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TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan NameTRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN
Plan identification number 501

TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN Benefits

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

401k Sponsoring company profile

TRANS/AIR MANUFACTURING CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:TRANS/AIR MANUFACTURING CORPORATION
Employer identification number (EIN):232201348
NAIC Classification:336990

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01BRIAN AUCHEY
5012017-01-01BRIAN AUCHEY
5012016-01-01BRIAN AUCHEY
5012015-01-01BRIAN AUCHEY
5012014-01-01BRIAN AUCHEY

Plan Statistics for TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN

401k plan membership statisitcs for TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2023: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-0189
Total number of active participants reported on line 7a of the Form 55002023-01-01117
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01117
2022: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0186
Total number of active participants reported on line 7a of the Form 55002022-01-0188
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0189
2021: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0187
Total number of active participants reported on line 7a of the Form 55002021-01-0185
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0186
2020: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0197
Total number of active participants reported on line 7a of the Form 55002020-01-0186
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0187
2019: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0182
Total number of active participants reported on line 7a of the Form 55002019-01-0195
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0197
2018: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0178
Total number of active participants reported on line 7a of the Form 55002018-01-0180
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0182
2017: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0179
Total number of active participants reported on line 7a of the Form 55002017-01-0178
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0178
2016: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0177
Total number of active participants reported on line 7a of the Form 55002016-01-0178
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0179
2015: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0173
Total number of active participants reported on line 7a of the Form 55002015-01-0177
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0177
2014: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0173
Total number of active participants reported on line 7a of the Form 55002014-01-0173
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0173

Financial Data on TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2023 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2023 401k financial data
Total plan liabilities at end of year2023-12-31$124,475
Total plan liabilities at beginning of year2023-12-31$70,192
Total income from all sources2023-12-31$1,524,522
Expenses. Total of all expenses incurred2023-12-31$1,355,895
Benefits paid (including direct rollovers)2023-12-31$766,076
Total plan assets at end of year2023-12-31$479,943
Total plan assets at beginning of year2023-12-31$257,033
Value of fidelity bond covering the plan2023-12-31$500,000
Total contributions received or receivable from participants2023-12-31$605,800
Expenses. Other expenses not covered elsewhere2023-12-31$515,505
Contributions received from other sources (not participants or employers)2023-12-31$0
Other income received2023-12-31$8,544
Net income (gross income less expenses)2023-12-31$168,627
Net plan assets at end of year (total assets less liabilities)2023-12-31$355,468
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$186,841
Total contributions received or receivable from employer(s)2023-12-31$910,178
Value of corrective distributions2023-12-31$74,314
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$0
2022 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$70,192
Total plan liabilities at beginning of year2022-12-31$131,238
Total income from all sources2022-12-31$1,143,366
Expenses. Total of all expenses incurred2022-12-31$1,219,052
Benefits paid (including direct rollovers)2022-12-31$671,218
Total plan assets at end of year2022-12-31$257,033
Total plan assets at beginning of year2022-12-31$393,765
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$107,634
Expenses. Other expenses not covered elsewhere2022-12-31$366,577
Contributions received from other sources (not participants or employers)2022-12-31$10,742
Other income received2022-12-31$985
Net income (gross income less expenses)2022-12-31$-75,686
Net plan assets at end of year (total assets less liabilities)2022-12-31$186,841
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$262,527
Total contributions received or receivable from employer(s)2022-12-31$1,024,005
Value of corrective distributions2022-12-31$176,456
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$4,801
2021 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$131,238
Total plan liabilities at beginning of year2021-12-31$65,133
Total income from all sources2021-12-31$1,248,867
Expenses. Total of all expenses incurred2021-12-31$1,267,636
Benefits paid (including direct rollovers)2021-12-31$675,920
Total plan assets at end of year2021-12-31$393,765
Total plan assets at beginning of year2021-12-31$346,429
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$128,464
Expenses. Other expenses not covered elsewhere2021-12-31$379,168
Contributions received from other sources (not participants or employers)2021-12-31$2,883
Other income received2021-12-31$1,122
Net income (gross income less expenses)2021-12-31$-18,769
Net plan assets at end of year (total assets less liabilities)2021-12-31$262,527
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$281,296
Total contributions received or receivable from employer(s)2021-12-31$1,116,398
Value of corrective distributions2021-12-31$196,666
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$15,882
2020 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$65,133
Total plan liabilities at beginning of year2020-12-31$74,713
Total income from all sources2020-12-31$1,401,556
Expenses. Total of all expenses incurred2020-12-31$1,146,946
Benefits paid (including direct rollovers)2020-12-31$720,793
Total plan assets at end of year2020-12-31$346,429
Total plan assets at beginning of year2020-12-31$101,399
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$118,883
Expenses. Other expenses not covered elsewhere2020-12-31$405,236
Contributions received from other sources (not participants or employers)2020-12-31$19,686
Other income received2020-12-31$670
Net income (gross income less expenses)2020-12-31$254,610
Net plan assets at end of year (total assets less liabilities)2020-12-31$281,296
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$26,686
Total contributions received or receivable from employer(s)2020-12-31$1,262,317
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$20,917
2019 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$74,713
Total plan liabilities at beginning of year2019-12-31$76,733
Total income from all sources2019-12-31$1,130,298
Expenses. Total of all expenses incurred2019-12-31$1,076,850
Benefits paid (including direct rollovers)2019-12-31$705,777
Total plan assets at end of year2019-12-31$101,399
Total plan assets at beginning of year2019-12-31$49,971
Value of fidelity bond covering the plan2019-12-31$500,000
Total contributions received or receivable from participants2019-12-31$76,886
Expenses. Other expenses not covered elsewhere2019-12-31$342,034
Contributions received from other sources (not participants or employers)2019-12-31$7,927
Other income received2019-12-31$231
Net income (gross income less expenses)2019-12-31$53,448
Net plan assets at end of year (total assets less liabilities)2019-12-31$26,686
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$-26,762
Total contributions received or receivable from employer(s)2019-12-31$1,045,254
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$29,039
2018 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$76,733
Total plan liabilities at beginning of year2018-12-31$55,228
Total income from all sources2018-12-31$1,207,667
Expenses. Total of all expenses incurred2018-12-31$1,271,370
Benefits paid (including direct rollovers)2018-12-31$839,657
Total plan assets at end of year2018-12-31$49,971
Total plan assets at beginning of year2018-12-31$92,169
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$66,878
Expenses. Other expenses not covered elsewhere2018-12-31$212,763
Other income received2018-12-31$370,903
Net income (gross income less expenses)2018-12-31$-63,703
Net plan assets at end of year (total assets less liabilities)2018-12-31$-26,762
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$36,941
Total contributions received or receivable from employer(s)2018-12-31$769,886
Value of corrective distributions2018-12-31$120,000
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$98,950
2017 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$55,228
Total plan liabilities at beginning of year2017-12-31$50,917
Total income from all sources2017-12-31$893,781
Expenses. Total of all expenses incurred2017-12-31$1,116,433
Benefits paid (including direct rollovers)2017-12-31$687,521
Total plan assets at end of year2017-12-31$92,169
Total plan assets at beginning of year2017-12-31$310,510
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$77,332
Expenses. Other expenses not covered elsewhere2017-12-31$198,044
Other income received2017-12-31$23,363
Net income (gross income less expenses)2017-12-31$-222,652
Net plan assets at end of year (total assets less liabilities)2017-12-31$36,941
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$259,593
Total contributions received or receivable from employer(s)2017-12-31$793,086
Value of corrective distributions2017-12-31$120,000
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$110,868
2016 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$50,917
Total plan liabilities at beginning of year2016-12-31$58,936
Total income from all sources2016-12-31$875,085
Expenses. Total of all expenses incurred2016-12-31$723,933
Benefits paid (including direct rollovers)2016-12-31$375,014
Total plan assets at end of year2016-12-31$310,510
Total plan assets at beginning of year2016-12-31$167,377
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$159,436
Expenses. Other expenses not covered elsewhere2016-12-31$194,553
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$5,351
Net income (gross income less expenses)2016-12-31$151,152
Net plan assets at end of year (total assets less liabilities)2016-12-31$259,593
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$108,441
Total contributions received or receivable from employer(s)2016-12-31$710,298
Value of corrective distributions2016-12-31$48,000
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$106,366
2015 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$58,936
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$992,204
Expenses. Total of all expenses incurred2015-12-31$932,179
Benefits paid (including direct rollovers)2015-12-31$636,587
Total plan assets at end of year2015-12-31$167,377
Total plan assets at beginning of year2015-12-31$48,416
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$167,914
Expenses. Other expenses not covered elsewhere2015-12-31$190,344
Other income received2015-12-31$156,016
Net income (gross income less expenses)2015-12-31$60,025
Net plan assets at end of year (total assets less liabilities)2015-12-31$108,441
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$48,416
Total contributions received or receivable from employer(s)2015-12-31$668,274
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$105,248
2014 : TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2014 401k financial data
Total income from all sources2014-12-31$971,796
Expenses. Total of all expenses incurred2014-12-31$923,380
Benefits paid (including direct rollovers)2014-12-31$635,888
Total plan assets at end of year2014-12-31$48,416
Total plan assets at beginning of year2014-12-31$0
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$165,884
Expenses. Other expenses not covered elsewhere2014-12-31$172,976
Other income received2014-12-31$163,329
Net income (gross income less expenses)2014-12-31$48,416
Net plan assets at end of year (total assets less liabilities)2014-12-31$48,416
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$642,583
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$114,516

Form 5500 Responses for TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN

2023: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: TRANS/AIR MFG., CORP. S/F MEDICAL REIMBURSEMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93340 )
Policy contract number407371-D
Policy instance 1
Insurance contract or identification number407371-D
Number of Individuals Covered117
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $440,287
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: 93340 )
Policy contract number407371
Policy instance 1
Insurance contract or identification number407371
Number of Individuals Covered90
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $305,153
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: 93340 )
Policy contract number407371
Policy instance 1
Insurance contract or identification number407371
Number of Individuals Covered86
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $316,274
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: 93340 )
Policy contract number4073471
Policy instance 2
Insurance contract or identification number4073471
Number of Individuals Covered87
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $332,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500102
Policy instance 1
Insurance contract or identification number30500102
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered97
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $268,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered82
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $212,763
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered78
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $198,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberVERIS
Policy instance 2
Insurance contract or identification numberVERIS
Number of Individuals Covered77
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 $190,506
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: 00000 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 $-162
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: 00000 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered73
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 $172,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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