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MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 401k Plan overview

Plan NameMENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN
Plan identification number 502

MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN Benefits

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

401k Sponsoring company profile

MENNEL MILLING COMPANY has sponsored the creation of one or more 401k plans.

Company Name:MENNEL MILLING COMPANY
Employer identification number (EIN):344302060
NAIC Classification:311200
NAIC Description: Grain and Oilseed Milling

Additional information about MENNEL MILLING COMPANY

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1904-04-25
Company Identification Number: 45432
Legal Registered Office Address: 220 WEST SANDUSKY STREET
-
FINDLAY
United States of America (USA)
45840

More information about MENNEL MILLING COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-07-01
5022021-07-01
5022020-07-01
5022019-07-01
5022018-07-01
5022017-07-01LORI KITCHEN LORI KITCHEN2019-01-10
5022016-07-01LORI KITCHEN LORI KITCHEN2018-03-14
5022015-07-01LORI KITCHEN LORI KITCHEN2016-12-13
5022014-07-01LORI KITCHEN2015-12-31 LORI KITCHEN2016-01-04
5022013-07-01LORI KITCHEN2015-01-28 LORI KITCHEN2015-01-30
5022012-07-01LORI KITCHEN2014-04-04 LORI KITCHEN2014-04-04
5022011-07-01LORI KITCHEN2013-04-15 LORI KITCHEN2013-04-15
5022009-07-01MARK HALL2011-04-13 MARK HALL2011-04-13

Plan Statistics for MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN

401k plan membership statisitcs for MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN

Measure Date Value
2022: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01437
Total number of active participants reported on line 7a of the Form 55002022-07-01547
Number of retired or separated participants receiving benefits2022-07-010
Total of all active and inactive participants2022-07-01547
Total participants2022-07-01547
2021: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01466
Total number of active participants reported on line 7a of the Form 55002021-07-01446
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01446
Total participants2021-07-01446
2020: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01444
Total number of active participants reported on line 7a of the Form 55002020-07-01476
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01476
Total participants2020-07-01476
2019: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01456
Total number of active participants reported on line 7a of the Form 55002019-07-01451
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01451
Total participants2019-07-01451
2018: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01405
Total number of active participants reported on line 7a of the Form 55002018-07-01446
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01446
Total participants2018-07-01446
2017: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01386
Total number of active participants reported on line 7a of the Form 55002017-07-01405
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01405
Total participants2017-07-01405
2016: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01263
Total number of active participants reported on line 7a of the Form 55002016-07-01386
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01386
Total participants2016-07-01386
2015: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01246
Total number of active participants reported on line 7a of the Form 55002015-07-01263
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01263
Total participants2015-07-01263
2014: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01251
Total number of active participants reported on line 7a of the Form 55002014-07-01246
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01246
Total participants2014-07-01246
2013: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01249
Total number of active participants reported on line 7a of the Form 55002013-07-01249
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01249
Total participants2013-07-01249
2012: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01253
Total number of active participants reported on line 7a of the Form 55002012-07-01251
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01251
Total participants2012-07-01251
2011: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01250
Total number of active participants reported on line 7a of the Form 55002011-07-01257
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01257
Total participants2011-07-01257
2009: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01210
Total number of active participants reported on line 7a of the Form 55002009-07-01219
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01219
Total participants2009-07-01219

Form 5500 Responses for MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN

2022: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – General assets of the sponsorYes
2012: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – General assets of the sponsorYes
2011: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – General assets of the sponsorYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – General assets of the sponsorYes
2009: MENNEL MILLING COMPANY MEDICAL, DENTAL, AND WEEKLY INCOME BENEFIT PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – General assets of the sponsorYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number10265
Policy instance 1
Insurance contract or identification number10265
Number of Individuals Covered547
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $19,401
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 $368,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,401
Insurance broker organization code?3
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number10265
Policy instance 1
Insurance contract or identification number10265
Number of Individuals Covered446
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
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 $474,501
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 number10265
Policy instance 1
Insurance contract or identification number10265
Number of Individuals Covered476
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $22,675
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 $430,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,675
Insurance broker organization code?5
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10265
Policy instance 1
Insurance contract or identification number10265
Number of Individuals Covered451
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $21,746
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 $413,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,746
Insurance broker organization code?5
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10265
Policy instance 1
Insurance contract or identification number10265
Number of Individuals Covered446
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $23,589
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 $448,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,589
Insurance broker organization code?5
HCC LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number10265
Policy instance 1
Insurance contract or identification number10265
Number of Individuals Covered405
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $22,375
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 $425,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,375
Insurance broker organization code?5
Insurance broker nameMEDICAL BENEFITS ADMINISTRATORS

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