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TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameTEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN
Plan identification number 501

TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

TEAMSTERS LOCAL 401 H AND W has sponsored the creation of one or more 401k plans.

Company Name:TEAMSTERS LOCAL 401 H AND W
Employer identification number (EIN):232024270
NAIC Classification:484200
NAIC Description: Specialized Freight Trucking

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01SCOTT KUCHARSKI CHAIRMAN, TRUSTEE2024-09-27
5012022-01-01SCOTT KUCHARSKI CHAIRMAN, TRUSTEE2023-09-26
5012021-01-01SCOTT KUCHARSKI CHAIRMAN, TRUSTEE2022-10-13
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01PATRICK CONNORS
5012016-01-01PATRICK CONNORS
5012016-01-01
5012015-01-01PATRICK CONNORS
5012014-01-01PATRICK CONNORS
5012013-01-01PATRICK CONNORS
5012012-01-01PATRICK CONNORS
5012011-01-01PATRICK CONNORS DONALD POSKITT2012-10-11
5012009-01-01PATRICK CONNORS DONALD POSKITT2010-10-15

Plan Statistics for TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN

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

Measure Date Value
2023: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01888
Total number of active participants reported on line 7a of the Form 55002023-01-01889
Total of all active and inactive participants2023-01-01889
Number of employers contributing to the scheme2023-01-014
2022: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01825
Total number of active participants reported on line 7a of the Form 55002022-01-01888
Total of all active and inactive participants2022-01-01888
Number of employers contributing to the scheme2022-01-014
2021: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01836
Total number of active participants reported on line 7a of the Form 55002021-01-01825
Total of all active and inactive participants2021-01-01825
Number of employers contributing to the scheme2021-01-014
2020: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01713
Total number of active participants reported on line 7a of the Form 55002020-01-01710
Number of retired or separated participants receiving benefits2020-01-01126
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01836
2019: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01648
Total number of active participants reported on line 7a of the Form 55002019-01-01596
Number of retired or separated participants receiving benefits2019-01-01117
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01713
2018: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01623
Total number of active participants reported on line 7a of the Form 55002018-01-01531
Number of retired or separated participants receiving benefits2018-01-01117
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01648
2017: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01542
Total number of active participants reported on line 7a of the Form 55002017-01-01523
Number of retired or separated participants receiving benefits2017-01-01100
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01623
2016: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01394
Total number of active participants reported on line 7a of the Form 55002016-01-01411
Number of retired or separated participants receiving benefits2016-01-01131
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01542
2015: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01392
Total number of active participants reported on line 7a of the Form 55002015-01-01394
Number of retired or separated participants receiving benefits2015-01-01126
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01520
2014: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01523
Total number of active participants reported on line 7a of the Form 55002014-01-01392
Number of retired or separated participants receiving benefits2014-01-01127
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01519
2013: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01516
Total number of active participants reported on line 7a of the Form 55002013-01-01397
Number of retired or separated participants receiving benefits2013-01-01126
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01523
2012: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01386
Total number of active participants reported on line 7a of the Form 55002012-01-01393
Number of retired or separated participants receiving benefits2012-01-01125
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01518
2011: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01520
Total number of active participants reported on line 7a of the Form 55002011-01-01386
Number of retired or separated participants receiving benefits2011-01-01130
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01516
2009: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01403
Total number of active participants reported on line 7a of the Form 55002009-01-01390
Number of retired or separated participants receiving benefits2009-01-01142
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01532

Financial Data on TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN

Measure Date Value
2023 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2023-12-31$63,796
Total unrealized appreciation/depreciation of assets2023-12-31$63,796
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$167,638
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$103,515
Total income from all sources (including contributions)2023-12-31$26,815,250
Total loss/gain on sale of assets2023-12-31$-6,758
Total of all expenses incurred2023-12-31$22,006,999
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$21,632,325
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$24,721,473
Value of total assets at end of year2023-12-31$22,501,194
Value of total assets at beginning of year2023-12-31$17,628,820
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$374,674
Total interest from all sources2023-12-31$115,035
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$342,118
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2023-12-31$303,642
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$543,957
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-12-31$50,225
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-12-31$28,360
Other income not declared elsewhere2023-12-31$6,677
Administrative expenses (other) incurred2023-12-31$60,096
Liabilities. Value of operating payables at end of year2023-12-31$42,010
Liabilities. Value of operating payables at beginning of year2023-12-31$9,442
Total non interest bearing cash at end of year2023-12-31$4,763,478
Total non interest bearing cash at beginning of year2023-12-31$3,842,034
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$4,808,251
Value of net assets at end of year (total assets less liabilities)2023-12-31$22,333,556
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$17,525,305
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Investment advisory and management fees2023-12-31$71,839
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$12,952,407
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$8,668,469
Income. Interest from US Government securities2023-12-31$23,498
Income. Interest from corporate debt instruments2023-12-31$10,461
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$1,356,289
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$2,853,587
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$2,853,587
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-12-31$81,076
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$20,365,307
Asset value of US Government securities at end of year2023-12-31$1,627,275
Asset value of US Government securities at beginning of year2023-12-31$296,088
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$1,572,909
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31Yes
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$24,177,516
Employer contributions (assets) at end of year2023-12-31$75,078
Employer contributions (assets) at beginning of year2023-12-31$167,405
Income. Dividends from common stock2023-12-31$38,476
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$1,267,018
Asset. Corporate debt instrument preferred debt at end of year2023-12-31$290,924
Asset. Corporate debt instrument preferred debt at beginning of year2023-12-31$581,415
Assets. Corporate common stocks other than exployer securities at end of year2023-12-31$1,372,518
Assets. Corporate common stocks other than exployer securities at beginning of year2023-12-31$1,191,462
Liabilities. Value of benefit claims payable at end of year2023-12-31$125,628
Liabilities. Value of benefit claims payable at beginning of year2023-12-31$94,073
Assets. Value of buildings and other operty used in plan operation at end of year2023-12-31$13,000
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Aggregate proceeds on sale of assets2023-12-31$4,826,043
Aggregate carrying amount (costs) on sale of assets2023-12-31$4,832,801
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31NOVAK FRANCELLA, LLC
Accountancy firm EIN2023-12-31611436956
2022 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-143,377
Total unrealized appreciation/depreciation of assets2022-12-31$-143,377
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$103,515
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$212,271
Total income from all sources (including contributions)2022-12-31$21,250,045
Total loss/gain on sale of assets2022-12-31$-29,579
Total of all expenses incurred2022-12-31$20,964,134
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$20,614,948
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$23,311,772
Value of total assets at end of year2022-12-31$17,628,820
Value of total assets at beginning of year2022-12-31$17,451,665
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$349,186
Total interest from all sources2022-12-31$43,611
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$314,366
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$280,720
Administrative expenses professional fees incurred2022-12-31$118,888
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$538,502
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$28,360
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$60,346
Other income not declared elsewhere2022-12-31$100,000
Administrative expenses (other) incurred2022-12-31$165,934
Liabilities. Value of operating payables at end of year2022-12-31$9,442
Liabilities. Value of operating payables at beginning of year2022-12-31$47,370
Total non interest bearing cash at end of year2022-12-31$3,842,034
Total non interest bearing cash at beginning of year2022-12-31$3,209,661
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$285,911
Value of net assets at end of year (total assets less liabilities)2022-12-31$17,525,305
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$17,239,394
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$64,364
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$8,668,469
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$11,268,540
Interest earned on other investments2022-12-31$10,930
Income. Interest from corporate debt instruments2022-12-31$15,775
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$2,853,587
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$797,054
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$797,054
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$16,906
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$19,938,041
Asset value of US Government securities at end of year2022-12-31$296,088
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-2,346,748
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$22,773,270
Employer contributions (assets) at end of year2022-12-31$167,405
Employer contributions (assets) at beginning of year2022-12-31$104,076
Income. Dividends from common stock2022-12-31$33,646
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$676,907
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$581,415
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$667,729
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$1,191,462
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$1,344,259
Liabilities. Value of benefit claims payable at end of year2022-12-31$94,073
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$164,901
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$1,426,931
Aggregate carrying amount (costs) on sale of assets2022-12-31$1,456,510
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31NOVAK FRANCELLA, LLC
Accountancy firm EIN2022-12-31611436956
2021 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$-68,822
Total unrealized appreciation/depreciation of assets2021-12-31$-68,822
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$212,271
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$22,055
Total income from all sources (including contributions)2021-12-31$21,784,512
Total loss/gain on sale of assets2021-12-31$26,368
Total of all expenses incurred2021-12-31$20,266,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$19,134,298
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$20,001,971
Value of total assets at end of year2021-12-31$17,451,665
Value of total assets at beginning of year2021-12-31$15,743,186
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,131,951
Total interest from all sources2021-12-31$17,870
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$407,955
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$378,623
Administrative expenses professional fees incurred2021-12-31$119,214
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31Yes
Amount of non-exempt transactions with any party-in-interest2021-12-31$15,080
Contributions received from participants2021-12-31$362,529
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$60,346
Administrative expenses (other) incurred2021-12-31$945,942
Liabilities. Value of operating payables at end of year2021-12-31$47,370
Liabilities. Value of operating payables at beginning of year2021-12-31$22,055
Total non interest bearing cash at end of year2021-12-31$3,209,661
Total non interest bearing cash at beginning of year2021-12-31$3,417,343
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,518,263
Value of net assets at end of year (total assets less liabilities)2021-12-31$17,239,394
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$15,721,131
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31Yes
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$66,795
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$11,268,540
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$8,695,693
Income. Interest from corporate debt instruments2021-12-31$17,613
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$797,054
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$1,442,852
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$1,442,852
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$257
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$18,362,071
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,399,170
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$19,639,442
Employer contributions (assets) at end of year2021-12-31$104,076
Income. Dividends from common stock2021-12-31$29,332
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$772,227
Asset. Corporate debt instrument preferred debt at end of year2021-12-31$667,729
Asset. Corporate debt instrument preferred debt at beginning of year2021-12-31$897,554
Assets. Corporate common stocks other than exployer securities at end of year2021-12-31$1,344,259
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$1,289,744
Liabilities. Value of benefit claims payable at end of year2021-12-31$164,901
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$2,024,693
Aggregate carrying amount (costs) on sale of assets2021-12-31$1,998,325
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31NOVAK FRANCELLA, LLC
Accountancy firm EIN2021-12-31611436956
2020 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$216,730
Total unrealized appreciation/depreciation of assets2020-12-31$216,730
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$22,055
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$20,252
Total income from all sources (including contributions)2020-12-31$18,347,852
Total loss/gain on sale of assets2020-12-31$-192,752
Total of all expenses incurred2020-12-31$15,634,646
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$15,333,478
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$17,215,541
Value of total assets at end of year2020-12-31$15,743,186
Value of total assets at beginning of year2020-12-31$13,028,177
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$301,168
Total interest from all sources2020-12-31$30,029
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$235,151
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$199,806
Administrative expenses professional fees incurred2020-12-31$58,595
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$405,297
Administrative expenses (other) incurred2020-12-31$168,121
Liabilities. Value of operating payables at end of year2020-12-31$22,055
Liabilities. Value of operating payables at beginning of year2020-12-31$20,252
Total non interest bearing cash at end of year2020-12-31$3,417,343
Total non interest bearing cash at beginning of year2020-12-31$557,704
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$2,713,206
Value of net assets at end of year (total assets less liabilities)2020-12-31$15,721,131
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$13,007,925
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$58,318
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$8,695,693
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$7,398,280
Income. Interest from corporate debt instruments2020-12-31$24,197
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$1,442,852
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$2,650,242
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$2,650,242
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$5,832
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$15,096,551
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$843,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$16,810,244
Income. Dividends from common stock2020-12-31$35,345
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$236,927
Asset. Corporate debt instrument preferred debt at end of year2020-12-31$897,554
Asset. Corporate debt instrument preferred debt at beginning of year2020-12-31$1,123,383
Contract administrator fees2020-12-31$16,134
Assets. Corporate common stocks other than exployer securities at end of year2020-12-31$1,289,744
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$1,298,568
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$2,343,077
Aggregate carrying amount (costs) on sale of assets2020-12-31$2,535,829
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2020-12-31232872012
2019 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$249,392
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$249,392
Total unrealized appreciation/depreciation of assets2019-12-31$249,392
Total unrealized appreciation/depreciation of assets2019-12-31$249,392
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$20,252
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$27,035
Total income from all sources (including contributions)2019-12-31$15,322,867
Total income from all sources (including contributions)2019-12-31$15,322,867
Total loss/gain on sale of assets2019-12-31$85,821
Total loss/gain on sale of assets2019-12-31$85,821
Total of all expenses incurred2019-12-31$13,050,175
Total of all expenses incurred2019-12-31$13,050,175
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$12,728,594
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$12,728,594
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$13,872,556
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$13,872,556
Value of total assets at end of year2019-12-31$13,028,177
Value of total assets at beginning of year2019-12-31$10,762,268
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$321,581
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$321,581
Total interest from all sources2019-12-31$48,132
Total interest from all sources2019-12-31$48,132
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$306,585
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$306,585
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$263,392
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$263,392
Administrative expenses professional fees incurred2019-12-31$60,695
Administrative expenses professional fees incurred2019-12-31$60,695
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$413,390
Contributions received from participants2019-12-31$413,390
Administrative expenses (other) incurred2019-12-31$186,353
Administrative expenses (other) incurred2019-12-31$186,353
Liabilities. Value of operating payables at end of year2019-12-31$20,252
Liabilities. Value of operating payables at beginning of year2019-12-31$27,035
Liabilities. Value of operating payables at beginning of year2019-12-31$27,035
Total non interest bearing cash at end of year2019-12-31$557,704
Total non interest bearing cash at end of year2019-12-31$557,704
Total non interest bearing cash at beginning of year2019-12-31$534,810
Total non interest bearing cash at beginning of year2019-12-31$534,810
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,272,692
Value of net income/loss2019-12-31$2,272,692
Value of net assets at end of year (total assets less liabilities)2019-12-31$13,007,925
Value of net assets at end of year (total assets less liabilities)2019-12-31$13,007,925
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$10,735,233
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$10,735,233
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$55,275
Investment advisory and management fees2019-12-31$55,275
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$7,398,280
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$7,398,280
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$6,072,368
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$6,072,368
Income. Interest from US Government securities2019-12-31$1,596
Income. Interest from US Government securities2019-12-31$1,596
Income. Interest from corporate debt instruments2019-12-31$30,879
Income. Interest from corporate debt instruments2019-12-31$30,879
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$2,650,242
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$2,650,242
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,229,165
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,229,165
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,229,165
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,229,165
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$15,657
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$15,657
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$12,472,852
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$12,472,852
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$760,381
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$760,381
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$13,459,166
Income. Dividends from common stock2019-12-31$43,193
Income. Dividends from common stock2019-12-31$43,193
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$255,742
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$255,742
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$1,123,383
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$1,095,960
Contract administrator fees2019-12-31$19,258
Contract administrator fees2019-12-31$19,258
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$1,298,568
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$1,298,568
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$1,829,919
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$1,829,919
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$46
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$46
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$4,622,413
Aggregate proceeds on sale of assets2019-12-31$4,622,413
Aggregate carrying amount (costs) on sale of assets2019-12-31$4,536,592
Aggregate carrying amount (costs) on sale of assets2019-12-31$4,536,592
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31KOSMERL & CO., P.C.
Accountancy firm name2019-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2019-12-31232872012
Accountancy firm EIN2019-12-31232872012
2018 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-217,027
Total unrealized appreciation/depreciation of assets2018-12-31$-217,027
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$27,035
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$10,872,547
Total loss/gain on sale of assets2018-12-31$-108,768
Total of all expenses incurred2018-12-31$11,225,564
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$10,923,554
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$11,262,937
Value of total assets at end of year2018-12-31$10,762,268
Value of total assets at beginning of year2018-12-31$11,088,250
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$302,010
Total interest from all sources2018-12-31$43,951
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$362,483
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$298,230
Administrative expenses professional fees incurred2018-12-31$57,475
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$416,260
Administrative expenses (other) incurred2018-12-31$172,330
Liabilities. Value of operating payables at end of year2018-12-31$27,035
Total non interest bearing cash at end of year2018-12-31$534,810
Total non interest bearing cash at beginning of year2018-12-31$421,050
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-353,017
Value of net assets at end of year (total assets less liabilities)2018-12-31$10,735,233
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$11,088,250
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$55,644
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$6,072,368
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$6,000,691
Income. Interest from corporate debt instruments2018-12-31$37,270
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$1,229,165
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$774,467
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$774,467
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$6,681
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$10,673,488
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-471,029
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$10,846,677
Income. Dividends from common stock2018-12-31$64,253
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$250,066
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$1,095,960
Asset. Corporate debt instrument preferred debt at beginning of year2018-12-31$1,724,281
Contract administrator fees2018-12-31$16,561
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$1,829,919
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$2,166,430
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$46
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$1,331
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$3,386,684
Aggregate carrying amount (costs) on sale of assets2018-12-31$3,495,452
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2018-12-31232872012
2017 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$220,733
Total unrealized appreciation/depreciation of assets2017-12-31$220,733
Total income from all sources (including contributions)2017-12-31$10,760,141
Total loss/gain on sale of assets2017-12-31$93,022
Total of all expenses incurred2017-12-31$9,669,989
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$9,389,170
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$9,938,433
Value of total assets at end of year2017-12-31$11,088,250
Value of total assets at beginning of year2017-12-31$9,998,098
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$280,819
Total interest from all sources2017-12-31$52,497
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$282,314
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$212,931
Administrative expenses professional fees incurred2017-12-31$58,869
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$416,934
Administrative expenses (other) incurred2017-12-31$153,871
Total non interest bearing cash at end of year2017-12-31$421,050
Total non interest bearing cash at beginning of year2017-12-31$185,367
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,090,152
Value of net assets at end of year (total assets less liabilities)2017-12-31$11,088,250
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$9,998,098
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$53,162
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$6,000,691
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$3,344,282
Income. Interest from corporate debt instruments2017-12-31$49,513
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$774,467
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$1,101,456
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$1,101,456
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$2,984
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$9,140,769
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$173,142
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$9,521,499
Income. Dividends from common stock2017-12-31$69,383
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$248,401
Asset. Corporate debt instrument preferred debt at end of year2017-12-31$1,724,281
Asset. Corporate debt instrument preferred debt at beginning of year2017-12-31$2,365,170
Contract administrator fees2017-12-31$14,917
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$2,166,430
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$2,998,282
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$1,331
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$3,541
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$5,131,960
Aggregate carrying amount (costs) on sale of assets2017-12-31$5,038,938
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2017-12-31232872012
2016 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$248,963
Total unrealized appreciation/depreciation of assets2016-12-31$248,963
Total income from all sources (including contributions)2016-12-31$8,857,703
Total loss/gain on sale of assets2016-12-31$-39,522
Total of all expenses incurred2016-12-31$8,083,981
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$7,806,273
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$8,424,787
Value of total assets at end of year2016-12-31$9,998,098
Value of total assets at beginning of year2016-12-31$9,224,376
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$277,708
Total interest from all sources2016-12-31$58,363
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$135,949
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$57,964
Administrative expenses professional fees incurred2016-12-31$50,190
Was this plan covered by a fidelity bond2016-12-31No
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$400,120
Administrative expenses (other) incurred2016-12-31$164,448
Total non interest bearing cash at end of year2016-12-31$185,367
Total non interest bearing cash at beginning of year2016-12-31$259,245
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$773,722
Value of net assets at end of year (total assets less liabilities)2016-12-31$9,998,098
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$9,224,376
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$48,891
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$3,344,282
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$4,974,494
Income. Interest from corporate debt instruments2016-12-31$53,770
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$1,101,456
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$1,928,841
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$1,928,841
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$4,593
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$7,580,088
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$29,163
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$8,024,667
Income. Dividends from common stock2016-12-31$77,985
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$226,185
Asset. Corporate debt instrument preferred debt at end of year2016-12-31$2,365,170
Contract administrator fees2016-12-31$14,179
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$2,998,282
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$2,056,045
Assets. Value of buildings and other operty used in plan operation at end of year2016-12-31$3,541
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$5,751
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$9,691,398
Aggregate carrying amount (costs) on sale of assets2016-12-31$9,730,920
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2016-12-31232872012
2015 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-36,983
Total unrealized appreciation/depreciation of assets2015-12-31$-36,983
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$30,228
Total income from all sources (including contributions)2015-12-31$7,708,189
Total loss/gain on sale of assets2015-12-31$-78,544
Total of all expenses incurred2015-12-31$7,470,056
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$7,175,880
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$7,684,838
Value of total assets at end of year2015-12-31$9,224,376
Value of total assets at beginning of year2015-12-31$9,016,471
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$294,176
Total interest from all sources2015-12-31$2,194
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$243,963
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$186,351
Administrative expenses professional fees incurred2015-12-31$49,335
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$401,721
Administrative expenses (other) incurred2015-12-31$184,694
Liabilities. Value of operating payables at beginning of year2015-12-31$1,000
Total non interest bearing cash at end of year2015-12-31$259,245
Total non interest bearing cash at beginning of year2015-12-31$179,855
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$238,133
Value of net assets at end of year (total assets less liabilities)2015-12-31$9,224,376
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$8,986,243
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$45,586
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$4,974,494
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$5,050,730
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$1,928,841
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$2,185,251
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$2,185,251
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$2,194
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$6,729,276
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-107,279
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$7,283,117
Income. Dividends from common stock2015-12-31$57,612
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$446,604
Contract administrator fees2015-12-31$14,561
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$2,056,045
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$1,592,527
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$29,228
Assets. Value of buildings and other operty used in plan operation at end of year2015-12-31$5,751
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-12-31$8,108
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$4,105,244
Aggregate carrying amount (costs) on sale of assets2015-12-31$4,183,788
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2015-12-31232872012
2014 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$74,068
Total unrealized appreciation/depreciation of assets2014-12-31$74,068
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$30,228
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$24,942
Total income from all sources (including contributions)2014-12-31$7,538,682
Total loss/gain on sale of assets2014-12-31$-59,755
Total of all expenses incurred2014-12-31$6,764,852
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$6,522,623
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$7,274,851
Value of total assets at end of year2014-12-31$9,016,471
Value of total assets at beginning of year2014-12-31$8,237,355
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$242,229
Total interest from all sources2014-12-31$2,896
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$258,484
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$227,522
Administrative expenses professional fees incurred2014-12-31$44,950
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$396,823
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$11,187
Other income not declared elsewhere2014-12-31$1,245
Administrative expenses (other) incurred2014-12-31$141,708
Liabilities. Value of operating payables at end of year2014-12-31$1,000
Liabilities. Value of operating payables at beginning of year2014-12-31$881
Total non interest bearing cash at end of year2014-12-31$179,855
Total non interest bearing cash at beginning of year2014-12-31$69,972
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$773,830
Value of net assets at end of year (total assets less liabilities)2014-12-31$8,986,243
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$8,212,413
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$41,909
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$5,050,730
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$6,233,658
Income. Interest from US Government securities2014-12-31$856
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$2,185,251
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$943,497
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$943,497
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$2,040
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$6,092,200
Asset value of US Government securities at beginning of year2014-12-31$201,698
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-13,107
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$6,878,028
Income. Dividends from common stock2014-12-31$30,962
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$430,423
Contract administrator fees2014-12-31$13,662
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$1,592,527
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$766,734
Liabilities. Value of benefit claims payable at end of year2014-12-31$29,228
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$24,061
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$8,108
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$10,609
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$3,447,504
Aggregate carrying amount (costs) on sale of assets2014-12-31$3,507,259
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2014-12-31232872012
2013 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$131,209
Total unrealized appreciation/depreciation of assets2013-12-31$131,209
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$24,942
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$26,200
Total income from all sources (including contributions)2013-12-31$7,219,808
Total loss/gain on sale of assets2013-12-31$12,621
Total of all expenses incurred2013-12-31$6,531,905
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$6,296,859
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$6,784,816
Value of total assets at end of year2013-12-31$8,237,355
Value of total assets at beginning of year2013-12-31$7,550,710
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$235,046
Total interest from all sources2013-12-31$4,707
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$203,089
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$189,010
Administrative expenses professional fees incurred2013-12-31$47,275
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$406,212
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$11,187
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$9,217
Other income not declared elsewhere2013-12-31$310
Administrative expenses (other) incurred2013-12-31$135,097
Liabilities. Value of operating payables at end of year2013-12-31$881
Liabilities. Value of operating payables at beginning of year2013-12-31$1,000
Total non interest bearing cash at end of year2013-12-31$69,972
Total non interest bearing cash at beginning of year2013-12-31$72,397
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$687,903
Value of net assets at end of year (total assets less liabilities)2013-12-31$8,212,413
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$7,524,510
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$40,263
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$6,233,658
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$6,225,192
Income. Interest from US Government securities2013-12-31$3,500
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$943,497
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$670,246
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$670,246
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$1,207
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$5,866,770
Asset value of US Government securities at end of year2013-12-31$201,698
Asset value of US Government securities at beginning of year2013-12-31$204,698
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$83,056
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$6,378,604
Income. Dividends from common stock2013-12-31$14,079
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$430,089
Contract administrator fees2013-12-31$12,411
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$766,734
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$367,080
Liabilities. Value of benefit claims payable at end of year2013-12-31$24,061
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$25,200
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$10,609
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$1,880
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$100,702
Aggregate carrying amount (costs) on sale of assets2013-12-31$88,081
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2013-12-31232872012
2012 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$7,494
Total unrealized appreciation/depreciation of assets2012-12-31$7,494
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$26,200
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$25,450
Total income from all sources (including contributions)2012-12-31$6,987,252
Total loss/gain on sale of assets2012-12-31$-2,649
Total of all expenses incurred2012-12-31$6,568,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$6,328,472
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$6,518,552
Value of total assets at end of year2012-12-31$7,550,710
Value of total assets at beginning of year2012-12-31$7,130,890
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$239,710
Total interest from all sources2012-12-31$7,422
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$176,640
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$168,248
Administrative expenses professional fees incurred2012-12-31$65,865
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$428,945
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$9,217
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$3,856
Administrative expenses (other) incurred2012-12-31$119,952
Liabilities. Value of operating payables at end of year2012-12-31$1,000
Liabilities. Value of operating payables at beginning of year2012-12-31$1,000
Total non interest bearing cash at end of year2012-12-31$72,397
Total non interest bearing cash at beginning of year2012-12-31$43,548
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$419,070
Value of net assets at end of year (total assets less liabilities)2012-12-31$7,524,510
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$7,105,440
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$39,226
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$6,225,192
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$6,137,936
Income. Interest from US Government securities2012-12-31$7,000
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$670,246
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$387,068
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$387,068
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$422
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$5,850,838
Asset value of US Government securities at end of year2012-12-31$204,698
Asset value of US Government securities at beginning of year2012-12-31$410,349
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$279,793
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$6,089,607
Income. Dividends from common stock2012-12-31$8,392
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$477,634
Contract administrator fees2012-12-31$14,667
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$367,080
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$146,380
Liabilities. Value of benefit claims payable at end of year2012-12-31$25,200
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$24,450
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$1,880
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$1,753
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$235,547
Aggregate carrying amount (costs) on sale of assets2012-12-31$238,196
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2012-12-31232872012
2011 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$25,450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$33,291
Total income from all sources (including contributions)2011-12-31$6,366,463
Total of all expenses incurred2011-12-31$6,237,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$5,989,804
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$6,146,783
Value of total assets at end of year2011-12-31$7,130,890
Value of total assets at beginning of year2011-12-31$7,009,316
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$247,244
Total interest from all sources2011-12-31$11,382
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$173,779
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$169,619
Administrative expenses professional fees incurred2011-12-31$38,975
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$507,125
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$3,856
Other income not declared elsewhere2011-12-31$1,071
Administrative expenses (other) incurred2011-12-31$156,411
Liabilities. Value of operating payables at end of year2011-12-31$1,000
Liabilities. Value of operating payables at beginning of year2011-12-31$7,971
Total non interest bearing cash at end of year2011-12-31$43,548
Total non interest bearing cash at beginning of year2011-12-31$27,277
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$129,415
Value of net assets at end of year (total assets less liabilities)2011-12-31$7,105,440
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$6,976,025
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$38,313
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$6,137,936
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$5,365,691
Income. Interest from US Government securities2011-12-31$10,690
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$387,068
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$354,236
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$354,236
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$692
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$5,514,958
Asset value of US Government securities at end of year2011-12-31$410,349
Asset value of US Government securities at beginning of year2011-12-31$1,112,399
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$33,448
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$5,639,658
Income. Dividends from common stock2011-12-31$4,160
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$474,846
Contract administrator fees2011-12-31$13,545
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$146,380
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$145,160
Liabilities. Value of benefit claims payable at end of year2011-12-31$24,450
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$25,320
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$1,753
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$4,553
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2011-12-31232872012
2010 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$33,291
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$28,856
Total income from all sources (including contributions)2010-12-31$6,043,236
Total of all expenses incurred2010-12-31$5,688,620
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$5,422,041
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$5,659,638
Value of total assets at end of year2010-12-31$7,009,316
Value of total assets at beginning of year2010-12-31$6,650,265
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$266,579
Total interest from all sources2010-12-31$17,528
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$156,342
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$156,342
Administrative expenses professional fees incurred2010-12-31$63,945
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$358,780
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$1,413
Other income not declared elsewhere2010-12-31$6,593
Administrative expenses (other) incurred2010-12-31$153,528
Liabilities. Value of operating payables at end of year2010-12-31$7,971
Liabilities. Value of operating payables at beginning of year2010-12-31$1,000
Total non interest bearing cash at end of year2010-12-31$27,277
Total non interest bearing cash at beginning of year2010-12-31$56,162
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$354,616
Value of net assets at end of year (total assets less liabilities)2010-12-31$6,976,025
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$6,621,409
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$36,218
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$5,365,691
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$5,664,100
Income. Interest from US Government securities2010-12-31$15,154
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$354,236
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$922,069
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$922,069
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$2,374
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$4,957,154
Asset value of US Government securities at end of year2010-12-31$1,112,399
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$203,135
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$5,300,858
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$464,887
Contract administrator fees2010-12-31$12,888
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$145,160
Liabilities. Value of benefit claims payable at end of year2010-12-31$25,320
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$27,856
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$4,553
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$6,521
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31KOSMERL & CO., P.C.
Accountancy firm EIN2010-12-31232872012

Form 5500 Responses for TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN

2023: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-01-01Type of plan entityMulti-employer plan
2023-01-01Plan is a collectively bargained planYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entityMulti-employer plan
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Submission has been amendedYes
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number540675/491034/2
Policy instance 2
Insurance contract or identification number540675/491034/2
Number of Individuals Covered896
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,425
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $303,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 54720 )
Policy contract number00531937
Policy instance 6
Insurance contract or identification number00531937
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,187,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number238539
Policy instance 5
Insurance contract or identification number238539
Number of Individuals Covered38
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $609,850
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 numberA 14204-099&000
Policy instance 4
Insurance contract or identification numberA 14204-099&000
Number of Individuals Covered72
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,732
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 number252043-000-005
Policy instance 3
Insurance contract or identification number252043-000-005
Number of Individuals Covered578
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $248,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number116552
Policy instance 1
Insurance contract or identification number116552
Number of Individuals Covered367
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,352,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229376
Policy instance 2
Insurance contract or identification number229376
Number of Individuals Covered1195
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,232,171
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number116552
Policy instance 1
Insurance contract or identification number116552
Number of Individuals Covered372
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,204,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number238539
Policy instance 6
Insurance contract or identification number238539
Number of Individuals Covered40
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $480,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number540675/491034/2
Policy instance 3
Insurance contract or identification number540675/491034/2
Number of Individuals Covered899
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $20,731
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $531,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,731
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number252043-000-005
Policy instance 4
Insurance contract or identification number252043-000-005
Number of Individuals Covered594
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $250,229
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 numberA 14204-099&000
Policy instance 5
Insurance contract or identification numberA 14204-099&000
Number of Individuals Covered71
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 54720 )
Policy contract number00531937
Policy instance 7
Insurance contract or identification number00531937
Number of Individuals Covered695
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,223,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number116552
Policy instance 1
Insurance contract or identification number116552
Number of Individuals Covered570
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,878,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229376
Policy instance 2
Insurance contract or identification number229376
Number of Individuals Covered589
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,147,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number540675/491034/2
Policy instance 3
Insurance contract or identification number540675/491034/2
Number of Individuals Covered1487
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $19,577
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $215,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,564
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number252043-000-004
Policy instance 4
Insurance contract or identification number252043-000-004
Number of Individuals Covered570
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $232,909
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number238539
Policy instance 6
Insurance contract or identification number238539
Number of Individuals Covered29
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $253,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number10404145
Policy instance 7
Insurance contract or identification number10404145
Number of Individuals Covered88
Insurance policy start date2021-01-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $358,377
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 numberA 14204-099&000
Policy instance 5
Insurance contract or identification numberA 14204-099&000
Number of Individuals Covered88
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229376
Policy instance 2
Insurance contract or identification number229376
Number of Individuals Covered520
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,950,881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number238539
Policy instance 9
Insurance contract or identification number238539
Number of Individuals Covered37
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,937
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 numberA14204-099&000
Policy instance 8
Insurance contract or identification numberA14204-099&000
Number of Individuals Covered37
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00540675
Policy instance 7
Insurance contract or identification number00540675
Number of Individuals Covered37
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $1,170
Welfare Benefit Premiums Paid to CarrierUSD $11,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,170
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number3217
Policy instance 6
Insurance contract or identification number3217
Number of Individuals Covered520
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $258,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number116552
Policy instance 1
Insurance contract or identification number116552
Number of Individuals Covered184
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,027,444
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491034
Policy instance 3
Insurance contract or identification number00491034
Number of Individuals Covered520
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $10,058
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $251,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,058
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number252043-000, ETC
Policy instance 5
Insurance contract or identification number252043-000, ETC
Number of Individuals Covered184
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $191,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491032
Policy instance 4
Insurance contract or identification number00491032
Number of Individuals Covered184
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $5,953
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,953
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number10404145
Policy instance 10
Insurance contract or identification number10404145
Number of Individuals Covered38
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $557,957
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 numberA14204-099&000
Policy instance 8
Insurance contract or identification numberA14204-099&000
Number of Individuals Covered38
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,717
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 number3217
Policy instance 6
Insurance contract or identification number3217
Number of Individuals Covered415
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,541
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $308,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,541
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00540675
Policy instance 7
Insurance contract or identification number00540675
Number of Individuals Covered38
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $1,146
Welfare Benefit Premiums Paid to CarrierUSD $11,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,146
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number116552
Policy instance 1
Insurance contract or identification number116552
Number of Individuals Covered174
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,390,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229376
Policy instance 2
Insurance contract or identification number229376
Number of Individuals Covered406
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,639,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491034
Policy instance 3
Insurance contract or identification number00491034
Number of Individuals Covered774
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $8,637
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $214,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,637
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491032
Policy instance 4
Insurance contract or identification number00491032
Number of Individuals Covered158
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $5,885
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,885
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number252043-000, ETC
Policy instance 5
Insurance contract or identification number252043-000, ETC
Number of Individuals Covered177
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $183,031
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 number3217
Policy instance 6
Insurance contract or identification number3217
Number of Individuals Covered352
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,325
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $281,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,325
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract numberA14204-099&000
Policy instance 8
Insurance contract or identification numberA14204-099&000
Number of Individuals Covered37
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491034
Policy instance 3
Insurance contract or identification number00491034
Number of Individuals Covered307
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $8,121
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $175,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,121
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229376
Policy instance 2
Insurance contract or identification number229376
Number of Individuals Covered302
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,858,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00540675
Policy instance 7
Insurance contract or identification number00540675
Number of Individuals Covered37
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Welfare Benefit Premiums Paid to CarrierUSD $12,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number116552
Policy instance 1
Insurance contract or identification number116552
Number of Individuals Covered173
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,077,194
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 number252043-000, ETC
Policy instance 5
Insurance contract or identification number252043-000, ETC
Number of Individuals Covered177
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491032
Policy instance 4
Insurance contract or identification number00491032
Number of Individuals Covered159
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $5,324
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,324
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number116552
Policy instance 1
Insurance contract or identification number116552
Number of Individuals Covered178
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,093,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491034
Policy instance 3
Insurance contract or identification number00491034
Number of Individuals Covered279
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $6,911
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,911
Insurance broker nameHOWELL BENEFIT SERVICES LLC
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number252043-000, ETC
Policy instance 5
Insurance contract or identification number252043-000, ETC
Number of Individuals Covered177
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $170,101
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 number3217
Policy instance 6
Insurance contract or identification number3217
Number of Individuals Covered314
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,193
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $253,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,193
Insurance broker nameDELAWARE VALLEY HEALTH CARE
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number229376
Policy instance 2
Insurance contract or identification number229376
Number of Individuals Covered302
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,705,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491032
Policy instance 4
Insurance contract or identification number00491032
Number of Individuals Covered157
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $5,187
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,187
Insurance broker nameHOWELL BENEFIT SERVICES INC
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number032868 & ETC
Policy instance 2
Insurance contract or identification number032868 & ETC
Number of Individuals Covered172
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00500104
Policy instance 3
Insurance contract or identification number00500104
Number of Individuals Covered256
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00500104
Policy instance 4
Insurance contract or identification number00500104
Number of Individuals Covered256
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00500104
Policy instance 5
Insurance contract or identification number00500104
Number of Individuals Covered256
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491034
Policy instance 6
Insurance contract or identification number00491034
Number of Individuals Covered234
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $5,880
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $95,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,880
Insurance broker nameHOWELL BENEFIT SERVICES LLC
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number252043-000, ETC
Policy instance 8
Insurance contract or identification number252043-000, ETC
Number of Individuals Covered520
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $170,170
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 number3217
Policy instance 9
Insurance contract or identification number3217
Number of Individuals Covered256
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,165
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $232,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,165
Insurance broker nameDELAWARE VALLEY HEALTH CARE
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491032
Policy instance 7
Insurance contract or identification number00491032
Number of Individuals Covered156
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $4,310
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,952
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,310
Insurance broker nameHOWELL BENEFIT SERVICES INC
BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 )
Policy contract number032868 & ETC
Policy instance 1
Insurance contract or identification number032868 & ETC
Number of Individuals Covered172
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491032
Policy instance 5
Insurance contract or identification number00491032
Number of Individuals Covered153
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $4,756
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,710
Insurance broker nameFINANCIAL BALANCE GROUP LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00491034
Policy instance 4
Insurance contract or identification number00491034
Number of Individuals Covered230
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $5,919
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,854
Insurance broker nameFINANCIAL BALANCE GROUP LLC
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number3217
Policy instance 7
Insurance contract or identification number3217
Number of Individuals Covered262
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,085
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $216,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,085
Insurance broker nameDELAWARE VALLEY HEALTH CARE COLTION
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 3
Insurance contract or identification number00500104
Number of Individuals Covered258
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54747 )
Policy contract number032868 & ETC
Policy instance 1
Insurance contract or identification number032868 & ETC
Number of Individuals Covered163
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 2
Insurance contract or identification number00500104
Number of Individuals Covered258
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number252043-000, ETC
Policy instance 6
Insurance contract or identification number252043-000, ETC
Number of Individuals Covered519
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $156,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 3
Insurance contract or identification number00500104
Number of Individuals Covered260
Insurance policy start date2013-01-01
Insurance policy end date2013-07-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54747 )
Policy contract number032868 & ETC
Policy instance 1
Insurance contract or identification number032868 & ETC
Number of Individuals Covered164
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00500104
Policy instance 12
Insurance contract or identification number00500104
Number of Individuals Covered259
Insurance policy start date2013-08-01
Insurance policy end date2013-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00500104
Policy instance 11
Insurance contract or identification number00500104
Number of Individuals Covered259
Insurance policy start date2013-08-01
Insurance policy end date2013-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00500104
Policy instance 10
Insurance contract or identification number00500104
Number of Individuals Covered259
Insurance policy start date2013-08-01
Insurance policy end date2013-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 9
Insurance contract or identification number00500104
Number of Individuals Covered260
Insurance policy start date2013-01-01
Insurance policy end date2013-07-31
Vision Insurance Welfare BenefitYes
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 number3217
Policy instance 8
Insurance contract or identification number3217
Number of Individuals Covered260
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $993
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $210,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $993
Insurance broker nameDELAWARE VALLEY HEALTH CARE COLTION
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG14346
Policy instance 7
Insurance contract or identification numberMG14346
Number of Individuals Covered230
Insurance policy start date2012-09-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $6,926
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,926
Insurance broker nameCONSOLIDATED BENEFIT DEPT 774232
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number252043-000, ETC
Policy instance 6
Insurance contract or identification number252043-000, ETC
Number of Individuals Covered529
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $154,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFWB0318
Policy instance 5
Insurance contract or identification numberFWB0318
Number of Individuals Covered147
Insurance policy start date2012-09-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $5,678
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,678
Insurance broker nameROGER G HOWELL
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 2
Insurance contract or identification number00500104
Number of Individuals Covered260
Insurance policy start date2013-01-01
Insurance policy end date2013-07-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFWB0029
Policy instance 4
Insurance contract or identification numberFWB0029
Number of Individuals Covered8
Insurance policy start date2012-09-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $472
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $472
Insurance broker nameHOWELL BENEFIT SERVICES INC
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number3217
Policy instance 8
Insurance contract or identification number3217
Number of Individuals Covered258
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,199
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $254,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,199
Insurance broker nameDELAWARE VALLEY HEALTH CARE COLTION
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG14346
Policy instance 7
Insurance contract or identification numberMG14346
Number of Individuals Covered232
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $6,374
Total amount of fees paid to insurance companyUSD $672
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $137,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,374
Amount paid for insurance broker fees672
Insurance broker nameCONSOLIDATED BENEFIT DEPT 774232
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number252043-000, ETC
Policy instance 6
Insurance contract or identification number252043-000, ETC
Number of Individuals Covered494
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $150,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFWB0318
Policy instance 5
Insurance contract or identification numberFWB0318
Number of Individuals Covered144
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $5,232
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,232
Insurance broker nameROGER G HOWELL
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFWB0029
Policy instance 4
Insurance contract or identification numberFWB0029
Number of Individuals Covered8
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $459
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $459
Insurance broker nameHOWELL BENEFIT SERVICES INC
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 3
Insurance contract or identification number00500104
Number of Individuals Covered257
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54747 )
Policy contract number032868 & ETC
Policy instance 1
Insurance contract or identification number032868 & ETC
Number of Individuals Covered164
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 9
Insurance contract or identification number00500104
Number of Individuals Covered257
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 2
Insurance contract or identification number00500104
Number of Individuals Covered257
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 2
Insurance contract or identification number00500104
Number of Individuals Covered266
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 3
Insurance contract or identification number00500104
Number of Individuals Covered266
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFWB0029
Policy instance 4
Insurance contract or identification numberFWB0029
Number of Individuals Covered8
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $493
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFWB0318
Policy instance 5
Insurance contract or identification numberFWB0318
Number of Individuals Covered140
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $5,164
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL VISION ADMINISTRATORS, LLC (National Association of Insurance Commissioners NAIC id number: 66842 )
Policy contract number00500104
Policy instance 6
Insurance contract or identification number00500104
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number252043-000 ETC
Policy instance 7
Insurance contract or identification number252043-000 ETC
Number of Individuals Covered484
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $169,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG14346
Policy instance 8
Insurance contract or identification numberMG14346
Number of Individuals Covered232
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $6,326
Total amount of fees paid to insurance companyUSD $604
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $136,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 10
Insurance contract or identification number00500104
Number of Individuals Covered265
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54747 )
Policy contract number032868 ETC
Policy instance 1
Insurance contract or identification number032868 ETC
Number of Individuals Covered155
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 number3217
Policy instance 9
Insurance contract or identification number3217
Number of Individuals Covered269
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,077
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $239,300
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 number3217
Policy instance 9
Insurance contract or identification number3217
Number of Individuals Covered271
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,036
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54747 )
Policy contract number032868 ETC
Policy instance 1
Insurance contract or identification number032868 ETC
Number of Individuals Covered156
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 2
Insurance contract or identification number00500104
Number of Individuals Covered270
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 )
Policy contract number00500104
Policy instance 3
Insurance contract or identification number00500104
Number of Individuals Covered270
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFWB0029
Policy instance 4
Insurance contract or identification numberFWB0029
Number of Individuals Covered10
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $573
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL VISION ADMINISTRATORS, LLC (National Association of Insurance Commissioners NAIC id number: 66842 )
Policy contract number00500104
Policy instance 6
Insurance contract or identification number00500104
Number of Individuals Covered269
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number252043-000 ETC
Policy instance 7
Insurance contract or identification number252043-000 ETC
Number of Individuals Covered490
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG14346
Policy instance 8
Insurance contract or identification numberMG14346
Number of Individuals Covered233
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $6,345
Total amount of fees paid to insurance companyUSD $362
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFWB0318
Policy instance 5
Insurance contract or identification numberFWB0318
Number of Individuals Covered143
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $4,880
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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