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REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 401k Plan overview

Plan NameREYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN
Plan identification number 510

REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN Benefits

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

401k Sponsoring company profile

REYNOLDS ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.

Company Name:REYNOLDS ENTERPRISES, INC.
Employer identification number (EIN):352485992
NAIC Classification:236200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5102019-10-01
5102018-10-01
5102017-10-01
5102017-10-01
5102016-10-01DEIDRA A. FOORE
5102015-10-01DEIDRA A. FOORE
5102014-10-01DEIDRA A. FOORE
5102013-10-01DEIDRA A. FOORE
5102012-10-01DEIDRA A. FOORE

Plan Statistics for REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN

401k plan membership statisitcs for REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN

Measure Date Value
2019: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-010
Total number of active participants reported on line 7a of the Form 55002019-10-010
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-010
2018: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01117
Total number of active participants reported on line 7a of the Form 55002018-10-010
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-010
2017: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01100
Total number of active participants reported on line 7a of the Form 55002017-10-01117
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01117
2016: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-0182
Total number of active participants reported on line 7a of the Form 55002016-10-01100
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01100
2015: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-0182
Total number of active participants reported on line 7a of the Form 55002015-10-0182
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-0182
2014: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-0184
Total number of active participants reported on line 7a of the Form 55002014-10-0181
Number of retired or separated participants receiving benefits2014-10-011
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-0182
2013: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-0185
Total number of active participants reported on line 7a of the Form 55002013-10-0183
Number of retired or separated participants receiving benefits2013-10-011
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-0184
2012: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-0179
Total number of active participants reported on line 7a of the Form 55002012-10-0184
Number of retired or separated participants receiving benefits2012-10-011
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-0185

Financial Data on REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN

Measure Date Value
2020 : REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2020 401k financial data
Transfers to/from the plan2020-01-31$-229,328
Total income from all sources2020-01-31$258
Expenses. Total of all expenses incurred2020-01-31$5,935
Benefits paid (including direct rollovers)2020-01-31$5,935
Total plan assets at end of year2020-01-31$0
Total plan assets at beginning of year2020-01-31$235,005
Other income received2020-01-31$258
Net income (gross income less expenses)2020-01-31$-5,677
Net plan assets at end of year (total assets less liabilities)2020-01-31$0
Net plan assets at beginning of year (total assets less liabilities)2020-01-31$235,005
2019 : REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2019 401k financial data
Total plan liabilities at end of year2019-09-30$0
Total plan liabilities at beginning of year2019-09-30$258,750
Total income from all sources2019-09-30$615,144
Expenses. Total of all expenses incurred2019-09-30$629,027
Benefits paid (including direct rollovers)2019-09-30$274,104
Total plan assets at end of year2019-09-30$235,005
Total plan assets at beginning of year2019-09-30$507,638
Value of fidelity bond covering the plan2019-09-30$2,000,000
Total contributions received or receivable from participants2019-09-30$126,746
Expenses. Other expenses not covered elsewhere2019-09-30$321,216
Other income received2019-09-30$656
Net income (gross income less expenses)2019-09-30$-13,883
Net plan assets at end of year (total assets less liabilities)2019-09-30$235,005
Net plan assets at beginning of year (total assets less liabilities)2019-09-30$248,888
Total contributions received or receivable from employer(s)2019-09-30$487,742
Expenses. Administrative service providers (salaries,fees and commissions)2019-09-30$33,707
2017 : REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2017 401k financial data
Total plan liabilities at end of year2017-09-30$214,496
Total plan liabilities at beginning of year2017-09-30$168,846
Total income from all sources2017-09-30$1,570,871
Expenses. Total of all expenses incurred2017-09-30$1,726,762
Benefits paid (including direct rollovers)2017-09-30$1,235,604
Total plan assets at end of year2017-09-30$274,641
Total plan assets at beginning of year2017-09-30$384,882
Value of fidelity bond covering the plan2017-09-30$2,000,000
Total contributions received or receivable from participants2017-09-30$419,996
Expenses. Other expenses not covered elsewhere2017-09-30$396,461
Other income received2017-09-30$414
Net income (gross income less expenses)2017-09-30$-155,891
Net plan assets at end of year (total assets less liabilities)2017-09-30$60,145
Net plan assets at beginning of year (total assets less liabilities)2017-09-30$216,036
Total contributions received or receivable from employer(s)2017-09-30$1,150,461
Expenses. Administrative service providers (salaries,fees and commissions)2017-09-30$94,697
2016 : REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2016 401k financial data
Total plan liabilities at end of year2016-09-30$168,846
Total plan liabilities at beginning of year2016-09-30$121,158
Total income from all sources2016-09-30$1,320,648
Expenses. Total of all expenses incurred2016-09-30$1,332,012
Benefits paid (including direct rollovers)2016-09-30$947,566
Total plan assets at end of year2016-09-30$384,882
Total plan assets at beginning of year2016-09-30$348,558
Value of fidelity bond covering the plan2016-09-30$2,000,000
Total contributions received or receivable from participants2016-09-30$348,656
Expenses. Other expenses not covered elsewhere2016-09-30$296,939
Other income received2016-09-30$658
Net income (gross income less expenses)2016-09-30$-11,364
Net plan assets at end of year (total assets less liabilities)2016-09-30$216,036
Net plan assets at beginning of year (total assets less liabilities)2016-09-30$227,400
Total contributions received or receivable from employer(s)2016-09-30$971,334
Expenses. Administrative service providers (salaries,fees and commissions)2016-09-30$87,507
2015 : REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2015 401k financial data
Total plan liabilities at end of year2015-09-30$121,158
Total plan liabilities at beginning of year2015-09-30$169,686
Total income from all sources2015-09-30$1,211,992
Expenses. Total of all expenses incurred2015-09-30$1,141,934
Benefits paid (including direct rollovers)2015-09-30$814,879
Total plan assets at end of year2015-09-30$348,558
Total plan assets at beginning of year2015-09-30$327,028
Value of fidelity bond covering the plan2015-09-30$2,000,000
Total contributions received or receivable from participants2015-09-30$279,693
Expenses. Other expenses not covered elsewhere2015-09-30$247,264
Other income received2015-09-30$439
Net income (gross income less expenses)2015-09-30$70,058
Net plan assets at end of year (total assets less liabilities)2015-09-30$227,400
Net plan assets at beginning of year (total assets less liabilities)2015-09-30$157,342
Total contributions received or receivable from employer(s)2015-09-30$931,860
Expenses. Administrative service providers (salaries,fees and commissions)2015-09-30$79,791
2014 : REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2014 401k financial data
Total plan liabilities at end of year2014-09-30$169,686
Total plan liabilities at beginning of year2014-09-30$138,749
Total income from all sources2014-09-30$1,438,674
Expenses. Total of all expenses incurred2014-09-30$1,305,309
Benefits paid (including direct rollovers)2014-09-30$1,000,205
Total plan assets at end of year2014-09-30$327,028
Total plan assets at beginning of year2014-09-30$162,726
Value of fidelity bond covering the plan2014-09-30$1,000,000
Total contributions received or receivable from participants2014-09-30$274,512
Expenses. Other expenses not covered elsewhere2014-09-30$219,840
Other income received2014-09-30$224,603
Net income (gross income less expenses)2014-09-30$133,365
Net plan assets at end of year (total assets less liabilities)2014-09-30$157,342
Net plan assets at beginning of year (total assets less liabilities)2014-09-30$23,977
Total contributions received or receivable from employer(s)2014-09-30$939,559
Expenses. Administrative service providers (salaries,fees and commissions)2014-09-30$85,264
2013 : REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2013 401k financial data
Total plan liabilities at end of year2013-09-30$138,749
Total income from all sources2013-09-30$1,103,982
Expenses. Total of all expenses incurred2013-09-30$1,080,005
Benefits paid (including direct rollovers)2013-09-30$807,163
Total plan assets at end of year2013-09-30$162,726
Value of fidelity bond covering the plan2013-09-30$1,000,000
Total contributions received or receivable from participants2013-09-30$213,529
Expenses. Other expenses not covered elsewhere2013-09-30$185,921
Other income received2013-09-30$142,529
Net income (gross income less expenses)2013-09-30$23,977
Net plan assets at end of year (total assets less liabilities)2013-09-30$23,977
Net plan assets at beginning of year (total assets less liabilities)2013-09-30$0
Total contributions received or receivable from employer(s)2013-09-30$747,924
Expenses. Administrative service providers (salaries,fees and commissions)2013-09-30$86,921

Form 5500 Responses for REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN

2019: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingYes
2019-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan benefit arrangement - TrustYes
2018: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – TrustYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement - TrustYes
2017: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2016: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2015: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2014: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2013: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2012: REYNOLDS ENTERPRISES, INC. EMPLOYEE MEDICAL PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered0
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
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 $321,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered117
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Welfare Benefit Premiums Paid to CarrierUSD $552,383
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered82
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
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 $296,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberGENESIS
Policy instance 2
Insurance contract or identification numberGENESIS
Number of Individuals Covered81
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
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 $86,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered81
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
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 $157,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered84
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
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 $219,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberGENESIS
Policy instance 1
Insurance contract or identification numberGENESIS
Number of Individuals Covered85
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
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 $185,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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