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UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 401k Plan overview

Plan NameUNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN
Plan identification number 533

UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN Benefits

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

401k Sponsoring company profile

UNITED FACILITIES INC. has sponsored the creation of one or more 401k plans.

Company Name:UNITED FACILITIES INC.
Employer identification number (EIN):370702793
NAIC Classification:493100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5332022-08-01
5332021-08-01
5332020-08-01
5332019-08-01
5332018-08-01
5332017-08-01
5332016-08-01RON KOCH
5332015-08-01RON KOCH
5332014-08-01RON KOCH
5332013-08-01RON KOCH
5332012-08-01RON KOCH
5332011-08-01RON KOCH RON KOCH2013-05-15
5332010-08-01RONALD G. KOCH SECRETARY
5332009-01-01
5332009-01-01RONALD G KOCH SECRETARY RONALD G KOCH SECRETARY2010-10-14
5332009-01-01

Plan Statistics for UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN

401k plan membership statisitcs for UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN

Measure Date Value
2022: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2022 401k membership
Total participants, beginning-of-year2022-08-01237
Total number of active participants reported on line 7a of the Form 55002022-08-01235
Number of retired or separated participants receiving benefits2022-08-012
Total of all active and inactive participants2022-08-01237
Total participants2022-08-01237
2021: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01230
Total number of active participants reported on line 7a of the Form 55002021-08-01234
Number of retired or separated participants receiving benefits2021-08-013
Total of all active and inactive participants2021-08-01237
Total participants2021-08-01237
2020: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01234
Total number of active participants reported on line 7a of the Form 55002020-08-01227
Number of retired or separated participants receiving benefits2020-08-013
Total of all active and inactive participants2020-08-01230
Total participants2020-08-01230
2019: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01330
Total number of active participants reported on line 7a of the Form 55002019-08-01232
Number of retired or separated participants receiving benefits2019-08-012
Total of all active and inactive participants2019-08-01234
Total participants2019-08-01234
2018: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01294
Total number of active participants reported on line 7a of the Form 55002018-08-01329
Number of retired or separated participants receiving benefits2018-08-011
Total of all active and inactive participants2018-08-01330
Total participants2018-08-01330
2017: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01235
Total number of active participants reported on line 7a of the Form 55002017-08-01293
Number of retired or separated participants receiving benefits2017-08-011
Total of all active and inactive participants2017-08-01294
Total participants2017-08-01294
2016: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01231
Total number of active participants reported on line 7a of the Form 55002016-08-01233
Number of retired or separated participants receiving benefits2016-08-012
Number of other retired or separated participants entitled to future benefits2016-08-010
Total of all active and inactive participants2016-08-01235
Total participants2016-08-01235
2015: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01227
Total number of active participants reported on line 7a of the Form 55002015-08-01228
Number of retired or separated participants receiving benefits2015-08-013
Number of other retired or separated participants entitled to future benefits2015-08-010
Total of all active and inactive participants2015-08-01231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-08-010
Total participants2015-08-01231
2014: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01221
Total number of active participants reported on line 7a of the Form 55002014-08-01225
Number of retired or separated participants receiving benefits2014-08-013
Total of all active and inactive participants2014-08-01228
Total participants2014-08-01228
2013: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01218
Total number of active participants reported on line 7a of the Form 55002013-08-01220
Number of retired or separated participants receiving benefits2013-08-011
Number of other retired or separated participants entitled to future benefits2013-08-010
Total of all active and inactive participants2013-08-01221
Total participants2013-08-01221
2012: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01229
Total number of active participants reported on line 7a of the Form 55002012-08-01215
Number of retired or separated participants receiving benefits2012-08-013
Total of all active and inactive participants2012-08-01218
Total participants2012-08-01218
2011: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01233
Total number of active participants reported on line 7a of the Form 55002011-08-01225
Number of retired or separated participants receiving benefits2011-08-014
Total of all active and inactive participants2011-08-01229
Total participants2011-08-01229
2010: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01282
Total number of active participants reported on line 7a of the Form 55002010-08-01231
Number of retired or separated participants receiving benefits2010-08-012
Total of all active and inactive participants2010-08-01233
2009: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01262
Total number of active participants reported on line 7a of the Form 55002009-01-01290
Number of retired or separated participants receiving benefits2009-01-012
Total of all active and inactive participants2009-01-01292

Form 5500 Responses for UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN

2022: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2022 form 5500 responses
2022-08-01Type of plan entitySingle employer plan
2022-08-01Submission has been amendedNo
2022-08-01This submission is the final filingNo
2022-08-01This return/report is a short plan year return/report (less than 12 months)No
2022-08-01Plan is a collectively bargained planNo
2022-08-01Plan funding arrangement – General assets of the sponsorYes
2022-08-01Plan benefit arrangement – General assets of the sponsorYes
2021: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Submission has been amendedNo
2021-08-01This submission is the final filingNo
2021-08-01This return/report is a short plan year return/report (less than 12 months)No
2021-08-01Plan is a collectively bargained planNo
2021-08-01Plan funding arrangement – General assets of the sponsorYes
2021-08-01Plan benefit arrangement – General assets of the sponsorYes
2020: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Submission has been amendedNo
2020-08-01This submission is the final filingNo
2020-08-01This return/report is a short plan year return/report (less than 12 months)No
2020-08-01Plan is a collectively bargained planNo
2020-08-01Plan funding arrangement – General assets of the sponsorYes
2020-08-01Plan benefit arrangement – General assets of the sponsorYes
2019: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Submission has been amendedNo
2019-08-01This submission is the final filingNo
2019-08-01This return/report is a short plan year return/report (less than 12 months)No
2019-08-01Plan is a collectively bargained planNo
2019-08-01Plan funding arrangement – General assets of the sponsorYes
2019-08-01Plan benefit arrangement – General assets of the sponsorYes
2018: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Submission has been amendedNo
2018-08-01This submission is the final filingNo
2018-08-01This return/report is a short plan year return/report (less than 12 months)No
2018-08-01Plan is a collectively bargained planNo
2018-08-01Plan funding arrangement – General assets of the sponsorYes
2018-08-01Plan benefit arrangement – General assets of the sponsorYes
2017: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Submission has been amendedNo
2017-08-01This submission is the final filingNo
2017-08-01This return/report is a short plan year return/report (less than 12 months)No
2017-08-01Plan is a collectively bargained planNo
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan funding arrangement – General assets of the sponsorYes
2017-08-01Plan benefit arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – General assets of the sponsorYes
2016: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – General assets of the sponsorYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – General assets of the sponsorYes
2015: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – General assets of the sponsorYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – General assets of the sponsorYes
2014: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – General assets of the sponsorYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – General assets of the sponsorYes
2013: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – General assets of the sponsorYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – General assets of the sponsorYes
2012: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – General assets of the sponsorYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – General assets of the sponsorYes
2011: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedNo
2011-08-01This submission is the final filingNo
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – General assets of the sponsorYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – General assets of the sponsorYes
2010: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Submission has been amendedNo
2010-08-01This submission is the final filingNo
2010-08-01This return/report is a short plan year return/report (less than 12 months)No
2010-08-01Plan is a collectively bargained planNo
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan funding arrangement – General assets of the sponsorYes
2010-08-01Plan benefit arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – General assets of the sponsorYes
2009: UNITED FACILITIES, INC. GROUP LIFE INSURANCE AND HOSPITALIZATION PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number112661
Policy instance 1
Insurance contract or identification number112661
Number of Individuals Covered294
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $6,074
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 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 $67,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number1112661
Policy instance 1
Insurance contract or identification number1112661
Number of Individuals Covered256
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $6,120
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 $61,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,120
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
Insurance broker nameGROUP BENEFITS LIMITED
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number1112661
Policy instance 1
Insurance contract or identification number1112661
Number of Individuals Covered250
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $5,991
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 $60,018
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,991
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
Insurance broker nameGROUP BENEFITS LTD
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number1112661
Policy instance 1
Insurance contract or identification number1112661
Number of Individuals Covered236
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $5,705
Total amount of fees paid to insurance companyUSD $0
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 $26,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,705
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND SERVICES
Insurance broker organization code?3
Insurance broker nameGROUP BENEFITS LTD
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number1112661
Policy instance 1
Insurance contract or identification number1112661
Number of Individuals Covered243
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $5,963
Total amount of fees paid to insurance companyUSD $0
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 $59,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,963
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND SERVICES
Insurance broker organization code?3
Insurance broker nameGROUP BENEFITS LTD
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number112661
Policy instance 1
Insurance contract or identification number112661
Number of Individuals Covered257
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $6,389
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number112661
Policy instance 1
Insurance contract or identification number112661
Number of Individuals Covered315
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $6,616
Total amount of fees paid to insurance companyUSD $0
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 $66,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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