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RENDR CARE PHYSICIANS 401(K) PLAN 401k Plan overview

Plan NameRENDR CARE PHYSICIANS 401(K) PLAN
Plan identification number 001

RENDR CARE PHYSICIANS 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

TRIBORO ADMINISTRATIVE SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:TRIBORO ADMINISTRATIVE SERVICES, LLC
Employer identification number (EIN):320618921
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RENDR CARE PHYSICIANS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01SIMON AMIRA2024-08-01
0012022-01-01DANIEL ROTHMAN2023-10-12
0012022-01-01DANIEL ROTHMAN2024-02-14
0012021-01-01DANIEL ROTHMAN2022-10-14
0012021-01-01DANIEL ROTHMAN2023-05-22
0012020-08-01DANIEL ROTHMAN2021-09-13

Plan Statistics for RENDR CARE PHYSICIANS 401(K) PLAN

401k plan membership statisitcs for RENDR CARE PHYSICIANS 401(K) PLAN

Measure Date Value
2023: RENDR CARE PHYSICIANS 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01740
Total number of active participants reported on line 7a of the Form 55002023-01-011,209
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-0188
Total of all active and inactive participants2023-01-011,297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-011,297
Number of participants with account balances2023-01-011,045
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-010
2022: RENDR CARE PHYSICIANS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01542
Total number of active participants reported on line 7a of the Form 55002022-01-01655
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0185
Total of all active and inactive participants2022-01-01740
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01740
Number of participants with account balances2022-01-01653
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: RENDR CARE PHYSICIANS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01356
Total number of active participants reported on line 7a of the Form 55002021-01-01465
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0177
Total of all active and inactive participants2021-01-01542
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01542
Number of participants with account balances2021-01-01269
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: RENDR CARE PHYSICIANS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01304
Total number of active participants reported on line 7a of the Form 55002020-08-01346
Number of other retired or separated participants entitled to future benefits2020-08-0110
Total of all active and inactive participants2020-08-01356
Total participants2020-08-01356
Number of participants with account balances2020-08-01188

Financial Data on RENDR CARE PHYSICIANS 401(K) PLAN

Measure Date Value
2023 : RENDR CARE PHYSICIANS 401(K) PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$8,114
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$15,901,857
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$962,858
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$916,211
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$13,808,512
Value of total assets at end of year2023-12-31$21,944,539
Value of total assets at beginning of year2023-12-31$6,997,426
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$46,647
Total interest from all sources2023-12-31$122,938
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$440,885
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2023-12-31$440,885
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$5,845,814
Participant contributions at end of year2023-12-31$43,655
Participant contributions at beginning of year2023-12-31$44,068
Participant contributions at end of year2023-12-31$0
Participant contributions at beginning of year2023-12-31$177,090
Assets. Other investments not covered elsewhere at end of year2023-12-31$959,709
Assets. Other investments not covered elsewhere at beginning of year2023-12-31$817,411
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$5,027,049
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-12-31$8,114
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$14,938,999
Value of net assets at end of year (total assets less liabilities)2023-12-31$21,936,425
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$6,997,426
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Investment advisory and management fees2023-12-31$46,647
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$20,373,021
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$4,661,379
Interest on participant loans2023-12-31$3,351
Interest earned on other investments2023-12-31$119,587
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$184,881
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$2
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$2
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$104,196
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$1,529,522
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$2,935,649
Employer contributions (assets) at end of year2023-12-31$383,273
Employer contributions (assets) at beginning of year2023-12-31$1,297,476
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$812,015
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31BDO USA P.C.
Accountancy firm EIN2023-12-31135381590
2022 : RENDR CARE PHYSICIANS 401(K) PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-196,492
Total unrealized appreciation/depreciation of assets2022-12-31$-196,492
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$238,144
Total income from all sources (including contributions)2022-12-31$5,305,559
Total loss/gain on sale of assets2022-12-31$-24,368
Total of all expenses incurred2022-12-31$387,029
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$132,635
Value of total corrective distributions2022-12-31$238,144
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$5,440,063
Value of total assets at end of year2022-12-31$6,997,428
Value of total assets at beginning of year2022-12-31$2,317,042
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$16,250
Total interest from all sources2022-12-31$465
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$85,891
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$85,891
Administrative expenses professional fees incurred2022-12-31$16,367
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
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$2,364,490
Participant contributions at end of year2022-12-31$44,068
Participant contributions at beginning of year2022-12-31$0
Participant contributions at end of year2022-12-31$177,090
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$817,411
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$1,778,097
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$24,323
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$238,144
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$4,918,530
Value of net assets at end of year (total assets less liabilities)2022-12-31$6,997,428
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,078,898
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
Investment advisory and management fees2022-12-31$6,244
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$4,661,381
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$2,246,431
Interest on participant loans2022-12-31$465
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$2
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$70,611
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$70,611
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$104,196
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-489,427
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$1,297,476
Employer contributions (assets) at end of year2022-12-31$1,297,476
Employer contributions (assets) at beginning of year2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$4,116
Contract administrator fees2022-12-31$10,006
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$-24,368
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BDO USA P.C.
Accountancy firm EIN2022-12-31135381590
2021 : RENDR CARE PHYSICIANS 401(K) PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$-117,643
Total unrealized appreciation/depreciation of assets2021-12-31$-117,643
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,768,903
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$9,095
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$3,010
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,609,855
Value of total assets at end of year2021-12-31$2,317,042
Value of total assets at beginning of year2021-12-31$557,234
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$6,085
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$38,907
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$38,907
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,296,410
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$313,445
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$238,144
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,759,808
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,317,042
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$557,234
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
Investment advisory and management fees2021-12-31$6,085
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$2,246,431
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$557,234
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$70,611
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$237,784
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$3,010
Did the plan have assets held for investment2021-12-31Yes
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 name2021-12-31BDO USA, LLP
Accountancy firm EIN2021-12-31135381590
2020 : RENDR CARE PHYSICIANS 401(K) PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$557,395
Total of all expenses incurred2020-12-31$161
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$161
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$523,587
Value of total assets at end of year2020-12-31$557,234
Value of total assets at beginning of year2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$6,855
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$6,855
Was this plan covered by a fidelity bond2020-12-31No
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$523,587
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$161
Total non interest bearing cash at end of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$557,234
Value of net assets at end of year (total assets less liabilities)2020-12-31$557,234
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$0
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$557,234
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$26,953
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
Did the plan have assets held for investment2020-12-31Yes
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

Form 5500 Responses for RENDR CARE PHYSICIANS 401(K) PLAN

2023: RENDR CARE PHYSICIANS 401(K) PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: RENDR CARE PHYSICIANS 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: RENDR CARE PHYSICIANS 401(K) 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 – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: RENDR CARE PHYSICIANS 401(K) PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01First time form 5500 has been submittedYes
2020-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-08-01Plan funding arrangement – TrustYes
2020-08-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number7780775
Policy instance 1
Insurance contract or identification number7780775
Number of Individuals Covered2
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $7,294
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number213215692
Policy instance 1
Insurance contract or identification number213215692
Number of Individuals Covered2
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?1
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number7780775
Policy instance 1
Insurance contract or identification number7780775
Number of Individuals Covered2
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,294
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,294

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