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VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 401k Plan overview

Plan NameVITAL CONSULTING GROUP, LLC INSURANCE PROGRAM
Plan identification number 501

VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

VITAL CONSULTING GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name:VITAL CONSULTING GROUP, LLC
Employer identification number (EIN):270879500
NAIC Classification:237310
NAIC Description:Highway, Street, and Bridge Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01VINCENT MARTINEZ2023-07-06 VINCENT MARTINEZ2023-07-06
5012021-01-01VINCENT MARTINEZ2022-09-27 VINCENT MARTINEZ2022-09-27
5012020-01-01VINCENT MARTINEZ2021-10-04 VINCENT MARTINEZ2021-10-04
5012019-01-01VINCENT MARTINEZ2020-07-05 VINCENT MARTINEZ2020-07-05
5012018-01-01
5012017-01-01

Plan Statistics for VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM

401k plan membership statisitcs for VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM

Measure Date Value
2022: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2022 401k membership
Total participants, beginning-of-year2022-01-013
Total number of active participants reported on line 7a of the Form 55002022-01-013
Total of all active and inactive participants2022-01-013
2021: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2021 401k membership
Total participants, beginning-of-year2021-01-013
Total number of active participants reported on line 7a of the Form 55002021-01-013
Total of all active and inactive participants2021-01-013
2020: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2020 401k membership
Total participants, beginning-of-year2020-01-0124
Total number of active participants reported on line 7a of the Form 55002020-01-013
Total of all active and inactive participants2020-01-013
2019: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2019 401k membership
Total participants, beginning-of-year2019-01-0129
Total number of active participants reported on line 7a of the Form 55002019-01-0124
Total of all active and inactive participants2019-01-0124
2018: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2018 401k membership
Total participants, beginning-of-year2018-01-0133
Total number of active participants reported on line 7a of the Form 55002018-01-0129
Total of all active and inactive participants2018-01-0129
2017: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2017 401k membership
Total participants, beginning-of-year2017-01-010
Total number of active participants reported on line 7a of the Form 55002017-01-0133
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 participants2017-01-0133

Financial Data on VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM

Measure Date Value
2022 : VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2022 401k financial data
Total income from all sources2022-12-31$0
Expenses. Total of all expenses incurred2022-12-31$144
Benefits paid (including direct rollovers)2022-12-31$0
Total plan assets at end of year2022-12-31$1,756
Total plan assets at beginning of year2022-12-31$1,900
Net income (gross income less expenses)2022-12-31$-144
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,756
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,900
Total contributions received or receivable from employer(s)2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$144
2021 : VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2021 401k financial data
Total income from all sources2021-12-31$0
Expenses. Total of all expenses incurred2021-12-31$177
Benefits paid (including direct rollovers)2021-12-31$36
Total plan assets at end of year2021-12-31$1,900
Total plan assets at beginning of year2021-12-31$2,077
Net income (gross income less expenses)2021-12-31$-177
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,900
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$2,077
Total contributions received or receivable from employer(s)2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$141
2020 : VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2020 401k financial data
Total income from all sources2020-12-31$0
Expenses. Total of all expenses incurred2020-12-31$5,765
Benefits paid (including direct rollovers)2020-12-31$4,881
Total plan assets at end of year2020-12-31$2,077
Total plan assets at beginning of year2020-12-31$7,842
Net income (gross income less expenses)2020-12-31$-5,765
Net plan assets at end of year (total assets less liabilities)2020-12-31$2,077
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$7,842
Total contributions received or receivable from employer(s)2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$884
2019 : VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2019 401k financial data
Total income from all sources2019-12-31$17,402
Expenses. Total of all expenses incurred2019-12-31$72,389
Benefits paid (including direct rollovers)2019-12-31$92,422
Total plan assets at end of year2019-12-31$7,842
Total plan assets at beginning of year2019-12-31$62,829
Net income (gross income less expenses)2019-12-31$-54,987
Net plan assets at end of year (total assets less liabilities)2019-12-31$7,842
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$62,829
Total contributions received or receivable from employer(s)2019-12-31$17,402
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$-20,033
2018 : VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2018 401k financial data
Total income from all sources2018-12-31$259,429
Expenses. Total of all expenses incurred2018-12-31$241,842
Benefits paid (including direct rollovers)2018-12-31$186,138
Total plan assets at end of year2018-12-31$62,829
Total plan assets at beginning of year2018-12-31$45,242
Net income (gross income less expenses)2018-12-31$17,587
Net plan assets at end of year (total assets less liabilities)2018-12-31$62,829
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$45,242
Total contributions received or receivable from employer(s)2018-12-31$259,429
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$55,704
2017 : VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 2017 401k financial data
Total income from all sources2017-12-31$218,108
Expenses. Total of all expenses incurred2017-12-31$172,866
Benefits paid (including direct rollovers)2017-12-31$201,186
Total plan assets at end of year2017-12-31$45,242
Total plan assets at beginning of year2017-12-31$0
Net income (gross income less expenses)2017-12-31$45,242
Net plan assets at end of year (total assets less liabilities)2017-12-31$45,242
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$0
Total contributions received or receivable from employer(s)2017-12-31$218,108
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$-28,320

Form 5500 Responses for VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM

2022: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 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 – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 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 – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 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 – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 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: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 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: VITAL CONSULTING GROUP, LLC INSURANCE PROGRAM 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

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1562280
Policy instance 1
Insurance contract or identification number1562280
Number of Individuals Covered18
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $2,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
PRESBYTERIAN HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 95330 )
Policy contract numberGR010273
Policy instance 2
Insurance contract or identification numberGR010273
Number of Individuals Covered18
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $81,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number005A12342000D00
Policy instance 3
Insurance contract or identification number005A12342000D00
Number of Individuals Covered18
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $4,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1562280
Policy instance 1
Insurance contract or identification number1562280
Number of Individuals Covered29
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $6,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
PRESBYTERIAN HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 95330 )
Policy contract numberGR010273
Policy instance 2
Insurance contract or identification numberGR010273
Number of Individuals Covered29
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $161,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number005A12342000D00
Policy instance 3
Insurance contract or identification number005A12342000D00
Number of Individuals Covered29
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $10,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1562280
Policy instance 1
Insurance contract or identification number1562280
Number of Individuals Covered33
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $6,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameBERGER & BRIGGS
PRESBYTERIAN HEALTHCARE SERVICES (National Association of Insurance Commissioners NAIC id number: 95330 )
Policy contract numberGR010273
Policy instance 2
Insurance contract or identification numberGR010273
Number of Individuals Covered33
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $178,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameBERGER & BRIGGS
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number005A12342000D00
Policy instance 3
Insurance contract or identification number005A12342000D00
Number of Individuals Covered33
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $9,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameBERGER & BRIGGS

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