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MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan NameMEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN
Plan identification number 501

MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. has sponsored the creation of one or more 401k plans.

Company Name:MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO.
Employer identification number (EIN):314210910
NAIC Classification:524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012017-01-01CAROLINE FRAKER JOHN E NYDEGGER JR2018-10-10
5012016-01-01CAROLINE FRAKER JOHN E NYDEGGER JR2017-10-12
5012015-01-01CAROLINE FRAKER2016-10-17 JOHN E NYDEGGER JR2016-10-17
5012014-01-01CAROLINE FRAKER JOHN E NYDEGGER JR2016-11-11
5012014-01-01CAROLINE FRAKER2015-10-14 JOHN E NYDEGGER JR2015-10-14
5012013-01-01CAROLINE FRAKER2015-07-31 JOHN E NYDEGGER JR2015-07-31
5012012-01-01CAROLINE FRAKER2015-07-31 JOHN E NYDEGGER JR2015-07-31
5012011-01-01CAROLINE FRAKER2015-07-31 JOHN E NYDEGGER JR2015-07-31
5012010-01-01CAROLINE FRAKER2015-07-31 JOHN E NYDEGGER JR2015-07-31
5012009-09-15CAROLINE FRAKER2015-07-31 JOHN E NYDEGGER JR2015-07-31
5012009-09-15TIMOTHY MULLIGAN2011-04-13 TIMOTHY MULLIGAN2011-04-14

Plan Statistics for MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2022: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01115
Total number of active participants reported on line 7a of the Form 55002022-01-01105
Number of retired or separated participants receiving benefits2022-01-018
Total of all active and inactive participants2022-01-01113
Total participants2022-01-01113
2021: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01121
Total number of active participants reported on line 7a of the Form 55002021-01-01115
Number of retired or separated participants receiving benefits2021-01-0119
Total of all active and inactive participants2021-01-01134
Total participants2021-01-01134
2020: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01122
Total number of active participants reported on line 7a of the Form 55002020-01-01121
Total of all active and inactive participants2020-01-01121
Total participants2020-01-01121
2019: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01115
Total number of active participants reported on line 7a of the Form 55002019-01-01122
Total of all active and inactive participants2019-01-01122
Total participants2019-01-01122
2017: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01129
Total number of active participants reported on line 7a of the Form 55002017-01-01114
Total of all active and inactive participants2017-01-01114
Total participants2017-01-01114
2016: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01134
Total number of active participants reported on line 7a of the Form 55002016-01-01128
Total of all active and inactive participants2016-01-01128
Total participants2016-01-01128
2015: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01134
Total number of active participants reported on line 7a of the Form 55002015-01-01134
Total of all active and inactive participants2015-01-01134
Total participants2015-01-01134
2014: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01139
Total number of active participants reported on line 7a of the Form 55002014-01-01134
Total of all active and inactive participants2014-01-01134
Total participants2014-01-01134
2013: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01138
Total number of active participants reported on line 7a of the Form 55002013-01-01139
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01139
Total participants2013-01-01139
2012: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01132
Total number of active participants reported on line 7a of the Form 55002012-01-01138
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01138
Total participants2012-01-01138
2011: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01137
Total number of active participants reported on line 7a of the Form 55002011-01-01132
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01132
Total participants2011-01-01132
2010: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01145
Total number of active participants reported on line 7a of the Form 55002010-01-01137
Number of retired or separated participants receiving benefits2010-01-010
Total of all active and inactive participants2010-01-01137
Total participants2010-01-01137
2009: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-15145
Total number of active participants reported on line 7a of the Form 55002009-09-15145
Number of retired or separated participants receiving benefits2009-09-150
Total of all active and inactive participants2009-09-15145
Total participants2009-09-15145
Number of other retired or separated participants entitled to future benefits2009-09-150

Financial Data on MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2022 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$73,644
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$245,137
Total income from all sources (including contributions)2022-12-31$1,572,098
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,409,740
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,388,011
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,572,098
Value of total assets at end of year2022-12-31$10,723
Value of total assets at beginning of year2022-12-31$19,858
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$21,729
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$21,729
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$3,100,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$212,075
Total non interest bearing cash at end of year2022-12-31$10,723
Total non interest bearing cash at beginning of year2022-12-31$19,858
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$162,358
Value of net assets at end of year (total assets less liabilities)2022-12-31$-62,921
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$-225,279
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$407,510
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,360,023
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$980,501
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Liabilities. Value of benefit claims payable at end of year2022-12-31$73,644
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$245,137
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WILSON SHANNON & SNOW
Accountancy firm EIN2022-12-31310829879
2021 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$245,137
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$92,338
Total income from all sources (including contributions)2021-12-31$1,783,881
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,927,525
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,902,122
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,783,881
Value of total assets at end of year2021-12-31$19,858
Value of total assets at beginning of year2021-12-31$10,703
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$25,403
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$25,403
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$3,100,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$248,881
Total non interest bearing cash at end of year2021-12-31$19,858
Total non interest bearing cash at beginning of year2021-12-31$10,703
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-143,644
Value of net assets at end of year (total assets less liabilities)2021-12-31$-225,279
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$-81,635
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$330,370
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,535,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,571,752
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Liabilities. Value of benefit claims payable at end of year2021-12-31$245,137
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$92,338
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WILSON SHANNON & SNOW
Accountancy firm EIN2021-12-31310829879
2020 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$92,338
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$110,365
Total income from all sources (including contributions)2020-12-31$1,531,417
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,512,395
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,487,665
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,531,417
Value of total assets at end of year2020-12-31$10,703
Value of total assets at beginning of year2020-12-31$9,708
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$24,730
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$24,730
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$3,100,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$271,377
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$40
Total non interest bearing cash at end of year2020-12-31$10,703
Total non interest bearing cash at beginning of year2020-12-31$9,708
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$19,022
Value of net assets at end of year (total assets less liabilities)2020-12-31$-81,635
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$-100,657
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$329,994
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,260,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,157,671
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Liabilities. Value of benefit claims payable at end of year2020-12-31$92,338
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$110,365
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31WILSON SHANNON & SNOW
Accountancy firm EIN2020-12-31310829879
2019 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$110,365
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$101,045
Total income from all sources (including contributions)2019-12-31$1,695,446
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,709,700
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,685,798
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,695,446
Value of total assets at end of year2019-12-31$9,708
Value of total assets at beginning of year2019-12-31$14,642
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$23,902
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$23,902
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$3,100,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$246,484
Total non interest bearing cash at end of year2019-12-31$9,708
Total non interest bearing cash at beginning of year2019-12-31$14,642
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-14,254
Value of net assets at end of year (total assets less liabilities)2019-12-31$-100,657
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-86,403
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$279,259
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$1,448,962
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,406,539
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Liabilities. Value of benefit claims payable at end of year2019-12-31$110,365
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$101,045
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31WILSON, SHANNON & SNOW
Accountancy firm EIN2019-12-31310829879
2018 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$101,045
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$121,709
Total income from all sources (including contributions)2018-12-31$1,440,411
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,407,324
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,384,682
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,440,411
Value of total assets at end of year2018-12-31$14,642
Value of total assets at beginning of year2018-12-31$2,219
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$22,642
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$22,642
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$3,100,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$202,727
Liabilities. Value of operating payables at end of year2018-12-31$0
Liabilities. Value of operating payables at beginning of year2018-12-31$2,933
Total non interest bearing cash at end of year2018-12-31$14,642
Total non interest bearing cash at beginning of year2018-12-31$2,219
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$33,087
Value of net assets at end of year (total assets less liabilities)2018-12-31$-86,403
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$-119,490
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$240,538
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$1,237,684
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,144,144
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$101,045
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$118,776
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31WILSON, SHANNON & SNOW
Accountancy firm EIN2018-12-31310829879
2017 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$121,709
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$82,143
Total income from all sources (including contributions)2017-12-31$1,397,411
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$1,463,386
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,440,661
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,397,411
Value of total assets at end of year2017-12-31$2,219
Value of total assets at beginning of year2017-12-31$28,628
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$22,725
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$22,725
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$3,100,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$208,544
Liabilities. Value of operating payables at end of year2017-12-31$2,933
Liabilities. Value of operating payables at beginning of year2017-12-31$2,933
Total non interest bearing cash at end of year2017-12-31$2,219
Total non interest bearing cash at beginning of year2017-12-31$28,628
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-65,975
Value of net assets at end of year (total assets less liabilities)2017-12-31$-119,490
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-53,515
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$209,637
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,188,867
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,231,024
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$118,776
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$79,210
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31WILSON, SHANNON & SNOW
Accountancy firm EIN2017-12-31310829879
2016 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$82,143
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$116,656
Total income from all sources (including contributions)2016-12-31$1,472,209
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,409,068
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,389,309
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,472,209
Value of total assets at end of year2016-12-31$28,628
Value of total assets at beginning of year2016-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$19,759
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$19,759
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$3,100,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$212,103
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$2,933
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$26,469
Total non interest bearing cash at end of year2016-12-31$28,628
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$63,141
Value of net assets at end of year (total assets less liabilities)2016-12-31$-53,515
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-116,656
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$192,703
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,260,106
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,196,606
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$79,210
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$90,187
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31WILSON, SHANNON & SNOW
Accountancy firm EIN2016-12-31310829879
2015 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$116,362
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$59,458
Total income from all sources (including contributions)2015-12-31$1,486,607
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$1,543,805
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,519,433
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,486,607
Value of total assets at end of year2015-12-31$-294
Value of total assets at beginning of year2015-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$24,372
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$20,372
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$3,100,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$224,813
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$26,175
Administrative expenses (other) incurred2015-12-31$4,000
Total non interest bearing cash at end of year2015-12-31$-294
Total non interest bearing cash at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-57,198
Value of net assets at end of year (total assets less liabilities)2015-12-31$-116,656
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-59,458
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$181,425
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$1,261,794
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,338,008
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$90,187
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$59,458
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31WILSON, SHANNON & SNOW
Accountancy firm EIN2015-12-31310829879
2014 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$59,458
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$328,009
Total income from all sources (including contributions)2014-12-31$1,666,356
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,633,090
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,597,462
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,666,356
Value of total assets at end of year2014-12-31$0
Value of total assets at beginning of year2014-12-31$235,285
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$35,628
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$21,117
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$3,100,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$222,337
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$198,305
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$196,120
Administrative expenses (other) incurred2014-12-31$14,511
Total non interest bearing cash at end of year2014-12-31$0
Total non interest bearing cash at beginning of year2014-12-31$36,980
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$33,266
Value of net assets at end of year (total assets less liabilities)2014-12-31$-59,458
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-92,724
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$215,362
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$1,444,019
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,382,100
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$59,458
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$131,889
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31WILSON, SHANNON & SNOW
Accountancy firm EIN2014-12-31310829879
2013 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$328,009
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$194,918
Total income from all sources (including contributions)2013-12-31$1,847,473
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$1,781,509
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,759,885
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,847,473
Value of total assets at end of year2013-12-31$235,285
Value of total assets at beginning of year2013-12-31$36,230
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$21,624
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$21,624
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$3,100,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$209,473
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$198,305
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$196,120
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$0
Total non interest bearing cash at end of year2013-12-31$36,980
Total non interest bearing cash at beginning of year2013-12-31$36,230
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$65,964
Value of net assets at end of year (total assets less liabilities)2013-12-31$-92,724
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-158,688
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$192,894
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$1,638,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,566,991
Liabilities. Value of benefit claims payable at end of year2013-12-31$131,889
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$194,918
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31WILSON, SHANNON & SNOW, INC.
Accountancy firm EIN2013-12-31310829879
2012 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$194,918
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$118,633
Total income from all sources (including contributions)2012-12-31$1,317,047
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,399,323
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,382,485
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,317,047
Value of total assets at end of year2012-12-31$36,230
Value of total assets at beginning of year2012-12-31$42,221
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$16,838
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$16,838
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$3,100,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$184,921
Total non interest bearing cash at end of year2012-12-31$36,230
Total non interest bearing cash at beginning of year2012-12-31$42,221
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-82,276
Value of net assets at end of year (total assets less liabilities)2012-12-31$-158,688
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-76,412
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$252,821
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,132,126
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,129,664
Liabilities. Value of benefit claims payable at end of year2012-12-31$194,918
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$118,633
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31WILSON, SHANNON & SNOW, INC.
Accountancy firm EIN2012-12-31310829879
2011 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$118,633
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$115,214
Total income from all sources (including contributions)2011-12-31$1,359,544
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$1,347,784
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,336,030
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,359,544
Value of total assets at end of year2011-12-31$42,221
Value of total assets at beginning of year2011-12-31$27,042
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$11,754
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$11,754
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$3,100,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$170,044
Total non interest bearing cash at end of year2011-12-31$42,221
Total non interest bearing cash at beginning of year2011-12-31$27,042
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$11,760
Value of net assets at end of year (total assets less liabilities)2011-12-31$-76,412
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-88,172
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$239,117
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$1,189,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,096,913
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$118,633
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$115,214
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31WILSON, SHANNON & SNOW, INC.
Accountancy firm EIN2011-12-31310829879
2010 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$115,214
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$152,222
Total income from all sources (including contributions)2010-12-31$1,286,410
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,253,819
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,241,619
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,286,410
Value of total assets at end of year2010-12-31$27,042
Value of total assets at beginning of year2010-12-31$31,459
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$12,200
Total interest from all sources2010-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$12,200
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$2,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$146,410
Total non interest bearing cash at end of year2010-12-31$27,042
Total non interest bearing cash at beginning of year2010-12-31$31,459
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$32,591
Value of net assets at end of year (total assets less liabilities)2010-12-31$-88,172
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-120,763
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$187,346
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$1,140,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,054,273
Liabilities. Value of benefit claims payable at end of year2010-12-31$115,214
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$152,222
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31WILSON, SHANNON & SNOW, INC.
Accountancy firm EIN2010-12-31310829879
2009 : MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2009 401k financial data
Total unrealized appreciation/depreciation of assets2009-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2009-12-31$152,222
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2009-12-31$0
Total income from all sources (including contributions)2009-12-31$379,628
Total loss/gain on sale of assets2009-12-31$0
Total of all expenses incurred2009-12-31$500,391
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2009-12-31$497,209
Total contributions o plan (from employers,participants, others, non cash contrinutions)2009-12-31$379,628
Value of total assets at end of year2009-12-31$31,459
Value of total assets at beginning of year2009-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2009-12-31$3,182
Total interest from all sources2009-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2009-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2009-12-31No
Administrative expenses professional fees incurred2009-12-31$3,182
Was this plan covered by a fidelity bond2009-12-31Yes
Value of fidelity bond cover2009-12-31$2,000,000
If this is an individual account plan, was there a blackout period2009-12-31No
Were there any nonexempt tranactions with any party-in-interest2009-12-31No
Contributions received from participants2009-12-31$47,833
Total non interest bearing cash at end of year2009-12-31$31,459
Total non interest bearing cash at beginning of year2009-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2009-12-31No
Value of net income/loss2009-12-31$-120,763
Value of net assets at end of year (total assets less liabilities)2009-12-31$-120,763
Value of net assets at beginning of year (total assets less liabilities)2009-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2009-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2009-12-31No
Were any leases to which the plan was party in default or uncollectible2009-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2009-12-31$28,017
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2009-12-31No
Was there a failure to transmit to the plan any participant contributions2009-12-31No
Has the plan failed to provide any benefit when due under the plan2009-12-31No
Contributions received in cash from employer2009-12-31$331,795
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2009-12-31$469,192
Liabilities. Value of benefit claims payable at end of year2009-12-31$152,222
Liabilities. Value of benefit claims payable at beginning of year2009-12-31$0
Did the plan have assets held for investment2009-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2009-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2009-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2009-12-31No
Opinion of an independent qualified public accountant for this plan2009-12-31Unqualified
Accountancy firm name2009-12-31WILSON, SHANNON & SNOW, INC.
Accountancy firm EIN2009-12-31310829879

Form 5500 Responses for MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN

2022: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT 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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
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 – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: MEDBEN EMPLOYEES HEALTH & WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-09-15Type of plan entitySingle employer plan
2009-09-15Submission has been amendedYes
2009-09-15This submission is the final filingNo
2009-09-15This return/report is a short plan year return/report (less than 12 months)No
2009-09-15Plan is a collectively bargained planNo
2009-09-15Plan funding arrangement – InsuranceYes
2009-09-15Plan funding arrangement – General assets of the sponsorYes
2009-09-15Plan benefit arrangement – InsuranceYes
2009-09-15Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

MEDICAL STOP LOSS COVERAGE - HCC BENEFITS (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered105
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 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 $407,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL STOP LOSS COVERAGE - HCC BENEFITS (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered115
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 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 $330,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL STOP LOSS COVERAGE - HCC BENEFITS (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered121
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $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 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 $329,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL STOP LOSS COVERAGE - HCC BENEFITS (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered122
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $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 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 $279,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL STOP LOSS COVERAGE - HCC BENEFITS (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $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 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 $209,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL STOP LOSS COVERAGE - HCC BENEFITS (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered136
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?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 $181,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered134
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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?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 $215,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered139
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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?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 $192,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered138
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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?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 $252,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered132
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?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 $239,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number19901
Policy instance 1
Insurance contract or identification number19901
Number of Individuals Covered145
Insurance policy start date2009-09-15
Insurance policy end date2009-12-31
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?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 $28,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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