H2, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan H2, L.L.C. EMPLOYEE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2024 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2024 401k financial data |
|---|
| Total plan liabilities at end of year | 2024-06-01 | $113,907 |
| Total plan liabilities at beginning of year | 2024-06-01 | $98,526 |
| Total income from all sources | 2024-06-01 | $41,343 |
| Expenses. Total of all expenses incurred | 2024-06-01 | $61,103 |
| Benefits paid (including direct rollovers) | 2024-06-01 | $46,494 |
| Total plan assets at end of year | 2024-06-01 | $5,447 |
| Total plan assets at beginning of year | 2024-06-01 | $9,826 |
| Value of fidelity bond covering the plan | 2024-06-01 | $250,000 |
| Total contributions received or receivable from participants | 2024-06-01 | $27,255 |
| Expenses. Other expenses not covered elsewhere | 2024-06-01 | $14,303 |
| Contributions received from other sources (not participants or employers) | 2024-06-01 | $0 |
| Other income received | 2024-06-01 | $23 |
| Net income (gross income less expenses) | 2024-06-01 | $-19,760 |
| Net plan assets at end of year (total assets less liabilities) | 2024-06-01 | $-108,460 |
| Net plan assets at beginning of year (total assets less liabilities) | 2024-06-01 | $-88,700 |
| Total contributions received or receivable from employer(s) | 2024-06-01 | $14,065 |
| Value of corrective distributions | 2024-06-01 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2024-06-01 | $306 |
| Total plan liabilities at end of year | 2024-05-31 | $98,526 |
| Total plan liabilities at beginning of year | 2024-05-31 | $49,588 |
| Total income from all sources | 2024-05-31 | $517,465 |
| Expenses. Total of all expenses incurred | 2024-05-31 | $735,269 |
| Benefits paid (including direct rollovers) | 2024-05-31 | $390,304 |
| Total plan assets at end of year | 2024-05-31 | $9,826 |
| Total plan assets at beginning of year | 2024-05-31 | $178,692 |
| Value of fidelity bond covering the plan | 2024-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2024-05-31 | $275,753 |
| Expenses. Other expenses not covered elsewhere | 2024-05-31 | $183,796 |
| Contributions received from other sources (not participants or employers) | 2024-05-31 | $0 |
| Other income received | 2024-05-31 | $1,408 |
| Net income (gross income less expenses) | 2024-05-31 | $-217,804 |
| Net plan assets at end of year (total assets less liabilities) | 2024-05-31 | $-88,700 |
| Net plan assets at beginning of year (total assets less liabilities) | 2024-05-31 | $129,104 |
| Total contributions received or receivable from employer(s) | 2024-05-31 | $240,304 |
| Value of corrective distributions | 2024-05-31 | $157,323 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2024-05-31 | $3,846 |
| 2023 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2023 401k financial data |
|---|
| Total plan liabilities at end of year | 2023-05-31 | $49,588 |
| Total plan liabilities at beginning of year | 2023-05-31 | $79,771 |
| Total income from all sources | 2023-05-31 | $692,596 |
| Expenses. Total of all expenses incurred | 2023-05-31 | $518,565 |
| Benefits paid (including direct rollovers) | 2023-05-31 | $150,940 |
| Total plan assets at end of year | 2023-05-31 | $178,692 |
| Total plan assets at beginning of year | 2023-05-31 | $34,844 |
| Value of fidelity bond covering the plan | 2023-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2023-05-31 | $289,882 |
| Expenses. Other expenses not covered elsewhere | 2023-05-31 | $213,003 |
| Contributions received from other sources (not participants or employers) | 2023-05-31 | $0 |
| Other income received | 2023-05-31 | $1,393 |
| Net income (gross income less expenses) | 2023-05-31 | $174,031 |
| Net plan assets at end of year (total assets less liabilities) | 2023-05-31 | $129,104 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-05-31 | $-44,927 |
| Total contributions received or receivable from employer(s) | 2023-05-31 | $401,321 |
| Value of corrective distributions | 2023-05-31 | $151,117 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2023-05-31 | $3,505 |
| 2022 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2022 401k financial data |
|---|
| Total plan liabilities at end of year | 2022-05-31 | $79,771 |
| Total plan liabilities at beginning of year | 2022-05-31 | $690 |
| Total income from all sources | 2022-05-31 | $627,447 |
| Expenses. Total of all expenses incurred | 2022-05-31 | $710,679 |
| Benefits paid (including direct rollovers) | 2022-05-31 | $419,008 |
| Total plan assets at end of year | 2022-05-31 | $34,844 |
| Total plan assets at beginning of year | 2022-05-31 | $38,995 |
| Value of fidelity bond covering the plan | 2022-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2022-05-31 | $257,878 |
| Expenses. Other expenses not covered elsewhere | 2022-05-31 | $184,173 |
| Other income received | 2022-05-31 | $28 |
| Net income (gross income less expenses) | 2022-05-31 | $-83,232 |
| Net plan assets at end of year (total assets less liabilities) | 2022-05-31 | $-44,927 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-05-31 | $38,305 |
| Total contributions received or receivable from employer(s) | 2022-05-31 | $369,541 |
| Value of corrective distributions | 2022-05-31 | $78,563 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-05-31 | $28,935 |
| 2021 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-05-31 | $690 |
| Total plan liabilities at beginning of year | 2021-05-31 | $10,861 |
| Total income from all sources | 2021-05-31 | $575,101 |
| Expenses. Total of all expenses incurred | 2021-05-31 | $591,546 |
| Benefits paid (including direct rollovers) | 2021-05-31 | $403,296 |
| Total plan assets at end of year | 2021-05-31 | $38,995 |
| Total plan assets at beginning of year | 2021-05-31 | $65,611 |
| Value of fidelity bond covering the plan | 2021-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2021-05-31 | $265,656 |
| Expenses. Other expenses not covered elsewhere | 2021-05-31 | $124,817 |
| Other income received | 2021-05-31 | $21 |
| Net income (gross income less expenses) | 2021-05-31 | $-16,445 |
| Net plan assets at end of year (total assets less liabilities) | 2021-05-31 | $38,305 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-05-31 | $54,750 |
| Total contributions received or receivable from employer(s) | 2021-05-31 | $309,424 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-05-31 | $63,433 |
| 2020 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-05-31 | $10,861 |
| Total plan liabilities at beginning of year | 2020-05-31 | $1,939 |
| Total income from all sources | 2020-05-31 | $512,162 |
| Expenses. Total of all expenses incurred | 2020-05-31 | $457,412 |
| Benefits paid (including direct rollovers) | 2020-05-31 | $274,895 |
| Total plan assets at end of year | 2020-05-31 | $65,611 |
| Total plan assets at beginning of year | 2020-05-31 | $1,939 |
| Value of fidelity bond covering the plan | 2020-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2020-05-31 | $270,996 |
| Expenses. Other expenses not covered elsewhere | 2020-05-31 | $113,565 |
| Other income received | 2020-05-31 | $50 |
| Net income (gross income less expenses) | 2020-05-31 | $54,750 |
| Net plan assets at end of year (total assets less liabilities) | 2020-05-31 | $54,750 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-05-31 | $0 |
| Total contributions received or receivable from employer(s) | 2020-05-31 | $241,116 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-05-31 | $68,952 |
| 2019 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-05-31 | $1,939 |
| Total plan liabilities at beginning of year | 2019-05-31 | $43,000 |
| Total income from all sources | 2019-05-31 | $492,715 |
| Expenses. Total of all expenses incurred | 2019-05-31 | $506,739 |
| Benefits paid (including direct rollovers) | 2019-05-31 | $321,478 |
| Total plan assets at end of year | 2019-05-31 | $1,939 |
| Total plan assets at beginning of year | 2019-05-31 | $57,024 |
| Value of fidelity bond covering the plan | 2019-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2019-05-31 | $291,395 |
| Expenses. Other expenses not covered elsewhere | 2019-05-31 | $107,687 |
| Other income received | 2019-05-31 | $50 |
| Net income (gross income less expenses) | 2019-05-31 | $-14,024 |
| Net plan assets at end of year (total assets less liabilities) | 2019-05-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-05-31 | $14,024 |
| Total contributions received or receivable from employer(s) | 2019-05-31 | $201,270 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-05-31 | $77,574 |
| 2018 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-05-31 | $43,000 |
| Total plan liabilities at beginning of year | 2018-05-31 | $90,032 |
| Total income from all sources | 2018-05-31 | $421,352 |
| Expenses. Total of all expenses incurred | 2018-05-31 | $363,440 |
| Benefits paid (including direct rollovers) | 2018-05-31 | $210,545 |
| Total plan assets at end of year | 2018-05-31 | $57,024 |
| Total plan assets at beginning of year | 2018-05-31 | $46,144 |
| Value of fidelity bond covering the plan | 2018-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2018-05-31 | $247,869 |
| Expenses. Other expenses not covered elsewhere | 2018-05-31 | $88,330 |
| Other income received | 2018-05-31 | $25 |
| Net income (gross income less expenses) | 2018-05-31 | $57,912 |
| Net plan assets at end of year (total assets less liabilities) | 2018-05-31 | $14,024 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-05-31 | $-43,888 |
| Total contributions received or receivable from employer(s) | 2018-05-31 | $173,458 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-05-31 | $64,565 |
| 2017 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-05-31 | $90,032 |
| Total plan liabilities at beginning of year | 2017-05-31 | $0 |
| Total income from all sources | 2017-05-31 | $357,001 |
| Expenses. Total of all expenses incurred | 2017-05-31 | $419,521 |
| Benefits paid (including direct rollovers) | 2017-05-31 | $289,765 |
| Total plan assets at end of year | 2017-05-31 | $46,144 |
| Total plan assets at beginning of year | 2017-05-31 | $18,632 |
| Value of fidelity bond covering the plan | 2017-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2017-05-31 | $228,146 |
| Expenses. Other expenses not covered elsewhere | 2017-05-31 | $71,179 |
| Other income received | 2017-05-31 | $12 |
| Net income (gross income less expenses) | 2017-05-31 | $-62,520 |
| Net plan assets at end of year (total assets less liabilities) | 2017-05-31 | $-43,888 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-05-31 | $18,632 |
| Total contributions received or receivable from employer(s) | 2017-05-31 | $128,843 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-05-31 | $58,577 |
| 2016 : H2, L.L.C. EMPLOYEE BENEFIT PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-05-31 | $28,998 |
| Expenses. Total of all expenses incurred | 2016-05-31 | $10,366 |
| Total plan assets at end of year | 2016-05-31 | $18,632 |
| Total plan assets at beginning of year | 2016-05-31 | $0 |
| Value of fidelity bond covering the plan | 2016-05-31 | $250,000 |
| Total contributions received or receivable from participants | 2016-05-31 | $17,296 |
| Expenses. Other expenses not covered elsewhere | 2016-05-31 | $5,805 |
| Net income (gross income less expenses) | 2016-05-31 | $18,632 |
| Net plan assets at end of year (total assets less liabilities) | 2016-05-31 | $18,632 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-05-31 | $0 |
| Total contributions received or receivable from employer(s) | 2016-05-31 | $11,702 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-05-31 | $4,561 |
| 2023: H2, L.L.C. EMPLOYEE BENEFIT PLAN 2023 form 5500 responses |
|---|
| 2023-06-01 | Type of plan entity | Single employer plan |
| 2023-06-01 | Submission has been amended | No |
| 2023-06-01 | This submission is the final filing | No |
| 2023-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-06-01 | Plan is a collectively bargained plan | No |
| 2023-06-01 | Plan funding arrangement – Insurance | Yes |
| 2023-06-01 | Plan funding arrangement – Trust | Yes |
| 2023-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-06-01 | Plan benefit arrangement - Trust | Yes |
| 2022: H2, L.L.C. EMPLOYEE BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-06-01 | Type of plan entity | Single employer plan |
| 2022-06-01 | Submission has been amended | No |
| 2022-06-01 | This submission is the final filing | No |
| 2022-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-06-01 | Plan is a collectively bargained plan | No |
| 2022-06-01 | Plan funding arrangement – Insurance | Yes |
| 2022-06-01 | Plan funding arrangement – Trust | Yes |
| 2022-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-06-01 | Plan benefit arrangement - Trust | Yes |
| 2021: H2, L.L.C. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-06-01 | Type of plan entity | Single employer plan |
| 2021-06-01 | Submission has been amended | No |
| 2021-06-01 | This submission is the final filing | No |
| 2021-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-06-01 | Plan is a collectively bargained plan | No |
| 2021-06-01 | Plan funding arrangement – Insurance | Yes |
| 2021-06-01 | Plan funding arrangement – Trust | Yes |
| 2021-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-06-01 | Plan benefit arrangement - Trust | Yes |
| 2020: H2, L.L.C. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | Submission has been amended | No |
| 2020-06-01 | This submission is the final filing | No |
| 2020-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-06-01 | Plan is a collectively bargained plan | No |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | Plan funding arrangement – Trust | Yes |
| 2020-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-06-01 | Plan benefit arrangement - Trust | Yes |
| 2019: H2, L.L.C. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Submission has been amended | No |
| 2019-06-01 | This submission is the final filing | No |
| 2019-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-06-01 | Plan is a collectively bargained plan | No |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan funding arrangement – Trust | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement - Trust | Yes |
| 2018: H2, L.L.C. EMPLOYEE BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Submission has been amended | No |
| 2018-06-01 | This submission is the final filing | No |
| 2018-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-06-01 | Plan is a collectively bargained plan | No |
| 2018-06-01 | Plan funding arrangement – Insurance | Yes |
| 2018-06-01 | Plan funding arrangement – Trust | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-06-01 | Plan benefit arrangement - Trust | Yes |
| 2017: H2, L.L.C. EMPLOYEE BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Submission has been amended | No |
| 2017-06-01 | This submission is the final filing | No |
| 2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-06-01 | Plan is a collectively bargained plan | No |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan funding arrangement – Trust | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement - Trust | Yes |
| 2016: H2, L.L.C. EMPLOYEE BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Submission has been amended | No |
| 2016-06-01 | This submission is the final filing | No |
| 2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-06-01 | Plan is a collectively bargained plan | No |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan funding arrangement – Trust | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement - Trust | Yes |
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | First time form 5500 has been submitted | Yes |
| 2016-05-01 | Submission has been amended | No |
| 2016-05-01 | This submission is the final filing | No |
| 2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2016-05-01 | Plan is a collectively bargained plan | No |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan funding arrangement – Trust | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement - Trust | Yes |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 960486 |
| Policy instance | 3 |
| Insurance contract or identification number | 960486 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2023-06-01 | | Insurance policy end date | 2024-05-31 | | Total amount of commissions paid to insurance broker | USD $8,293 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENT, VOLUNTARY LIFE AND AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $73,736 | | 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 | 00531865 |
| Policy instance | 2 |
| Insurance contract or identification number | 00531865 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2023-06-01 | | Insurance policy end date | 2024-05-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | SL30800016 |
| Policy instance | 1 |
| Insurance contract or identification number | SL30800016 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2023-06-01 | | Insurance policy end date | 2024-05-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $145,292 | | 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 | 00531865 |
| Policy instance | 3 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1126876 |
| Policy instance | 2 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | SL30800016 |
| Policy instance | 1 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | SL30800016 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 00000 |
| Policy instance | 2 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8912 |
| Policy instance | 4 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 136873 |
| Policy instance | 3 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 00000 |
| Policy instance | 2 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | SL30800016 |
| Policy instance | 1 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8912 |
| Policy instance | 5 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 136873 |
| Policy instance | 4 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 163304 |
| Policy instance | 3 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | SL30800016 |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 163304 |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 163304 |
| Policy instance | 1 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | GENESIS |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 163304 |
| Policy instance | 3 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 136873 |
| Policy instance | 4 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 8912 |
| Policy instance | 5 |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
| Policy contract number | GENESIS |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00448428 |
| Policy instance | 1 |
