GROSS MCGINLEY, LLP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROSS MCGINLEY, LLP GROUP HEALTH PLAN
| Measure | Date | Value |
|---|
| 2023 : GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2023 401k financial data |
|---|
| Total plan liabilities at end of year | 2023-12-31 | $53,193 |
| Total plan liabilities at beginning of year | 2023-12-31 | $32,122 |
| Total income from all sources | 2023-12-31 | $663,177 |
| Expenses. Total of all expenses incurred | 2023-12-31 | $859,864 |
| Benefits paid (including direct rollovers) | 2023-12-31 | $357,476 |
| Total plan assets at end of year | 2023-12-31 | $91,327 |
| Total plan assets at beginning of year | 2023-12-31 | $266,943 |
| Value of fidelity bond covering the plan | 2023-12-31 | $720,000 |
| Total contributions received or receivable from participants | 2023-12-31 | $38,527 |
| Expenses. Other expenses not covered elsewhere | 2023-12-31 | $264,632 |
| Contributions received from other sources (not participants or employers) | 2023-12-31 | $0 |
| Other income received | 2023-12-31 | $3,858 |
| Net income (gross income less expenses) | 2023-12-31 | $-196,687 |
| Net plan assets at end of year (total assets less liabilities) | 2023-12-31 | $38,134 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-12-31 | $234,821 |
| Total contributions received or receivable from employer(s) | 2023-12-31 | $620,792 |
| Value of corrective distributions | 2023-12-31 | $237,738 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2023-12-31 | $18 |
| 2022 : GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2022 401k financial data |
|---|
| Total plan liabilities at end of year | 2022-12-31 | $32,122 |
| Total plan liabilities at beginning of year | 2022-12-31 | $45,607 |
| Total income from all sources | 2022-12-31 | $732,036 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $772,886 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $210,867 |
| Total plan assets at end of year | 2022-12-31 | $266,943 |
| Total plan assets at beginning of year | 2022-12-31 | $321,278 |
| Value of fidelity bond covering the plan | 2022-12-31 | $750,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $41,613 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $207,086 |
| Contributions received from other sources (not participants or employers) | 2022-12-31 | $1,128 |
| Other income received | 2022-12-31 | $1,067 |
| Net income (gross income less expenses) | 2022-12-31 | $-40,850 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $234,821 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $275,671 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $688,228 |
| Value of corrective distributions | 2022-12-31 | $351,537 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $3,396 |
| 2021 : GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-12-31 | $45,607 |
| Total plan liabilities at beginning of year | 2021-12-31 | $48,254 |
| Total income from all sources | 2021-12-31 | $651,105 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $441,143 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $262,577 |
| Total plan assets at end of year | 2021-12-31 | $321,278 |
| Total plan assets at beginning of year | 2021-12-31 | $113,963 |
| Value of fidelity bond covering the plan | 2021-12-31 | $720,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $40,621 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $169,601 |
| Other income received | 2021-12-31 | $635 |
| Net income (gross income less expenses) | 2021-12-31 | $209,962 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $275,671 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $65,709 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $609,849 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $8,965 |
| 2020 : GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-12-31 | $48,254 |
| Total plan liabilities at beginning of year | 2020-12-31 | $57,795 |
| Total income from all sources | 2020-12-31 | $665,911 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $567,508 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $393,091 |
| Total plan assets at end of year | 2020-12-31 | $113,963 |
| Total plan assets at beginning of year | 2020-12-31 | $25,101 |
| Value of fidelity bond covering the plan | 2020-12-31 | $720,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $143,711 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $162,261 |
| Contributions received from other sources (not participants or employers) | 2020-12-31 | $11,536 |
| Other income received | 2020-12-31 | $231 |
| Net income (gross income less expenses) | 2020-12-31 | $98,403 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $65,709 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $-32,694 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $510,433 |
| Value of corrective distributions | 2020-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $12,156 |
| 2019 : GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-31 | $57,795 |
| Total plan liabilities at beginning of year | 2019-12-31 | $253,403 |
| Total income from all sources | 2019-12-31 | $563,750 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $402,421 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $198,093 |
| Total plan assets at end of year | 2019-12-31 | $25,101 |
| Total plan assets at beginning of year | 2019-12-31 | $59,380 |
| Value of fidelity bond covering the plan | 2019-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $134,025 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $186,587 |
| Contributions received from other sources (not participants or employers) | 2019-12-31 | $17,662 |
| Other income received | 2019-12-31 | $147 |
| Net income (gross income less expenses) | 2019-12-31 | $161,329 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $-32,694 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $-194,023 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $411,916 |
| Value of corrective distributions | 2019-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $17,741 |
| 2018 : GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-12-31 | $253,403 |
| Total plan liabilities at beginning of year | 2018-12-31 | $56,364 |
| Total income from all sources | 2018-12-31 | $524,472 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $662,628 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $458,160 |
| Total plan assets at end of year | 2018-12-31 | $59,380 |
| Total plan assets at beginning of year | 2018-12-31 | $497 |
| Value of fidelity bond covering the plan | 2018-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $197,924 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $185,836 |
| Other income received | 2018-12-31 | $46 |
| Net income (gross income less expenses) | 2018-12-31 | $-138,156 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $-194,023 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $-55,867 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $326,502 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $18,632 |
| 2017 : GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-12-31 | $56,364 |
| Total income from all sources | 2017-12-31 | $488,910 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $544,777 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $341,109 |
| Total plan assets at end of year | 2017-12-31 | $497 |
| Value of fidelity bond covering the plan | 2017-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $58,629 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $177,369 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $0 |
| Other income received | 2017-12-31 | $7 |
| Net income (gross income less expenses) | 2017-12-31 | $-55,867 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $-55,867 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $430,274 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $26,299 |
| 2023: GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single 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 | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – Trust | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement - Trust | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single 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 | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single 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 | No |
| 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: GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single 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 | No |
| 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: GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single 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 | No |
| 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: GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single 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 | No |
| 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: GROSS MCGINLEY, LLP GROUP HEALTH PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 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 | No |
| 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 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | SL30500254-221 |
| Policy instance | 5 |
| Insurance contract or identification number | SL30500254-221 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $770 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 0 |
| Policy instance | 4 |
| Insurance contract or identification number | 0 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | VOL. LIFE & ADD&D, VOL. STD, VOL. LTD, SPOUSE & CHILD VOL. LIFE & 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 $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-203440 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-203440 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $216,997 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8065 |
| Policy instance | 2 |
| Insurance contract or identification number | 8065 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 $1,071 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 855262 |
| Policy instance | 1 |
| Insurance contract or identification number | 855262 | | Number of Individuals Covered | 81 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $32,139 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 855262 |
| Policy instance | 1 |
| Insurance contract or identification number | 855262 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $31,534 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8065 |
| Policy instance | 2 |
| Insurance contract or identification number | 8065 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 $996 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | 30500254 |
| Policy instance | 3 |
| Insurance contract or identification number | 30500254 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $166,458 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 932579 |
| Policy instance | 4 |
| Insurance contract or identification number | 932579 | | Number of Individuals Covered | 629175 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $7,703 | | 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 | VOL. LIFE & ADD&D, VOL. STD, VOL. LTD, SPOUSE & CHILD VOL. LIFE & 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 $47,886 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 932579 |
| Policy instance | 4 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | 30500254 |
| Policy instance | 3 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8065 |
| Policy instance | 2 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 855262 |
| Policy instance | 1 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 932579 |
| Policy instance | 4 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | 30500254 |
| Policy instance | 3 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8065 |
| Policy instance | 2 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 855262 |
| Policy instance | 1 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 855262 |
| Policy instance | 1 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8065 |
| Policy instance | 2 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | VERIS |
| Policy instance | 3 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | VERIS |
| Policy instance | 3 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8065 |
| Policy instance | 2 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 855262 |
| Policy instance | 1 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | VERIS |
| Policy instance | 3 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8065 |
| Policy instance | 2 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 855262 |
| Policy instance | 1 |
