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NAVISTAR, INC. HEALTH PLAN 401k Plan overview

Plan NameNAVISTAR, INC. HEALTH PLAN
Plan identification number 534

NAVISTAR, INC. HEALTH PLAN Benefits

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

401k Sponsoring company profile

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

Company Name:NAVISTAR, INC
Employer identification number (EIN):361264810
NAIC Classification:336100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NAVISTAR, INC. HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5342023-11-01
5342022-11-01
5342021-11-01
5342020-11-01
5342019-11-01
5342018-11-01
5342017-11-01
5342016-11-01DOUGLAS ELSTON DOUGLAS ELSTON2018-08-14
5342015-11-01DAN PIKELNY DAN PIKELNY2017-08-14
5342014-11-01DAN PIKELNY
5342013-11-01DAN PIKELNY
5342012-11-01DAN PIKELNY
5342011-11-01ANNETTE FREUND
5342009-11-01WILLIAM BUNN
5342008-11-01WILLIAM BUNN

Plan Statistics for NAVISTAR, INC. HEALTH PLAN

401k plan membership statisitcs for NAVISTAR, INC. HEALTH PLAN

Measure Date Value
2023: NAVISTAR, INC. HEALTH PLAN 2023 401k membership
Total participants, beginning-of-year2023-11-017,863
Total number of active participants reported on line 7a of the Form 55002023-11-017,739
Number of retired or separated participants receiving benefits2023-11-01198
Number of other retired or separated participants entitled to future benefits2023-11-017
Total of all active and inactive participants2023-11-017,944
2022: NAVISTAR, INC. HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-11-017,194
Total number of active participants reported on line 7a of the Form 55002022-11-017,634
Number of retired or separated participants receiving benefits2022-11-01222
Number of other retired or separated participants entitled to future benefits2022-11-017
Total of all active and inactive participants2022-11-017,863
2021: NAVISTAR, INC. HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-11-016,886
Total number of active participants reported on line 7a of the Form 55002021-11-017,103
Number of retired or separated participants receiving benefits2021-11-0171
Number of other retired or separated participants entitled to future benefits2021-11-0119
Total of all active and inactive participants2021-11-017,193
2020: NAVISTAR, INC. HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-11-016,858
Total number of active participants reported on line 7a of the Form 55002020-11-016,703
Number of retired or separated participants receiving benefits2020-11-01123
Number of other retired or separated participants entitled to future benefits2020-11-0125
Total of all active and inactive participants2020-11-016,851
2019: NAVISTAR, INC. HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-017,382
Total number of active participants reported on line 7a of the Form 55002019-11-015,481
Number of retired or separated participants receiving benefits2019-11-011,351
Number of other retired or separated participants entitled to future benefits2019-11-0126
Total of all active and inactive participants2019-11-016,858
2018: NAVISTAR, INC. HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-11-017,406
Total number of active participants reported on line 7a of the Form 55002018-11-016,106
Number of retired or separated participants receiving benefits2018-11-011,253
Number of other retired or separated participants entitled to future benefits2018-11-0123
Total of all active and inactive participants2018-11-017,382
2017: NAVISTAR, INC. HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-017,375
Total number of active participants reported on line 7a of the Form 55002017-11-017,279
Number of retired or separated participants receiving benefits2017-11-01106
Number of other retired or separated participants entitled to future benefits2017-11-0121
Total of all active and inactive participants2017-11-017,406
2016: NAVISTAR, INC. HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-017,346
Total number of active participants reported on line 7a of the Form 55002016-11-015,475
Number of retired or separated participants receiving benefits2016-11-011,879
Number of other retired or separated participants entitled to future benefits2016-11-0121
Total of all active and inactive participants2016-11-017,375
2015: NAVISTAR, INC. HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-018,403
Total number of active participants reported on line 7a of the Form 55002015-11-015,234
Number of retired or separated participants receiving benefits2015-11-012,100
Number of other retired or separated participants entitled to future benefits2015-11-0112
Total of all active and inactive participants2015-11-017,346
2014: NAVISTAR, INC. HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-018,432
Total number of active participants reported on line 7a of the Form 55002014-11-017,435
Number of retired or separated participants receiving benefits2014-11-01968
Number of other retired or separated participants entitled to future benefits2014-11-010
Total of all active and inactive participants2014-11-018,403
2013: NAVISTAR, INC. HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-019,220
Total number of active participants reported on line 7a of the Form 55002013-11-018,156
Number of retired or separated participants receiving benefits2013-11-01276
Number of other retired or separated participants entitled to future benefits2013-11-010
Total of all active and inactive participants2013-11-018,432
2012: NAVISTAR, INC. HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-0111,296
Total number of active participants reported on line 7a of the Form 55002012-11-018,706
Number of retired or separated participants receiving benefits2012-11-01514
Number of other retired or separated participants entitled to future benefits2012-11-010
Total of all active and inactive participants2012-11-019,220
2011: NAVISTAR, INC. HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-0111,517
Total number of active participants reported on line 7a of the Form 55002011-11-0110,498
Number of retired or separated participants receiving benefits2011-11-01798
Total of all active and inactive participants2011-11-0111,296
Total participants2011-11-0111,296
2009: NAVISTAR, INC. HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-0110,524
Total number of active participants reported on line 7a of the Form 55002009-11-019,761
Number of retired or separated participants receiving benefits2009-11-01881
Number of other retired or separated participants entitled to future benefits2009-11-010
Total of all active and inactive participants2009-11-0110,642
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-11-010
Total participants2009-11-0110,642
2008: NAVISTAR, INC. HEALTH PLAN 2008 401k membership
Total participants, beginning-of-year2008-11-0111,512
Total number of active participants reported on line 7a of the Form 55002008-11-019,591
Number of retired or separated participants receiving benefits2008-11-01912
Number of other retired or separated participants entitled to future benefits2008-11-0121
Total of all active and inactive participants2008-11-0110,524
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-11-010
Total participants2008-11-0110,524

Form 5500 Responses for NAVISTAR, INC. HEALTH PLAN

2023: NAVISTAR, INC. HEALTH PLAN 2023 form 5500 responses
2023-11-01Type of plan entitySingle employer plan
2023-11-01Submission has been amendedNo
2023-11-01This submission is the final filingNo
2023-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2023-11-01Plan is a collectively bargained planYes
2023-11-01Plan funding arrangement – InsuranceYes
2023-11-01Plan funding arrangement – General assets of the sponsorYes
2023-11-01Plan benefit arrangement – InsuranceYes
2023-11-01Plan benefit arrangement – General assets of the sponsorYes
2022: NAVISTAR, INC. HEALTH PLAN 2022 form 5500 responses
2022-11-01Type of plan entitySingle employer plan
2022-11-01Submission has been amendedNo
2022-11-01This submission is the final filingNo
2022-11-01This return/report is a short plan year return/report (less than 12 months)No
2022-11-01Plan is a collectively bargained planYes
2022-11-01Plan funding arrangement – InsuranceYes
2022-11-01Plan funding arrangement – General assets of the sponsorYes
2022-11-01Plan benefit arrangement – InsuranceYes
2022-11-01Plan benefit arrangement – General assets of the sponsorYes
2021: NAVISTAR, INC. HEALTH PLAN 2021 form 5500 responses
2021-11-01Type of plan entitySingle employer plan
2021-11-01Submission has been amendedNo
2021-11-01This submission is the final filingNo
2021-11-01This return/report is a short plan year return/report (less than 12 months)No
2021-11-01Plan is a collectively bargained planYes
2021-11-01Plan funding arrangement – InsuranceYes
2021-11-01Plan funding arrangement – General assets of the sponsorYes
2021-11-01Plan benefit arrangement – InsuranceYes
2021-11-01Plan benefit arrangement – General assets of the sponsorYes
2020: NAVISTAR, INC. HEALTH PLAN 2020 form 5500 responses
2020-11-01Type of plan entitySingle employer plan
2020-11-01Submission has been amendedNo
2020-11-01This submission is the final filingNo
2020-11-01This return/report is a short plan year return/report (less than 12 months)No
2020-11-01Plan is a collectively bargained planYes
2020-11-01Plan funding arrangement – InsuranceYes
2020-11-01Plan funding arrangement – General assets of the sponsorYes
2020-11-01Plan benefit arrangement – InsuranceYes
2020-11-01Plan benefit arrangement – General assets of the sponsorYes
2019: NAVISTAR, INC. HEALTH PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Submission has been amendedNo
2019-11-01This submission is the final filingNo
2019-11-01This return/report is a short plan year return/report (less than 12 months)No
2019-11-01Plan is a collectively bargained planYes
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan funding arrangement – General assets of the sponsorYes
2019-11-01Plan benefit arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – General assets of the sponsorYes
2018: NAVISTAR, INC. HEALTH PLAN 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Submission has been amendedNo
2018-11-01This submission is the final filingNo
2018-11-01This return/report is a short plan year return/report (less than 12 months)No
2018-11-01Plan is a collectively bargained planYes
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan funding arrangement – General assets of the sponsorYes
2018-11-01Plan benefit arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – General assets of the sponsorYes
2017: NAVISTAR, INC. HEALTH PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Submission has been amendedNo
2017-11-01This submission is the final filingNo
2017-11-01This return/report is a short plan year return/report (less than 12 months)No
2017-11-01Plan is a collectively bargained planYes
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan funding arrangement – General assets of the sponsorYes
2017-11-01Plan benefit arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – General assets of the sponsorYes
2016: NAVISTAR, INC. HEALTH PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planYes
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan funding arrangement – General assets of the sponsorYes
2016-11-01Plan benefit arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – General assets of the sponsorYes
2015: NAVISTAR, INC. HEALTH PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)No
2015-11-01Plan is a collectively bargained planYes
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan funding arrangement – General assets of the sponsorYes
2015-11-01Plan benefit arrangement – InsuranceYes
2014: NAVISTAR, INC. HEALTH PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planYes
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan funding arrangement – General assets of the sponsorYes
2014-11-01Plan benefit arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – General assets of the sponsorYes
2013: NAVISTAR, INC. HEALTH PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedYes
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)No
2013-11-01Plan is a collectively bargained planYes
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan funding arrangement – General assets of the sponsorYes
2013-11-01Plan benefit arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – General assets of the sponsorYes
2012: NAVISTAR, INC. HEALTH PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planYes
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan funding arrangement – General assets of the sponsorYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – General assets of the sponsorYes
2011: NAVISTAR, INC. HEALTH PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Submission has been amendedNo
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planYes
2011-11-01Plan funding arrangement – General assets of the sponsorYes
2011-11-01Plan benefit arrangement – General assets of the sponsorYes
2009: NAVISTAR, INC. HEALTH PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planYes
2009-11-01Plan funding arrangement – General assets of the sponsorYes
2009-11-01Plan benefit arrangement – General assets of the sponsorYes
2008: NAVISTAR, INC. HEALTH PLAN 2008 form 5500 responses
2008-11-01Type of plan entitySingle employer plan
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planYes
2008-11-01Plan funding arrangement – General assets of the sponsorYes
2008-11-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 1
Insurance contract or identification numberH2001
Number of Individuals Covered255
Insurance policy start date2023-11-01
Insurance policy end date2023-12-31
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 BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 1
Insurance contract or identification numberH2001
Number of Individuals Covered279
Insurance policy start date2022-11-01
Insurance policy end date2023-10-31
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 BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 1
Insurance contract or identification numberH2001
Number of Individuals Covered274
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
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 BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 1
Insurance contract or identification numberH2001
Number of Individuals Covered258
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 1
Insurance contract or identification numberH2001
Number of Individuals Covered258
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
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 BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 1
Insurance contract or identification numberH2001
Number of Individuals Covered243
Insurance policy start date2019-01-01
Insurance policy end date2019-10-31
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 BenefitYes
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 $12,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 71420 )
Policy contract numberH2001
Policy instance 1
Insurance contract or identification numberH2001
Number of Individuals Covered236
Insurance policy start date2018-01-01
Insurance policy end date2018-10-31
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 BenefitYes
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 $49,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract numberAE457260
Policy instance 1
Insurance contract or identification numberAE457260
Number of Individuals Covered182
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
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 $232,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract numberAE457260
Policy instance 1
Insurance contract or identification numberAE457260
Number of Individuals Covered145
Insurance policy start date2014-01-01
Insurance policy end date2014-10-31
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 $110,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract numberAE457260
Policy instance 1
Insurance contract or identification numberAE457260
Number of Individuals Covered145
Insurance policy start date2013-01-01
Insurance policy end date2013-10-31
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 $91,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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