TEAMSTERS LOCAL 401 H AND W has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN
| Measure | Date | Value |
|---|
| 2022 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-143,377 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-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 assets | 2022-12-31 | $-29,579 |
| Total of all expenses incurred | 2022-12-31 | $20,964,134 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $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 year | 2022-12-31 | $17,628,820 |
| Value of total assets at beginning of year | 2022-12-31 | $17,451,665 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $349,186 |
| Total interest from all sources | 2022-12-31 | $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 year | 2022-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $280,720 |
| Administrative expenses professional fees incurred | 2022-12-31 | $118,888 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $538,502 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $28,360 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $60,346 |
| Other income not declared elsewhere | 2022-12-31 | $100,000 |
| Administrative expenses (other) incurred | 2022-12-31 | $165,934 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $9,442 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $47,370 |
| Total non interest bearing cash at end of year | 2022-12-31 | $3,842,034 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $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 appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $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) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $64,364 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $8,668,469 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $11,268,540 |
| Interest earned on other investments | 2022-12-31 | $10,930 |
| Income. Interest from corporate debt instruments | 2022-12-31 | $15,775 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $2,853,587 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $797,054 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $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 benefits | 2022-12-31 | $19,938,041 |
| Asset value of US Government securities at end of year | 2022-12-31 | $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 assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $22,773,270 |
| Employer contributions (assets) at end of year | 2022-12-31 | $167,405 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $104,076 |
| Income. Dividends from common stock | 2022-12-31 | $33,646 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $676,907 |
| Asset. Corporate debt instrument preferred debt at end of year | 2022-12-31 | $581,415 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2022-12-31 | $667,729 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2022-12-31 | $1,191,462 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2022-12-31 | $1,344,259 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $94,073 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $164,901 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Aggregate proceeds on sale of assets | 2022-12-31 | $1,426,931 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $1,456,510 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2022-12-31 | 611436956 |
| 2021 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $-68,822 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $-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 assets | 2021-12-31 | $26,368 |
| Total of all expenses incurred | 2021-12-31 | $20,266,249 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $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 year | 2021-12-31 | $17,451,665 |
| Value of total assets at beginning of year | 2021-12-31 | $15,743,186 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $1,131,951 |
| Total interest from all sources | 2021-12-31 | $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 year | 2021-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $378,623 |
| Administrative expenses professional fees incurred | 2021-12-31 | $119,214 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | Yes |
| Amount of non-exempt transactions with any party-in-interest | 2021-12-31 | $15,080 |
| Contributions received from participants | 2021-12-31 | $362,529 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $60,346 |
| Administrative expenses (other) incurred | 2021-12-31 | $945,942 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $47,370 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $22,055 |
| Total non interest bearing cash at end of year | 2021-12-31 | $3,209,661 |
| Total non interest bearing cash at beginning of year | 2021-12-31 | $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 appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $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) | 2021-12-31 | Yes |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Investment advisory and management fees | 2021-12-31 | $66,795 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $11,268,540 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $8,695,693 |
| Income. Interest from corporate debt instruments | 2021-12-31 | $17,613 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $797,054 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $1,442,852 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $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 benefits | 2021-12-31 | $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 assets | 2021-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $19,639,442 |
| Employer contributions (assets) at end of year | 2021-12-31 | $104,076 |
| Income. Dividends from common stock | 2021-12-31 | $29,332 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $772,227 |
| Asset. Corporate debt instrument preferred debt at end of year | 2021-12-31 | $667,729 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2021-12-31 | $897,554 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2021-12-31 | $1,344,259 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2021-12-31 | $1,289,744 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $164,901 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Aggregate proceeds on sale of assets | 2021-12-31 | $2,024,693 |
| Aggregate carrying amount (costs) on sale of assets | 2021-12-31 | $1,998,325 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | NOVAK FRANCELLA, LLC |
| Accountancy firm EIN | 2021-12-31 | 611436956 |
| 2020 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $216,730 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $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 assets | 2020-12-31 | $-192,752 |
| Total of all expenses incurred | 2020-12-31 | $15,634,646 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $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 year | 2020-12-31 | $15,743,186 |
| Value of total assets at beginning of year | 2020-12-31 | $13,028,177 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $301,168 |
| Total interest from all sources | 2020-12-31 | $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 year | 2020-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $199,806 |
| Administrative expenses professional fees incurred | 2020-12-31 | $58,595 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $405,297 |
| Administrative expenses (other) incurred | 2020-12-31 | $168,121 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $22,055 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $20,252 |
| Total non interest bearing cash at end of year | 2020-12-31 | $3,417,343 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $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 appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $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) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Investment advisory and management fees | 2020-12-31 | $58,318 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $8,695,693 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $7,398,280 |
| Income. Interest from corporate debt instruments | 2020-12-31 | $24,197 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $1,442,852 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $2,650,242 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $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 benefits | 2020-12-31 | $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 assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $16,810,244 |
| Income. Dividends from common stock | 2020-12-31 | $35,345 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $236,927 |
| Asset. Corporate debt instrument preferred debt at end of year | 2020-12-31 | $897,554 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2020-12-31 | $1,123,383 |
| Contract administrator fees | 2020-12-31 | $16,134 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2020-12-31 | $1,289,744 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2020-12-31 | $1,298,568 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Aggregate proceeds on sale of assets | 2020-12-31 | $2,343,077 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $2,535,829 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Disclaimer |
| Accountancy firm name | 2020-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2020-12-31 | 232872012 |
| 2019 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $249,392 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $249,392 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $249,392 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $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 assets | 2019-12-31 | $85,821 |
| Total loss/gain on sale of assets | 2019-12-31 | $85,821 |
| Total of all expenses incurred | 2019-12-31 | $13,050,175 |
| Total of all expenses incurred | 2019-12-31 | $13,050,175 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $12,728,594 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $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 year | 2019-12-31 | $13,028,177 |
| Value of total assets at beginning of year | 2019-12-31 | $10,762,268 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $321,581 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $321,581 |
| Total interest from all sources | 2019-12-31 | $48,132 |
| Total interest from all sources | 2019-12-31 | $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 year | 2019-12-31 | No |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $263,392 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $263,392 |
| Administrative expenses professional fees incurred | 2019-12-31 | $60,695 |
| Administrative expenses professional fees incurred | 2019-12-31 | $60,695 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $413,390 |
| Contributions received from participants | 2019-12-31 | $413,390 |
| Administrative expenses (other) incurred | 2019-12-31 | $186,353 |
| Administrative expenses (other) incurred | 2019-12-31 | $186,353 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $20,252 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $27,035 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $27,035 |
| Total non interest bearing cash at end of year | 2019-12-31 | $557,704 |
| Total non interest bearing cash at end of year | 2019-12-31 | $557,704 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $534,810 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $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 appraiser | 2019-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $2,272,692 |
| Value of net income/loss | 2019-12-31 | $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) | 2019-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Investment advisory and management fees | 2019-12-31 | $55,275 |
| Investment advisory and management fees | 2019-12-31 | $55,275 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $7,398,280 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $7,398,280 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $6,072,368 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $6,072,368 |
| Income. Interest from US Government securities | 2019-12-31 | $1,596 |
| Income. Interest from US Government securities | 2019-12-31 | $1,596 |
| Income. Interest from corporate debt instruments | 2019-12-31 | $30,879 |
| Income. Interest from corporate debt instruments | 2019-12-31 | $30,879 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $2,650,242 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $2,650,242 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $1,229,165 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $1,229,165 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $1,229,165 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $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 benefits | 2019-12-31 | $12,472,852 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $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 assets | 2019-12-31 | Yes |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $13,459,166 |
| Income. Dividends from common stock | 2019-12-31 | $43,193 |
| Income. Dividends from common stock | 2019-12-31 | $43,193 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $255,742 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $255,742 |
| Asset. Corporate debt instrument preferred debt at end of year | 2019-12-31 | $1,123,383 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2019-12-31 | $1,095,960 |
| Contract administrator fees | 2019-12-31 | $19,258 |
| Contract administrator fees | 2019-12-31 | $19,258 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2019-12-31 | $1,298,568 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2019-12-31 | $1,298,568 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2019-12-31 | $1,829,919 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2019-12-31 | $1,829,919 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-12-31 | $46 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-12-31 | $46 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Aggregate proceeds on sale of assets | 2019-12-31 | $4,622,413 |
| Aggregate proceeds on sale of assets | 2019-12-31 | $4,622,413 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $4,536,592 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $4,536,592 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Accountancy firm name | 2019-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm name | 2019-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2019-12-31 | 232872012 |
| Accountancy firm EIN | 2019-12-31 | 232872012 |
| 2018 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-217,027 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-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 assets | 2018-12-31 | $-108,768 |
| Total of all expenses incurred | 2018-12-31 | $11,225,564 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $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 year | 2018-12-31 | $10,762,268 |
| Value of total assets at beginning of year | 2018-12-31 | $11,088,250 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $302,010 |
| Total interest from all sources | 2018-12-31 | $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 year | 2018-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $298,230 |
| Administrative expenses professional fees incurred | 2018-12-31 | $57,475 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $416,260 |
| Administrative expenses (other) incurred | 2018-12-31 | $172,330 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $27,035 |
| Total non interest bearing cash at end of year | 2018-12-31 | $534,810 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $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 appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $-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) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Investment advisory and management fees | 2018-12-31 | $55,644 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $6,072,368 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $6,000,691 |
| Income. Interest from corporate debt instruments | 2018-12-31 | $37,270 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $1,229,165 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $774,467 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $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 benefits | 2018-12-31 | $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 assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $10,846,677 |
| Income. Dividends from common stock | 2018-12-31 | $64,253 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $250,066 |
| Asset. Corporate debt instrument preferred debt at end of year | 2018-12-31 | $1,095,960 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2018-12-31 | $1,724,281 |
| Contract administrator fees | 2018-12-31 | $16,561 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2018-12-31 | $1,829,919 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2018-12-31 | $2,166,430 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2018-12-31 | $46 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2018-12-31 | $1,331 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Aggregate proceeds on sale of assets | 2018-12-31 | $3,386,684 |
| Aggregate carrying amount (costs) on sale of assets | 2018-12-31 | $3,495,452 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Disclaimer |
| Accountancy firm name | 2018-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2018-12-31 | 232872012 |
| 2017 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $220,733 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $220,733 |
| Total income from all sources (including contributions) | 2017-12-31 | $10,760,141 |
| Total loss/gain on sale of assets | 2017-12-31 | $93,022 |
| Total of all expenses incurred | 2017-12-31 | $9,669,989 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $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 year | 2017-12-31 | $11,088,250 |
| Value of total assets at beginning of year | 2017-12-31 | $9,998,098 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $280,819 |
| Total interest from all sources | 2017-12-31 | $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 year | 2017-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $212,931 |
| Administrative expenses professional fees incurred | 2017-12-31 | $58,869 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $416,934 |
| Administrative expenses (other) incurred | 2017-12-31 | $153,871 |
| Total non interest bearing cash at end of year | 2017-12-31 | $421,050 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $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 appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $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) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Investment advisory and management fees | 2017-12-31 | $53,162 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $6,000,691 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $3,344,282 |
| Income. Interest from corporate debt instruments | 2017-12-31 | $49,513 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $774,467 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $1,101,456 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $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 benefits | 2017-12-31 | $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 assets | 2017-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $9,521,499 |
| Income. Dividends from common stock | 2017-12-31 | $69,383 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $248,401 |
| Asset. Corporate debt instrument preferred debt at end of year | 2017-12-31 | $1,724,281 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2017-12-31 | $2,365,170 |
| Contract administrator fees | 2017-12-31 | $14,917 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2017-12-31 | $2,166,430 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2017-12-31 | $2,998,282 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2017-12-31 | $1,331 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2017-12-31 | $3,541 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Aggregate proceeds on sale of assets | 2017-12-31 | $5,131,960 |
| Aggregate carrying amount (costs) on sale of assets | 2017-12-31 | $5,038,938 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Disclaimer |
| Accountancy firm name | 2017-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2017-12-31 | 232872012 |
| 2016 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $248,963 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $248,963 |
| Total income from all sources (including contributions) | 2016-12-31 | $8,857,703 |
| Total loss/gain on sale of assets | 2016-12-31 | $-39,522 |
| Total of all expenses incurred | 2016-12-31 | $8,083,981 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $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 year | 2016-12-31 | $9,998,098 |
| Value of total assets at beginning of year | 2016-12-31 | $9,224,376 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $277,708 |
| Total interest from all sources | 2016-12-31 | $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 year | 2016-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-12-31 | $57,964 |
| Administrative expenses professional fees incurred | 2016-12-31 | $50,190 |
| Was this plan covered by a fidelity bond | 2016-12-31 | No |
| Value of fidelity bond cover | 2016-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $400,120 |
| Administrative expenses (other) incurred | 2016-12-31 | $164,448 |
| Total non interest bearing cash at end of year | 2016-12-31 | $185,367 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $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 appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $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) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $48,891 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $3,344,282 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $4,974,494 |
| Income. Interest from corporate debt instruments | 2016-12-31 | $53,770 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $1,101,456 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $1,928,841 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $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 benefits | 2016-12-31 | $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 assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $8,024,667 |
| Income. Dividends from common stock | 2016-12-31 | $77,985 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $226,185 |
| Asset. Corporate debt instrument preferred debt at end of year | 2016-12-31 | $2,365,170 |
| Contract administrator fees | 2016-12-31 | $14,179 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2016-12-31 | $2,998,282 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2016-12-31 | $2,056,045 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2016-12-31 | $3,541 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2016-12-31 | $5,751 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Aggregate proceeds on sale of assets | 2016-12-31 | $9,691,398 |
| Aggregate carrying amount (costs) on sale of assets | 2016-12-31 | $9,730,920 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
| Accountancy firm name | 2016-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2016-12-31 | 232872012 |
| 2015 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $-36,983 |
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $-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 assets | 2015-12-31 | $-78,544 |
| Total of all expenses incurred | 2015-12-31 | $7,470,056 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $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 year | 2015-12-31 | $9,224,376 |
| Value of total assets at beginning of year | 2015-12-31 | $9,016,471 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $294,176 |
| Total interest from all sources | 2015-12-31 | $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 year | 2015-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-12-31 | $186,351 |
| Administrative expenses professional fees incurred | 2015-12-31 | $49,335 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $401,721 |
| Administrative expenses (other) incurred | 2015-12-31 | $184,694 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $1,000 |
| Total non interest bearing cash at end of year | 2015-12-31 | $259,245 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $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 appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $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) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Investment advisory and management fees | 2015-12-31 | $45,586 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $4,974,494 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $5,050,730 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $1,928,841 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $2,185,251 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $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 benefits | 2015-12-31 | $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 assets | 2015-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $7,283,117 |
| Income. Dividends from common stock | 2015-12-31 | $57,612 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $446,604 |
| Contract administrator fees | 2015-12-31 | $14,561 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2015-12-31 | $2,056,045 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2015-12-31 | $1,592,527 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $29,228 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2015-12-31 | $5,751 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-12-31 | $8,108 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Aggregate proceeds on sale of assets | 2015-12-31 | $4,105,244 |
| Aggregate carrying amount (costs) on sale of assets | 2015-12-31 | $4,183,788 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Disclaimer |
| Accountancy firm name | 2015-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2015-12-31 | 232872012 |
| 2014 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $74,068 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $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 assets | 2014-12-31 | $-59,755 |
| Total of all expenses incurred | 2014-12-31 | $6,764,852 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $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 year | 2014-12-31 | $9,016,471 |
| Value of total assets at beginning of year | 2014-12-31 | $8,237,355 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $242,229 |
| Total interest from all sources | 2014-12-31 | $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 year | 2014-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-12-31 | $227,522 |
| Administrative expenses professional fees incurred | 2014-12-31 | $44,950 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $396,823 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $11,187 |
| Other income not declared elsewhere | 2014-12-31 | $1,245 |
| Administrative expenses (other) incurred | 2014-12-31 | $141,708 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $1,000 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $881 |
| Total non interest bearing cash at end of year | 2014-12-31 | $179,855 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $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 appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $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) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Investment advisory and management fees | 2014-12-31 | $41,909 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $5,050,730 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $6,233,658 |
| Income. Interest from US Government securities | 2014-12-31 | $856 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $2,185,251 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $943,497 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $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 benefits | 2014-12-31 | $6,092,200 |
| Asset value of US Government securities at beginning of year | 2014-12-31 | $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 assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $6,878,028 |
| Income. Dividends from common stock | 2014-12-31 | $30,962 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $430,423 |
| Contract administrator fees | 2014-12-31 | $13,662 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2014-12-31 | $1,592,527 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2014-12-31 | $766,734 |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $29,228 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $24,061 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2014-12-31 | $8,108 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2014-12-31 | $10,609 |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Aggregate proceeds on sale of assets | 2014-12-31 | $3,447,504 |
| Aggregate carrying amount (costs) on sale of assets | 2014-12-31 | $3,507,259 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Disclaimer |
| Accountancy firm name | 2014-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2014-12-31 | 232872012 |
| 2013 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $131,209 |
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $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 assets | 2013-12-31 | $12,621 |
| Total of all expenses incurred | 2013-12-31 | $6,531,905 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $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 year | 2013-12-31 | $8,237,355 |
| Value of total assets at beginning of year | 2013-12-31 | $7,550,710 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $235,046 |
| Total interest from all sources | 2013-12-31 | $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 year | 2013-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-12-31 | $189,010 |
| Administrative expenses professional fees incurred | 2013-12-31 | $47,275 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $406,212 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $11,187 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $9,217 |
| Other income not declared elsewhere | 2013-12-31 | $310 |
| Administrative expenses (other) incurred | 2013-12-31 | $135,097 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $881 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $1,000 |
| Total non interest bearing cash at end of year | 2013-12-31 | $69,972 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $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 appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $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) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Investment advisory and management fees | 2013-12-31 | $40,263 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $6,233,658 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $6,225,192 |
| Income. Interest from US Government securities | 2013-12-31 | $3,500 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $943,497 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $670,246 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $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 benefits | 2013-12-31 | $5,866,770 |
| Asset value of US Government securities at end of year | 2013-12-31 | $201,698 |
| Asset value of US Government securities at beginning of year | 2013-12-31 | $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 assets | 2013-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $6,378,604 |
| Income. Dividends from common stock | 2013-12-31 | $14,079 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $430,089 |
| Contract administrator fees | 2013-12-31 | $12,411 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2013-12-31 | $766,734 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2013-12-31 | $367,080 |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $24,061 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $25,200 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2013-12-31 | $10,609 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2013-12-31 | $1,880 |
| Did the plan have assets held for investment | 2013-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Aggregate proceeds on sale of assets | 2013-12-31 | $100,702 |
| Aggregate carrying amount (costs) on sale of assets | 2013-12-31 | $88,081 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
| Accountancy firm name | 2013-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2013-12-31 | 232872012 |
| 2012 : TEAMSTERS LOCAL 401 HEALTH AND WELFARE PLAN 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $7,494 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $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 assets | 2012-12-31 | $-2,649 |
| Total of all expenses incurred | 2012-12-31 | $6,568,182 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $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 year | 2012-12-31 | $7,550,710 |
| Value of total assets at beginning of year | 2012-12-31 | $7,130,890 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $239,710 |
| Total interest from all sources | 2012-12-31 | $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 year | 2012-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $168,248 |
| Administrative expenses professional fees incurred | 2012-12-31 | $65,865 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $428,945 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $9,217 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $3,856 |
| Administrative expenses (other) incurred | 2012-12-31 | $119,952 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $1,000 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $1,000 |
| Total non interest bearing cash at end of year | 2012-12-31 | $72,397 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $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 appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $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) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Investment advisory and management fees | 2012-12-31 | $39,226 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $6,225,192 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $6,137,936 |
| Income. Interest from US Government securities | 2012-12-31 | $7,000 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $670,246 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $387,068 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $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 benefits | 2012-12-31 | $5,850,838 |
| Asset value of US Government securities at end of year | 2012-12-31 | $204,698 |
| Asset value of US Government securities at beginning of year | 2012-12-31 | $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 assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $6,089,607 |
| Income. Dividends from common stock | 2012-12-31 | $8,392 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $477,634 |
| Contract administrator fees | 2012-12-31 | $14,667 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2012-12-31 | $367,080 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2012-12-31 | $146,380 |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $25,200 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $24,450 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2012-12-31 | $1,880 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-12-31 | $1,753 |
| Did the plan have assets held for investment | 2012-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Aggregate proceeds on sale of assets | 2012-12-31 | $235,547 |
| Aggregate carrying amount (costs) on sale of assets | 2012-12-31 | $238,196 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
| Accountancy firm name | 2012-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2012-12-31 | 232872012 |
| 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 incurred | 2011-12-31 | $6,237,048 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $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 year | 2011-12-31 | $7,130,890 |
| Value of total assets at beginning of year | 2011-12-31 | $7,009,316 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $247,244 |
| Total interest from all sources | 2011-12-31 | $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 year | 2011-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-12-31 | $169,619 |
| Administrative expenses professional fees incurred | 2011-12-31 | $38,975 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $507,125 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $3,856 |
| Other income not declared elsewhere | 2011-12-31 | $1,071 |
| Administrative expenses (other) incurred | 2011-12-31 | $156,411 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $1,000 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $7,971 |
| Total non interest bearing cash at end of year | 2011-12-31 | $43,548 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $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 appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $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) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Investment advisory and management fees | 2011-12-31 | $38,313 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $6,137,936 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $5,365,691 |
| Income. Interest from US Government securities | 2011-12-31 | $10,690 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $387,068 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $354,236 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $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 benefits | 2011-12-31 | $5,514,958 |
| Asset value of US Government securities at end of year | 2011-12-31 | $410,349 |
| Asset value of US Government securities at beginning of year | 2011-12-31 | $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 assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $5,639,658 |
| Income. Dividends from common stock | 2011-12-31 | $4,160 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $474,846 |
| Contract administrator fees | 2011-12-31 | $13,545 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2011-12-31 | $146,380 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2011-12-31 | $145,160 |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $24,450 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $25,320 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2011-12-31 | $1,753 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-12-31 | $4,553 |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
| Accountancy firm name | 2011-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2011-12-31 | 232872012 |
| 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 incurred | 2010-12-31 | $5,688,620 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $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 year | 2010-12-31 | $7,009,316 |
| Value of total assets at beginning of year | 2010-12-31 | $6,650,265 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $266,579 |
| Total interest from all sources | 2010-12-31 | $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 year | 2010-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2010-12-31 | $156,342 |
| Administrative expenses professional fees incurred | 2010-12-31 | $63,945 |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $358,780 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $1,413 |
| Other income not declared elsewhere | 2010-12-31 | $6,593 |
| Administrative expenses (other) incurred | 2010-12-31 | $153,528 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $7,971 |
| Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $1,000 |
| Total non interest bearing cash at end of year | 2010-12-31 | $27,277 |
| Total non interest bearing cash at beginning of year | 2010-12-31 | $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 appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $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) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Investment advisory and management fees | 2010-12-31 | $36,218 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $5,365,691 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $5,664,100 |
| Income. Interest from US Government securities | 2010-12-31 | $15,154 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $354,236 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $922,069 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $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 benefits | 2010-12-31 | $4,957,154 |
| Asset value of US Government securities at end of year | 2010-12-31 | $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 assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $5,300,858 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $464,887 |
| Contract administrator fees | 2010-12-31 | $12,888 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2010-12-31 | $145,160 |
| Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $25,320 |
| Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $27,856 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2010-12-31 | $4,553 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2010-12-31 | $6,521 |
| Did the plan have assets held for investment | 2010-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
| Accountancy firm name | 2010-12-31 | KOSMERL & CO., P.C. |
| Accountancy firm EIN | 2010-12-31 | 232872012 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 116552 |
| Policy instance | 1 |
| Insurance contract or identification number | 116552 | | Number of Individuals Covered | 372 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 229376 |
| Policy instance | 2 |
| Insurance contract or identification number | 229376 | | Number of Individuals Covered | 1195 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,232,171 | | 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 number | 540675/491034/2 |
| Policy instance | 3 |
| Insurance contract or identification number | 540675/491034/2 | | Number of Individuals Covered | 899 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $20,731 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $531,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,731 | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 252043-000-005 |
| Policy instance | 4 |
| Insurance contract or identification number | 252043-000-005 | | Number of Individuals Covered | 594 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | A 14204-099&000 |
| Policy instance | 5 |
| Insurance contract or identification number | A 14204-099&000 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,175 | | 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 number | 238539 |
| Policy instance | 6 |
| Insurance contract or identification number | 238539 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $480,921 | | 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 number | 00531937 |
| Policy instance | 7 |
| Insurance contract or identification number | 00531937 | | Number of Individuals Covered | 695 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,223,281 | | 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 number | 540675/491034/2 |
| Policy instance | 3 |
| Insurance contract or identification number | 540675/491034/2 | | Number of Individuals Covered | 1487 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $19,577 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $215,762 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,564 | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 229376 |
| Policy instance | 2 |
| Insurance contract or identification number | 229376 | | Number of Individuals Covered | 589 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,147,330 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 252043-000-004 |
| Policy instance | 4 |
| Insurance contract or identification number | 252043-000-004 | | Number of Individuals Covered | 570 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $232,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | A 14204-099&000 |
| Policy instance | 5 |
| Insurance contract or identification number | A 14204-099&000 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 238539 |
| Policy instance | 6 |
| Insurance contract or identification number | 238539 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 10404145 |
| Policy instance | 7 |
| Insurance contract or identification number | 10404145 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $358,377 | | 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 number | 116552 |
| Policy instance | 1 |
| Insurance contract or identification number | 116552 | | Number of Individuals Covered | 570 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 116552 |
| Policy instance | 1 |
| Insurance contract or identification number | 116552 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 00491034 |
| Policy instance | 3 |
| Insurance contract or identification number | 00491034 | | Number of Individuals Covered | 520 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $10,058 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $251,458 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,058 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 229376 |
| Policy instance | 2 |
| Insurance contract or identification number | 229376 | | Number of Individuals Covered | 520 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,950,881 | | 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 number | 00491032 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491032 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $5,953 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $106,299 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,953 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 252043-000, ETC |
| Policy instance | 5 |
| Insurance contract or identification number | 252043-000, ETC | | Number of Individuals Covered | 184 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $191,747 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 6 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 520 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $258,147 | | 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 number | 00540675 |
| Policy instance | 7 |
| Insurance contract or identification number | 00540675 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $1,170 | | Welfare Benefit Premiums Paid to Carrier | USD $11,699 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,170 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 238539 |
| Policy instance | 9 |
| Insurance contract or identification number | 238539 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | A14204-099&000 |
| Policy instance | 8 |
| Insurance contract or identification number | A14204-099&000 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,540 | | 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 number | 10404145 |
| Policy instance | 10 |
| Insurance contract or identification number | 10404145 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $557,957 | | 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 number | 229376 |
| Policy instance | 2 |
| Insurance contract or identification number | 229376 | | Number of Individuals Covered | 406 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 00491034 |
| Policy instance | 3 |
| Insurance contract or identification number | 00491034 | | Number of Individuals Covered | 774 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $8,637 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $214,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,637 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00540675 |
| Policy instance | 7 |
| Insurance contract or identification number | 00540675 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $1,146 | | Welfare Benefit Premiums Paid to Carrier | USD $11,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,146 |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 6 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 415 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,541 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $308,128 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,541 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 252043-000, ETC |
| Policy instance | 5 |
| Insurance contract or identification number | 252043-000, ETC | | Number of Individuals Covered | 177 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $183,031 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | A14204-099&000 |
| Policy instance | 8 |
| Insurance contract or identification number | A14204-099&000 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,717 | | 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 number | 00491032 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491032 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $5,885 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $105,344 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,885 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 116552 |
| Policy instance | 1 |
| Insurance contract or identification number | 116552 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 229376 |
| Policy instance | 2 |
| Insurance contract or identification number | 229376 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,858,409 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 6 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 352 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,325 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $281,544 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,325 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00540675 |
| Policy instance | 7 |
| Insurance contract or identification number | 00540675 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Welfare Benefit Premiums Paid to Carrier | USD $12,949 | | 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 number | 00491032 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491032 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $5,324 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $87,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,324 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 116552 |
| Policy instance | 1 |
| Insurance contract or identification number | 116552 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,077,194 | | 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 number | 00491034 |
| Policy instance | 3 |
| Insurance contract or identification number | 00491034 | | Number of Individuals Covered | 307 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $8,121 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $175,794 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,121 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | A14204-099&000 |
| Policy instance | 8 |
| Insurance contract or identification number | A14204-099&000 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,983 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 252043-000, ETC |
| Policy instance | 5 |
| Insurance contract or identification number | 252043-000, ETC | | Number of Individuals Covered | 177 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 00491032 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491032 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | Total amount of commissions paid to insurance broker | USD $5,187 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $83,386 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,187 | | Insurance broker name | HOWELL BENEFIT SERVICES INC |
|
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
| Policy contract number | 252043-000, ETC |
| Policy instance | 5 |
| Insurance contract or identification number | 252043-000, ETC | | Number of Individuals Covered | 177 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 3217 |
| Policy instance | 6 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 314 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,193 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $253,585 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,193 | | Insurance broker name | DELAWARE VALLEY HEALTH CARE |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491034 |
| Policy instance | 3 |
| Insurance contract or identification number | 00491034 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | Total amount of commissions paid to insurance broker | USD $6,911 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $146,365 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,911 | | Insurance broker name | HOWELL BENEFIT SERVICES LLC |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 229376 |
| Policy instance | 2 |
| Insurance contract or identification number | 229376 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,705,133 | | 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 number | 116552 |
| Policy instance | 1 |
| Insurance contract or identification number | 116552 | | Number of Individuals Covered | 178 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,093,994 | | 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 number | 00500104 |
| Policy instance | 3 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | 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: 60147 ) |
| Policy contract number | 032868 & ETC |
| Policy instance | 1 |
| Insurance contract or identification number | 032868 & ETC | | Number of Individuals Covered | 172 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 032868 & ETC |
| Policy instance | 2 |
| Insurance contract or identification number | 032868 & ETC | | Number of Individuals Covered | 172 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | 00500104 |
| Policy instance | 5 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | 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 number | 00491034 |
| Policy instance | 6 |
| Insurance contract or identification number | 00491034 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $5,880 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,544 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,880 | | Insurance broker name | HOWELL BENEFIT SERVICES LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491032 |
| Policy instance | 7 |
| Insurance contract or identification number | 00491032 | | Number of Individuals Covered | 156 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $4,310 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $52,952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,310 | | Insurance broker name | HOWELL BENEFIT SERVICES INC |
|
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
| Policy contract number | 252043-000, ETC |
| Policy instance | 8 |
| Insurance contract or identification number | 252043-000, ETC | | Number of Individuals Covered | 520 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $170,170 | | 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 number | 00500104 |
| Policy instance | 4 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 9 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,165 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $232,981 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,165 | | Insurance broker name | DELAWARE VALLEY HEALTH CARE |
|
| CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
| Policy contract number | 00500104 |
| Policy instance | 3 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | 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 number | 032868 & ETC |
| Policy instance | 1 |
| Insurance contract or identification number | 032868 & ETC | | Number of Individuals Covered | 163 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | 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 number | 252043-000, ETC |
| Policy instance | 6 |
| Insurance contract or identification number | 252043-000, ETC | | Number of Individuals Covered | 519 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $156,479 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 7 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,085 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $216,946 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,085 | | Insurance broker name | DELAWARE VALLEY HEALTH CARE COLTION |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491032 |
| Policy instance | 5 |
| Insurance contract or identification number | 00491032 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $4,756 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,735 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,710 | | Insurance broker name | FINANCIAL BALANCE GROUP LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00491034 |
| Policy instance | 4 |
| Insurance contract or identification number | 00491034 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $5,919 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $94,448 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,854 | | Insurance broker name | FINANCIAL BALANCE GROUP LLC |
|
| CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
| Policy contract number | 00500104 |
| Policy instance | 2 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | 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 number | 00500104 |
| Policy instance | 3 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 260 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-07-31 | | 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 number | 032868 & ETC |
| Policy instance | 1 |
| Insurance contract or identification number | 032868 & ETC | | Number of Individuals Covered | 164 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | 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 number | 00500104 |
| Policy instance | 12 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2013-12-31 | | 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 number | 00500104 |
| Policy instance | 11 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2013-12-31 | | Vision Insurance Welfare Benefit | Yes | | 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 number | 00500104 |
| Policy instance | 10 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2013-12-31 | | 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 number | 00500104 |
| Policy instance | 9 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 260 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-07-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 8 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 260 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $993 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $210,989 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $993 | | Insurance broker name | DELAWARE VALLEY HEALTH CARE COLTION |
|
| CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
| Policy contract number | 00500104 |
| Policy instance | 2 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 260 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-07-31 | | 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 number | MG14346 |
| Policy instance | 7 |
| Insurance contract or identification number | MG14346 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $6,926 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $146,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,926 | | Insurance broker name | CONSOLIDATED BENEFIT DEPT 774232 |
|
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
| Policy contract number | 252043-000, ETC |
| Policy instance | 6 |
| Insurance contract or identification number | 252043-000, ETC | | Number of Individuals Covered | 529 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | FWB0318 |
| Policy instance | 5 |
| Insurance contract or identification number | FWB0318 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $5,678 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $97,851 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,678 | | Insurance broker name | ROGER G HOWELL |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | FWB0029 |
| Policy instance | 4 |
| Insurance contract or identification number | FWB0029 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $472 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,146 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $472 | | Insurance broker name | HOWELL BENEFIT SERVICES INC |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 8 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,199 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $254,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,199 | | Insurance broker name | DELAWARE VALLEY HEALTH CARE COLTION |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | MG14346 |
| Policy instance | 7 |
| Insurance contract or identification number | MG14346 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $6,374 | | Total amount of fees paid to insurance company | USD $672 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $137,630 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,374 | | Amount paid for insurance broker fees | 672 | | Insurance broker name | CONSOLIDATED BENEFIT DEPT 774232 |
|
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
| Policy contract number | 252043-000, ETC |
| Policy instance | 6 |
| Insurance contract or identification number | 252043-000, ETC | | Number of Individuals Covered | 494 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | FWB0318 |
| Policy instance | 5 |
| Insurance contract or identification number | FWB0318 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $5,232 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,262 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,232 | | Insurance broker name | ROGER G HOWELL |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | FWB0029 |
| Policy instance | 4 |
| Insurance contract or identification number | FWB0029 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $459 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,057 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $459 | | Insurance broker name | HOWELL BENEFIT SERVICES INC |
|
| CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
| Policy contract number | 00500104 |
| Policy instance | 3 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 257 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | 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 number | 00500104 |
| Policy instance | 2 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 257 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | 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 number | 00500104 |
| Policy instance | 9 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 257 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Vision Insurance Welfare Benefit | Yes | | 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 number | 032868 & ETC |
| Policy instance | 1 |
| Insurance contract or identification number | 032868 & ETC | | Number of Individuals Covered | 164 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 9 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 269 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,077 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $239,300 | | 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 number | MG14346 |
| Policy instance | 8 |
| Insurance contract or identification number | MG14346 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $6,326 | | Total amount of fees paid to insurance company | USD $604 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $136,949 | | 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 number | 252043-000 ETC |
| Policy instance | 7 |
| Insurance contract or identification number | 252043-000 ETC | | Number of Individuals Covered | 484 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | FWB0318 |
| Policy instance | 5 |
| Insurance contract or identification number | FWB0318 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $5,164 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,928 | | 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 number | FWB0029 |
| Policy instance | 4 |
| Insurance contract or identification number | FWB0029 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $493 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,285 | | 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 number | 00500104 |
| Policy instance | 3 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 266 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | 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 number | 00500104 |
| Policy instance | 2 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 266 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | 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 number | 032868 ETC |
| Policy instance | 1 |
| Insurance contract or identification number | 032868 ETC | | Number of Individuals Covered | 155 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | 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 number | 00500104 |
| Policy instance | 10 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 265 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Vision Insurance Welfare Benefit | Yes | | 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 number | 00500104 |
| Policy instance | 6 |
| Insurance contract or identification number | 00500104 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Vision Insurance Welfare Benefit | Yes | | 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 number | 00500104 |
| Policy instance | 3 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 270 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | 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 number | 032868 ETC |
| Policy instance | 1 |
| Insurance contract or identification number | 032868 ETC | | Number of Individuals Covered | 156 | | Insurance policy start date | 2009-09-01 | | Insurance policy end date | 2010-08-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | 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 number | 00500104 |
| Policy instance | 2 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 270 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | 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 number | FWB0029 |
| Policy instance | 4 |
| Insurance contract or identification number | FWB0029 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2009-07-01 | | Insurance policy end date | 2010-06-30 | | Total amount of commissions paid to insurance broker | USD $573 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,821 | | 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 number | FWB0318 |
| Policy instance | 5 |
| Insurance contract or identification number | FWB0318 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2009-09-01 | | Insurance policy end date | 2010-08-31 | | Total amount of commissions paid to insurance broker | USD $4,880 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,408 | | 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 number | 00500104 |
| Policy instance | 6 |
| Insurance contract or identification number | 00500104 | | Number of Individuals Covered | 269 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Vision Insurance Welfare Benefit | Yes | | 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 number | 252043-000 ETC |
| Policy instance | 7 |
| Insurance contract or identification number | 252043-000 ETC | | Number of Individuals Covered | 490 | | Insurance policy start date | 2009-09-01 | | Insurance policy end date | 2010-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $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 number | MG14346 |
| Policy instance | 8 |
| Insurance contract or identification number | MG14346 | | Number of Individuals Covered | 233 | | Insurance policy start date | 2009-08-01 | | Insurance policy end date | 2010-07-31 | | Total amount of commissions paid to insurance broker | USD $6,345 | | Total amount of fees paid to insurance company | USD $362 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $140,261 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
| Policy contract number | 3217 |
| Policy instance | 9 |
| Insurance contract or identification number | 3217 | | Number of Individuals Covered | 271 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,036 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $219,999 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
