $102,170
Insurance broker organization code?	3
Insurance broker name	CBIZ BENEFITS & INSURANCE

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )

Policy contract number

8386-BCS

Policy instance

Insurance contract or identification number	8386-BCS
Number of Individuals Covered	290
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,285
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
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 $40,976
Commission paid to Insurance Broker	USD $3,285
Insurance broker organization code?	3
Insurance broker name	LABOR FIRST LLC

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

SE3E50028

Policy instance

Insurance contract or identification number	SE3E50028
Number of Individuals Covered	155
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $27,928
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	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 $186,191
Commission paid to Insurance Broker	USD $13,964
Insurance broker organization code?	3
Insurance broker name	AON CONSULTING

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3072

Policy instance

Insurance contract or identification number	PA3072
Number of Individuals Covered	177
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $67
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $14,917

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )

Policy contract number

87543

Policy instance

Insurance contract or identification number	87543
Number of Individuals Covered	300
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

SE3E50028

Policy instance

Insurance contract or identification number	SE3E50028
Number of Individuals Covered	196
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $26,652
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	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 $177,684

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )

Policy contract number

8386-BCS

Policy instance

Insurance contract or identification number	8386-BCS
Number of Individuals Covered	297
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,302
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
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 $41,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3064

Policy instance

Insurance contract or identification number	PA3064
Number of Individuals Covered	699
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $760
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $160,940

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3072

Policy instance

Insurance contract or identification number	PA3072
Number of Individuals Covered	153
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $81
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $12,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )

Policy contract number

SE3E-50028

Policy instance

Insurance contract or identification number	SE3E-50028
Number of Individuals Covered	164
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	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 $226,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )

Policy contract number

LO 8386

Policy instance

Insurance contract or identification number	LO 8386
Number of Individuals Covered	259
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,005
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 $47,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

PA3064

Policy instance

Insurance contract or identification number	PA3064
Number of Individuals Covered	658
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $814
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	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 $165,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

6130

Policy instance

Insurance contract or identification number	6130
Number of Individuals Covered	3
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $24
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )

Policy contract number

87543

Policy instance

Insurance contract or identification number	87543
Number of Individuals Covered	285
Insurance policy start date	2010-01-01
Insurance policy end date	2010-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	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 $18,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

6130

Policy instance

Insurance contract or identification number	6130
Number of Individuals Covered	372
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $61,503
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	LOCAL 837 HEALTH AND WELFARE PLAN BOARD OF TRUSTEES
Employer identification number (EIN):	231685740
NAIC Classification:	493100