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VARI CORPORATION GROUP MEDICAL PLAN 401k Plan overview

Plan NameVARI CORPORATION GROUP MEDICAL PLAN
Plan identification number 501

VARI CORPORATION GROUP MEDICAL PLAN Benefits

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

401k Sponsoring company profile

VARI CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:VARI CORPORATION
Employer identification number (EIN):232106519
NAIC Classification:332900

Additional information about VARI CORPORATION

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2052579

More information about VARI CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VARI CORPORATION GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01
5012021-04-01
5012020-04-01
5012019-04-01
5012018-04-01
5012017-04-01TERRY RISMILLER
5012016-04-01JAMES F. MEADE
5012015-04-01JAMES F. MEADE
5012014-04-01JAMES F. MEADE

Plan Statistics for VARI CORPORATION GROUP MEDICAL PLAN

401k plan membership statisitcs for VARI CORPORATION GROUP MEDICAL PLAN

Measure Date Value
2022: VARI CORPORATION GROUP MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-0167
Total number of active participants reported on line 7a of the Form 55002022-04-0172
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-0172
2021: VARI CORPORATION GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-0171
Total number of active participants reported on line 7a of the Form 55002021-04-0166
Number of retired or separated participants receiving benefits2021-04-011
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-0167
2020: VARI CORPORATION GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-0176
Total number of active participants reported on line 7a of the Form 55002020-04-0171
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-0171
2019: VARI CORPORATION GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-0178
Total number of active participants reported on line 7a of the Form 55002019-04-0176
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-0176
2018: VARI CORPORATION GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-0170
Total number of active participants reported on line 7a of the Form 55002018-04-0176
Number of retired or separated participants receiving benefits2018-04-012
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-0178
2017: VARI CORPORATION GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-0170
Total number of active participants reported on line 7a of the Form 55002017-04-0168
Number of retired or separated participants receiving benefits2017-04-012
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-0170
2016: VARI CORPORATION GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-0177
Total number of active participants reported on line 7a of the Form 55002016-04-0169
Number of retired or separated participants receiving benefits2016-04-011
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-0170
2015: VARI CORPORATION GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-0179
Total number of active participants reported on line 7a of the Form 55002015-04-0176
Number of retired or separated participants receiving benefits2015-04-011
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-0177
2014: VARI CORPORATION GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-0180
Total number of active participants reported on line 7a of the Form 55002014-04-0179
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-0179

Financial Data on VARI CORPORATION GROUP MEDICAL PLAN

Measure Date Value
2023 : VARI CORPORATION GROUP MEDICAL PLAN 2023 401k financial data
Total plan liabilities at end of year2023-03-31$80,293
Total plan liabilities at beginning of year2023-03-31$788,377
Total income from all sources2023-03-31$1,677,516
Expenses. Total of all expenses incurred2023-03-31$1,072,384
Benefits paid (including direct rollovers)2023-03-31$283,400
Total plan assets at end of year2023-03-31$393,848
Total plan assets at beginning of year2023-03-31$496,800
Value of fidelity bond covering the plan2023-03-31$100,000
Total contributions received or receivable from participants2023-03-31$218,211
Expenses. Other expenses not covered elsewhere2023-03-31$715,945
Contributions received from other sources (not participants or employers)2023-03-31$99,999
Other income received2023-03-31$2,477
Net income (gross income less expenses)2023-03-31$605,132
Net plan assets at end of year (total assets less liabilities)2023-03-31$313,555
Net plan assets at beginning of year (total assets less liabilities)2023-03-31$-291,577
Total contributions received or receivable from employer(s)2023-03-31$1,356,829
Value of corrective distributions2023-03-31$68,119
Expenses. Administrative service providers (salaries,fees and commissions)2023-03-31$4,920
2022 : VARI CORPORATION GROUP MEDICAL PLAN 2022 401k financial data
Total plan liabilities at end of year2022-03-31$788,377
Total plan liabilities at beginning of year2022-03-31$152,899
Total income from all sources2022-03-31$1,409,463
Expenses. Total of all expenses incurred2022-03-31$1,799,816
Benefits paid (including direct rollovers)2022-03-31$922,029
Total plan assets at end of year2022-03-31$496,800
Total plan assets at beginning of year2022-03-31$251,675
Value of fidelity bond covering the plan2022-03-31$100,000
Total contributions received or receivable from participants2022-03-31$196,626
Expenses. Other expenses not covered elsewhere2022-03-31$593,171
Contributions received from other sources (not participants or employers)2022-03-31$7,275
Other income received2022-03-31$1,622
Net income (gross income less expenses)2022-03-31$-390,353
Net plan assets at end of year (total assets less liabilities)2022-03-31$-291,577
Net plan assets at beginning of year (total assets less liabilities)2022-03-31$98,776
Total contributions received or receivable from employer(s)2022-03-31$1,203,940
Value of corrective distributions2022-03-31$279,129
Expenses. Administrative service providers (salaries,fees and commissions)2022-03-31$5,487
2021 : VARI CORPORATION GROUP MEDICAL PLAN 2021 401k financial data
Total plan liabilities at end of year2021-03-31$152,899
Total plan liabilities at beginning of year2021-03-31$243,062
Total income from all sources2021-03-31$1,496,393
Expenses. Total of all expenses incurred2021-03-31$1,523,867
Benefits paid (including direct rollovers)2021-03-31$658,267
Total plan assets at end of year2021-03-31$251,675
Total plan assets at beginning of year2021-03-31$369,312
Value of fidelity bond covering the plan2021-03-31$100,000
Total contributions received or receivable from participants2021-03-31$202,293
Expenses. Other expenses not covered elsewhere2021-03-31$615,945
Contributions received from other sources (not participants or employers)2021-03-31$0
Other income received2021-03-31$1,816
Net income (gross income less expenses)2021-03-31$-27,474
Net plan assets at end of year (total assets less liabilities)2021-03-31$98,776
Net plan assets at beginning of year (total assets less liabilities)2021-03-31$126,250
Total contributions received or receivable from employer(s)2021-03-31$1,292,284
Value of corrective distributions2021-03-31$237,937
Expenses. Administrative service providers (salaries,fees and commissions)2021-03-31$11,718
2020 : VARI CORPORATION GROUP MEDICAL PLAN 2020 401k financial data
Total plan liabilities at end of year2020-03-31$243,062
Total plan liabilities at beginning of year2020-03-31$81,656
Total income from all sources2020-03-31$1,545,677
Expenses. Total of all expenses incurred2020-03-31$1,777,372
Benefits paid (including direct rollovers)2020-03-31$947,417
Total plan assets at end of year2020-03-31$369,312
Total plan assets at beginning of year2020-03-31$439,601
Value of fidelity bond covering the plan2020-03-31$100,000
Total contributions received or receivable from participants2020-03-31$177,865
Expenses. Other expenses not covered elsewhere2020-03-31$599,395
Contributions received from other sources (not participants or employers)2020-03-31$31
Other income received2020-03-31$4,533
Net income (gross income less expenses)2020-03-31$-231,695
Net plan assets at end of year (total assets less liabilities)2020-03-31$126,250
Net plan assets at beginning of year (total assets less liabilities)2020-03-31$357,945
Total contributions received or receivable from employer(s)2020-03-31$1,363,248
Value of corrective distributions2020-03-31$207,036
Expenses. Administrative service providers (salaries,fees and commissions)2020-03-31$23,524
2019 : VARI CORPORATION GROUP MEDICAL PLAN 2019 401k financial data
Total plan liabilities at end of year2019-03-31$81,656
Total plan liabilities at beginning of year2019-03-31$58,847
Total income from all sources2019-03-31$1,468,649
Expenses. Total of all expenses incurred2019-03-31$1,495,742
Benefits paid (including direct rollovers)2019-03-31$606,717
Total plan assets at end of year2019-03-31$439,601
Total plan assets at beginning of year2019-03-31$443,885
Value of fidelity bond covering the plan2019-03-31$500,000
Total contributions received or receivable from participants2019-03-31$182,725
Expenses. Other expenses not covered elsewhere2019-03-31$567,376
Other income received2019-03-31$3,137
Net income (gross income less expenses)2019-03-31$-27,093
Net plan assets at end of year (total assets less liabilities)2019-03-31$357,945
Net plan assets at beginning of year (total assets less liabilities)2019-03-31$385,038
Total contributions received or receivable from employer(s)2019-03-31$1,282,787
Value of corrective distributions2019-03-31$293,644
Expenses. Administrative service providers (salaries,fees and commissions)2019-03-31$28,005
2018 : VARI CORPORATION GROUP MEDICAL PLAN 2018 401k financial data
Total plan liabilities at end of year2018-03-31$58,847
Total plan liabilities at beginning of year2018-03-31$71,102
Total income from all sources2018-03-31$1,383,860
Expenses. Total of all expenses incurred2018-03-31$1,226,408
Benefits paid (including direct rollovers)2018-03-31$533,645
Total plan assets at end of year2018-03-31$443,885
Total plan assets at beginning of year2018-03-31$298,688
Value of fidelity bond covering the plan2018-03-31$500,000
Total contributions received or receivable from participants2018-03-31$169,833
Expenses. Other expenses not covered elsewhere2018-03-31$487,121
Other income received2018-03-31$663
Net income (gross income less expenses)2018-03-31$157,452
Net plan assets at end of year (total assets less liabilities)2018-03-31$385,038
Net plan assets at beginning of year (total assets less liabilities)2018-03-31$227,586
Total contributions received or receivable from employer(s)2018-03-31$1,213,364
Value of corrective distributions2018-03-31$169,788
Expenses. Administrative service providers (salaries,fees and commissions)2018-03-31$35,854
2017 : VARI CORPORATION GROUP MEDICAL PLAN 2017 401k financial data
Total plan liabilities at end of year2017-03-31$71,102
Total plan liabilities at beginning of year2017-03-31$91,043
Total income from all sources2017-03-31$1,317,437
Expenses. Total of all expenses incurred2017-03-31$1,013,382
Benefits paid (including direct rollovers)2017-03-31$549,977
Total plan assets at end of year2017-03-31$298,688
Total plan assets at beginning of year2017-03-31$14,574
Value of fidelity bond covering the plan2017-03-31$500,000
Total contributions received or receivable from participants2017-03-31$152,100
Expenses. Other expenses not covered elsewhere2017-03-31$424,075
Other income received2017-03-31$268
Net income (gross income less expenses)2017-03-31$304,055
Net plan assets at end of year (total assets less liabilities)2017-03-31$227,586
Net plan assets at beginning of year (total assets less liabilities)2017-03-31$-76,469
Total contributions received or receivable from employer(s)2017-03-31$1,165,069
Expenses. Administrative service providers (salaries,fees and commissions)2017-03-31$39,330
2016 : VARI CORPORATION GROUP MEDICAL PLAN 2016 401k financial data
Total plan liabilities at end of year2016-03-31$91,043
Total plan liabilities at beginning of year2016-03-31$90,971
Total income from all sources2016-03-31$1,055,330
Expenses. Total of all expenses incurred2016-03-31$1,130,608
Benefits paid (including direct rollovers)2016-03-31$746,091
Total plan assets at end of year2016-03-31$14,574
Total plan assets at beginning of year2016-03-31$89,780
Value of fidelity bond covering the plan2016-03-31$500,000
Total contributions received or receivable from participants2016-03-31$143,468
Expenses. Other expenses not covered elsewhere2016-03-31$318,263
Contributions received from other sources (not participants or employers)2016-03-31$0
Other income received2016-03-31$77
Net income (gross income less expenses)2016-03-31$-75,278
Net plan assets at end of year (total assets less liabilities)2016-03-31$-76,469
Net plan assets at beginning of year (total assets less liabilities)2016-03-31$-1,191
Total contributions received or receivable from employer(s)2016-03-31$911,785
Value of corrective distributions2016-03-31$26,082
Expenses. Administrative service providers (salaries,fees and commissions)2016-03-31$40,172
2015 : VARI CORPORATION GROUP MEDICAL PLAN 2015 401k financial data
Total plan liabilities at end of year2015-03-31$90,971
Total income from all sources2015-03-31$1,080,805
Expenses. Total of all expenses incurred2015-03-31$1,081,996
Benefits paid (including direct rollovers)2015-03-31$678,227
Total plan assets at end of year2015-03-31$89,780
Value of fidelity bond covering the plan2015-03-31$500,000
Total contributions received or receivable from participants2015-03-31$128,186
Expenses. Other expenses not covered elsewhere2015-03-31$364,074
Contributions received from other sources (not participants or employers)2015-03-31$0
Other income received2015-03-31$57
Noncash contributions received2015-03-31$0
Net income (gross income less expenses)2015-03-31$-1,191
Net plan assets at end of year (total assets less liabilities)2015-03-31$-1,191
Net plan assets at beginning of year (total assets less liabilities)2015-03-31$0
Total contributions received or receivable from employer(s)2015-03-31$952,562
Value of certain deemed distributions of participant loans2015-03-31$0
Value of corrective distributions2015-03-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-03-31$39,695

Form 5500 Responses for VARI CORPORATION GROUP MEDICAL PLAN

2022: VARI CORPORATION GROUP MEDICAL PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Submission has been amendedNo
2022-04-01This submission is the final filingNo
2022-04-01This return/report is a short plan year return/report (less than 12 months)No
2022-04-01Plan is a collectively bargained planNo
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – TrustYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement - TrustYes
2021: VARI CORPORATION GROUP MEDICAL PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – TrustYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement - TrustYes
2020: VARI CORPORATION GROUP MEDICAL PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – TrustYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement - TrustYes
2019: VARI CORPORATION GROUP MEDICAL PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes
2018: VARI CORPORATION GROUP MEDICAL PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement - TrustYes
2017: VARI CORPORATION GROUP MEDICAL PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – TrustYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement - TrustYes
2016: VARI CORPORATION GROUP MEDICAL PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – TrustYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement - TrustYes
2015: VARI CORPORATION GROUP MEDICAL PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – TrustYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement - TrustYes
2014: VARI CORPORATION GROUP MEDICAL PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01First time form 5500 has been submittedYes
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – TrustYes
2014-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number408419
Policy instance 2
Insurance contract or identification number408419
Number of Individuals Covered72
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $178,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30700002
Policy instance 1
Insurance contract or identification number30700002
Number of Individuals Covered72
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $495,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30700002
Policy instance 1
Insurance contract or identification number30700002
Number of Individuals Covered66
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $605,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30700002
Policy instance 1
Insurance contract or identification number30700002
Number of Individuals Covered71
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $580,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30700002
Policy instance 1
Insurance contract or identification number30700002
Number of Individuals Covered76
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $559,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberPCI
Policy instance 1
Insurance contract or identification numberPCI
Number of Individuals Covered78
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $528,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberPCI
Policy instance 1
Insurance contract or identification numberPCI
Number of Individuals Covered70
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $450,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberPCI BENEFITS
Policy instance 1
Insurance contract or identification numberPCI BENEFITS
Number of Individuals Covered77
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $312,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberPCI BENEFITS
Policy instance 1
Insurance contract or identification numberPCI BENEFITS
Number of Individuals Covered79
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $218,696
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberPCI BENEFITS
Policy instance 2
Insurance contract or identification numberPCI BENEFITS
Number of Individuals Covered79
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $76,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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