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PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan NamePRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number 501

PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN Benefits

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

401k Sponsoring company profile

PRESTIGE GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:PRESTIGE GROUP, INC.
Employer identification number (EIN):351642811
NAIC Classification:488510
NAIC Description:Freight Transportation Arrangement

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01
5012017-01-01
5012017-01-01
5012017-01-01
5012017-01-01
5012016-01-01WILLIAM LARSON WILLIAM LARSON2017-07-10
5012015-01-01WILLIAM LARSON2016-07-01 WILLIAM LARSON2016-07-01
5012014-01-01WILLIAM LARSON2015-10-08 WILLIAM LARSON2015-10-09
5012013-01-01WILLIAM LARSON2014-10-14 WILLIAM LARSON2014-10-14
5012012-01-01WILLIAM LARSON2013-10-10 WILLIAM LARSON2013-10-10
5012011-01-01STEVEN WINTERS2012-10-18 STEVEN WINTERS2012-10-19

Plan Statistics for PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN

401k plan membership statisitcs for PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2018: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-010
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-010
2017: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0125
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0125
Total number of active participants reported on line 7a of the Form 55002016-01-0126
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0126
Total participants2016-01-0126
2015: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0130
Total number of active participants reported on line 7a of the Form 55002015-01-0125
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0125
Total participants2015-01-0125
2014: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0128
Total number of active participants reported on line 7a of the Form 55002014-01-0130
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0130
Total participants2014-01-0130
2013: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0131
Total number of active participants reported on line 7a of the Form 55002013-01-0132
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 participants2013-01-0132
Total participants2013-01-0132
2012: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0127
Total number of active participants reported on line 7a of the Form 55002012-01-0133
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 participants2012-01-0133
Total participants2012-01-0133
2011: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0127
Total number of active participants reported on line 7a of the Form 55002011-01-0126
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 participants2011-01-0126
Total participants2011-01-0126

Financial Data on PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2018 : PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$-480,687
Total income from all sources2018-12-31$63
Total plan assets at end of year2018-12-31$0
Total plan assets at beginning of year2018-12-31$480,624
Other income received2018-12-31$63
Net income (gross income less expenses)2018-12-31$63
Net plan assets at end of year (total assets less liabilities)2018-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$480,624
2017 : PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k financial data
Total income from all sources2017-12-31$222,842
Expenses. Total of all expenses incurred2017-12-31$175,998
Benefits paid (including direct rollovers)2017-12-31$59,267
Total plan assets at end of year2017-12-31$480,624
Total plan assets at beginning of year2017-12-31$433,780
Value of fidelity bond covering the plan2017-12-31$300,000
Total contributions received or receivable from participants2017-12-31$47,295
Expenses. Other expenses not covered elsewhere2017-12-31$107,380
Contributions received from other sources (not participants or employers)2017-12-31$232
Net income (gross income less expenses)2017-12-31$46,844
Net plan assets at end of year (total assets less liabilities)2017-12-31$480,624
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$433,780
Total contributions received or receivable from employer(s)2017-12-31$175,315
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$9,351
2016 : PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k financial data
Total income from all sources2016-12-31$282,567
Expenses. Total of all expenses incurred2016-12-31$236,898
Benefits paid (including direct rollovers)2016-12-31$96,002
Total plan assets at end of year2016-12-31$433,780
Total plan assets at beginning of year2016-12-31$388,111
Value of fidelity bond covering the plan2016-12-31$300,000
Total contributions received or receivable from participants2016-12-31$47,295
Expenses. Other expenses not covered elsewhere2016-12-31$132,738
Contributions received from other sources (not participants or employers)2016-12-31$206
Net income (gross income less expenses)2016-12-31$45,669
Net plan assets at end of year (total assets less liabilities)2016-12-31$433,780
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$388,111
Total contributions received or receivable from employer(s)2016-12-31$235,066
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$8,158
2015 : PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k financial data
Total income from all sources2015-12-31$357,036
Expenses. Total of all expenses incurred2015-12-31$320,290
Benefits paid (including direct rollovers)2015-12-31$154,025
Total plan assets at end of year2015-12-31$388,111
Total plan assets at beginning of year2015-12-31$351,365
Value of fidelity bond covering the plan2015-12-31$300,000
Total contributions received or receivable from participants2015-12-31$41,370
Expenses. Other expenses not covered elsewhere2015-12-31$153,006
Contributions received from other sources (not participants or employers)2015-12-31$4,251
Net income (gross income less expenses)2015-12-31$36,746
Net plan assets at end of year (total assets less liabilities)2015-12-31$388,111
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$351,365
Total contributions received or receivable from employer(s)2015-12-31$311,415
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$13,259
2014 : PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k financial data
Total income from all sources2014-12-31$424,630
Expenses. Total of all expenses incurred2014-12-31$379,699
Benefits paid (including direct rollovers)2014-12-31$218,303
Total plan assets at end of year2014-12-31$351,365
Total plan assets at beginning of year2014-12-31$306,434
Value of fidelity bond covering the plan2014-12-31$300,000
Expenses. Other expenses not covered elsewhere2014-12-31$151,784
Other income received2014-12-31$61,648
Net income (gross income less expenses)2014-12-31$44,931
Net plan assets at end of year (total assets less liabilities)2014-12-31$351,365
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$306,434
Total contributions received or receivable from employer(s)2014-12-31$362,982
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$9,612
2013 : PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k financial data
Total income from all sources2013-12-31$909,487
Expenses. Total of all expenses incurred2013-12-31$744,801
Benefits paid (including direct rollovers)2013-12-31$600,242
Total plan assets at end of year2013-12-31$306,434
Total plan assets at beginning of year2013-12-31$141,748
Value of fidelity bond covering the plan2013-12-31$300,000
Expenses. Other expenses not covered elsewhere2013-12-31$144,559
Other income received2013-12-31$458,688
Net income (gross income less expenses)2013-12-31$164,686
Net plan assets at end of year (total assets less liabilities)2013-12-31$306,434
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$141,748
Total contributions received or receivable from employer(s)2013-12-31$450,799
2012 : PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k financial data
Total income from all sources2012-12-31$441,115
Expenses. Total of all expenses incurred2012-12-31$419,383
Benefits paid (including direct rollovers)2012-12-31$311,811
Total plan assets at end of year2012-12-31$141,748
Total plan assets at beginning of year2012-12-31$120,016
Value of fidelity bond covering the plan2012-12-31$300,000
Total contributions received or receivable from participants2012-12-31$37,205
Expenses. Other expenses not covered elsewhere2012-12-31$107,572
Other income received2012-12-31$64,892
Net income (gross income less expenses)2012-12-31$21,732
Net plan assets at end of year (total assets less liabilities)2012-12-31$141,748
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$120,016
Total contributions received or receivable from employer(s)2012-12-31$339,018
2011 : PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k financial data
Total income from all sources2011-12-31$350,605
Expenses. Total of all expenses incurred2011-12-31$230,589
Benefits paid (including direct rollovers)2011-12-31$122,430
Total plan assets at end of year2011-12-31$120,016
Total plan assets at beginning of year2011-12-31$0
Value of fidelity bond covering the plan2011-12-31$300,000
Expenses. Other expenses not covered elsewhere2011-12-31$108,159
Other income received2011-12-31$536
Net income (gross income less expenses)2011-12-31$120,016
Net plan assets at end of year (total assets less liabilities)2011-12-31$120,016
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$350,069

Form 5500 Responses for PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN

2018: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: PRESTIGE GROUP, INC. EMPLOYEE HEALTH 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 benefit arrangement – InsuranceYes
2015: PRESTIGE GROUP, INC. EMPLOYEE HEALTH 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 benefit arrangement – InsuranceYes
2014: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
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: PRESTIGE GROUP, INC. EMPLOYEE HEALTH 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 benefit arrangement – InsuranceYes
2012: PRESTIGE GROUP, INC. EMPLOYEE HEALTH 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 benefit arrangement – InsuranceYes
2011: PRESTIGE GROUP, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10400
Policy instance 1
Insurance contract or identification number10400
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10400
Policy instance 1
Insurance contract or identification number10400
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $11,427
Welfare Benefit Premiums Paid to CarrierUSD $92,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,378
Insurance broker organization code?3
Insurance broker nameINSURANCE BENEFITS SERVICES, INC
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10400
Policy instance 2
Insurance contract or identification number10400
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $57
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57
Insurance broker organization code?3
Insurance broker nameINSURANCE BENEFITS SERVICES, INC
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10400
Policy instance 1
Insurance contract or identification number10400
Number of Individuals Covered25
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $107
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $107
Insurance broker organization code?3
Insurance broker nameINSURANCE BENEFITS SERVICES
PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number10400
Policy instance 2
Insurance contract or identification number10400
Number of Individuals Covered25
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $19,995
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 $127,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,880
Insurance broker organization code?5
Insurance broker nameINSURANCE BENEFITS SERVICES
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10400
Policy instance 1
Insurance contract or identification number10400
Number of Individuals Covered3
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $112
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,168
Commission paid to Insurance BrokerUSD $112
Insurance broker organization code?3
Insurance broker nameINTERGRATED FINANCIAL CONCEPTS
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10400
Policy instance 2
Insurance contract or identification number10400
Number of Individuals Covered32
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $136
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,828
Commission paid to Insurance BrokerUSD $136
Insurance broker organization code?3
Insurance broker nameINTERGRATED FINANCIAL CONCEPTS
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10400
Policy instance 1
Insurance contract or identification number10400
Number of Individuals Covered33
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
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,939
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 74322 )
Policy contract number10400
Policy instance 2
Insurance contract or identification number10400
Number of Individuals Covered26
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
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,371

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