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HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 401k Plan overview

Plan NameHOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN
Plan identification number 501

HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN Benefits

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

401k Sponsoring company profile

HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. has sponsored the creation of one or more 401k plans.

Company Name:HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC.
Employer identification number (EIN):370860281
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01
5012017-01-01MARTIN ADAMS
5012016-01-01
5012015-01-01
5012014-01-01MARTIN ADAMS2018-10-02
5012013-01-01MARTIN ADAMS
5012012-01-01MARTIN ADAMS
5012011-01-01MARTIN ADAMS
5012010-01-01MARTIN ADAMS
5012009-01-01MARTIN ADAMS
5012008-01-01MARTIN ADAMS
5012007-01-01MARTIN ADAMS
5012006-01-01MARTIN ADAMS
5012005-01-01MARTIN ADAMS
5012004-01-01MARTIN ADAMS
5012003-01-01MARTIN ADAMS
5012002-01-01MARTIN ADAMS
5012001-01-01MARTIN ADAMS
5012000-01-01MARTIN ADAMS
5011999-01-01MARTIN ADAMS
5011998-01-01MARTIN ADAMS
5011997-01-01MARTIN ADAMS
5011996-01-01MARTIN ADAMS
5011995-01-01MARTIN ADAMS
5011994-01-01MARTIN ADAMS
5011993-01-01MARTIN ADAMS
5011992-01-01MARTIN ADAMS
5011991-01-01MARTIN ADAMS
5011990-01-01MARTIN ADAMS
5011989-01-01MARTIN ADAMS
5011988-01-01MARTIN ADAMS

Plan Statistics for HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN

401k plan membership statisitcs for HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN

Measure Date Value
2018: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01344
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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01333
Total number of active participants reported on line 7a of the Form 55002017-01-01343
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01344
2016: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01305
Total number of active participants reported on line 7a of the Form 55002016-01-01334
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01335
2015: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01271
Total number of active participants reported on line 7a of the Form 55002015-01-01296
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01298
2014: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01252
Total number of active participants reported on line 7a of the Form 55002014-01-01264
Number of retired or separated participants receiving benefits2014-01-011
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01265
2013: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01253
Total number of active participants reported on line 7a of the Form 55002013-01-01254
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01255
2012: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01243
Total number of active participants reported on line 7a of the Form 55002012-01-01254
Number of retired or separated participants receiving benefits2012-01-011
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01255
2011: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01235
Total number of active participants reported on line 7a of the Form 55002011-01-01243
Number of retired or separated participants receiving benefits2011-01-011
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01244
2010: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01232
Total number of active participants reported on line 7a of the Form 55002010-01-01234
Number of retired or separated participants receiving benefits2010-01-011
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01235
2009: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01232
Total number of active participants reported on line 7a of the Form 55002009-01-01227
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01229
2008: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01241
Total number of active participants reported on line 7a of the Form 55002008-01-01232
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-010
Total of all active and inactive participants2008-01-01232
2007: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01227
Total number of active participants reported on line 7a of the Form 55002007-01-01230
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-01230
2006: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01193
Total number of active participants reported on line 7a of the Form 55002006-01-01227
Number of retired or separated participants receiving benefits2006-01-010
Number of other retired or separated participants entitled to future benefits2006-01-010
Total of all active and inactive participants2006-01-01227
2005: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01183
Total number of active participants reported on line 7a of the Form 55002005-01-01193
Number of retired or separated participants receiving benefits2005-01-010
Number of other retired or separated participants entitled to future benefits2005-01-010
Total of all active and inactive participants2005-01-01193
2004: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01186
Total number of active participants reported on line 7a of the Form 55002004-01-01183
Number of retired or separated participants receiving benefits2004-01-010
Number of other retired or separated participants entitled to future benefits2004-01-010
Total of all active and inactive participants2004-01-01183
2003: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01168
Total number of active participants reported on line 7a of the Form 55002003-01-01186
Number of retired or separated participants receiving benefits2003-01-010
Number of other retired or separated participants entitled to future benefits2003-01-010
Total of all active and inactive participants2003-01-01186
2002: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01157
Total number of active participants reported on line 7a of the Form 55002002-01-01168
Number of retired or separated participants receiving benefits2002-01-010
Number of other retired or separated participants entitled to future benefits2002-01-010
Total of all active and inactive participants2002-01-01168
2001: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2001 401k membership
Total participants, beginning-of-year2001-01-01126
Total number of active participants reported on line 7a of the Form 55002001-01-01127
Number of retired or separated participants receiving benefits2001-01-010
Number of other retired or separated participants entitled to future benefits2001-01-010
Total of all active and inactive participants2001-01-01127
2000: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2000 401k membership
Total participants, beginning-of-year2000-01-01156
Total number of active participants reported on line 7a of the Form 55002000-01-01126
Number of retired or separated participants receiving benefits2000-01-010
Number of other retired or separated participants entitled to future benefits2000-01-010
Total of all active and inactive participants2000-01-01126
1999: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1999 401k membership
Total participants, beginning-of-year1999-01-01165
Total number of active participants reported on line 7a of the Form 55001999-01-01156
Number of retired or separated participants receiving benefits1999-01-010
Number of other retired or separated participants entitled to future benefits1999-01-010
Total of all active and inactive participants1999-01-01156
1998: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1998 401k membership
Total participants, beginning-of-year1998-01-01173
Total number of active participants reported on line 7a of the Form 55001998-01-01165
Number of retired or separated participants receiving benefits1998-01-010
Number of other retired or separated participants entitled to future benefits1998-01-010
Total of all active and inactive participants1998-01-01165
1997: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1997 401k membership
Total participants, beginning-of-year1997-01-01135
Total number of active participants reported on line 7a of the Form 55001997-01-01173
Number of retired or separated participants receiving benefits1997-01-010
Number of other retired or separated participants entitled to future benefits1997-01-010
Total of all active and inactive participants1997-01-01173
1996: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1996 401k membership
Total participants, beginning-of-year1996-01-01135
Total number of active participants reported on line 7a of the Form 55001996-01-01135
Number of retired or separated participants receiving benefits1996-01-010
Number of other retired or separated participants entitled to future benefits1996-01-010
Total of all active and inactive participants1996-01-01135
1995: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1995 401k membership
Total participants, beginning-of-year1995-01-01135
Total number of active participants reported on line 7a of the Form 55001995-01-01135
Number of retired or separated participants receiving benefits1995-01-010
Number of other retired or separated participants entitled to future benefits1995-01-010
Total of all active and inactive participants1995-01-01135
1994: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1994 401k membership
Total participants, beginning-of-year1994-01-01135
Total number of active participants reported on line 7a of the Form 55001994-01-01135
Number of retired or separated participants receiving benefits1994-01-010
Number of other retired or separated participants entitled to future benefits1994-01-010
Total of all active and inactive participants1994-01-01135
1993: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1993 401k membership
Total participants, beginning-of-year1993-01-01135
Total number of active participants reported on line 7a of the Form 55001993-01-01135
Number of retired or separated participants receiving benefits1993-01-010
Number of other retired or separated participants entitled to future benefits1993-01-010
Total of all active and inactive participants1993-01-01135
1992: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1992 401k membership
Total participants, beginning-of-year1992-01-01135
Total number of active participants reported on line 7a of the Form 55001992-01-01135
Number of retired or separated participants receiving benefits1992-01-010
Number of other retired or separated participants entitled to future benefits1992-01-010
Total of all active and inactive participants1992-01-01135
1991: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1991 401k membership
Total participants, beginning-of-year1991-01-01135
Total number of active participants reported on line 7a of the Form 55001991-01-01135
Number of retired or separated participants receiving benefits1991-01-010
Number of other retired or separated participants entitled to future benefits1991-01-010
Total of all active and inactive participants1991-01-01135
1990: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1990 401k membership
Total participants, beginning-of-year1990-01-01135
Total number of active participants reported on line 7a of the Form 55001990-01-01135
Number of retired or separated participants receiving benefits1990-01-010
Number of other retired or separated participants entitled to future benefits1990-01-010
Total of all active and inactive participants1990-01-01135
1989: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1989 401k membership
Total participants, beginning-of-year1989-01-01135
Total number of active participants reported on line 7a of the Form 55001989-01-01135
Number of retired or separated participants receiving benefits1989-01-010
Number of other retired or separated participants entitled to future benefits1989-01-010
Total of all active and inactive participants1989-01-01135
1988: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1988 401k membership
Total participants, beginning-of-year1988-01-01135
Total number of active participants reported on line 7a of the Form 55001988-01-01135
Number of retired or separated participants receiving benefits1988-01-010
Number of other retired or separated participants entitled to future benefits1988-01-010
Total of all active and inactive participants1988-01-01135

Form 5500 Responses for HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN

2018: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingYes
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 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 funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 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 funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 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 funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 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 funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
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 funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 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
2008: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – General assets of the sponsorYes
2008-01-01Plan benefit arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – General assets of the sponsorYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – General assets of the sponsorYes
2006: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan funding arrangement – General assets of the sponsorYes
2006-01-01Plan benefit arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – General assets of the sponsorYes
2005: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan funding arrangement – General assets of the sponsorYes
2005-01-01Plan benefit arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – General assets of the sponsorYes
2004: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedNo
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan funding arrangement – General assets of the sponsorYes
2004-01-01Plan benefit arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – General assets of the sponsorYes
2003: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Submission has been amendedNo
2003-01-01This submission is the final filingNo
2003-01-01This return/report is a short plan year return/report (less than 12 months)No
2003-01-01Plan is a collectively bargained planNo
2003-01-01Plan funding arrangement – InsuranceYes
2003-01-01Plan funding arrangement – General assets of the sponsorYes
2003-01-01Plan benefit arrangement – InsuranceYes
2003-01-01Plan benefit arrangement – General assets of the sponsorYes
2002: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2002 form 5500 responses
2002-01-01Type of plan entitySingle employer plan
2002-01-01Submission has been amendedNo
2002-01-01This submission is the final filingNo
2002-01-01This return/report is a short plan year return/report (less than 12 months)No
2002-01-01Plan is a collectively bargained planNo
2002-01-01Plan funding arrangement – InsuranceYes
2002-01-01Plan funding arrangement – General assets of the sponsorYes
2002-01-01Plan benefit arrangement – InsuranceYes
2002-01-01Plan benefit arrangement – General assets of the sponsorYes
2001: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Submission has been amendedNo
2001-01-01This submission is the final filingNo
2001-01-01This return/report is a short plan year return/report (less than 12 months)No
2001-01-01Plan is a collectively bargained planNo
2001-01-01Plan funding arrangement – InsuranceYes
2001-01-01Plan funding arrangement – General assets of the sponsorYes
2001-01-01Plan benefit arrangement – InsuranceYes
2001-01-01Plan benefit arrangement – General assets of the sponsorYes
2000: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 2000 form 5500 responses
2000-01-01Type of plan entitySingle employer plan
2000-01-01Submission has been amendedNo
2000-01-01This submission is the final filingNo
2000-01-01This return/report is a short plan year return/report (less than 12 months)No
2000-01-01Plan is a collectively bargained planNo
2000-01-01Plan funding arrangement – InsuranceYes
2000-01-01Plan funding arrangement – General assets of the sponsorYes
2000-01-01Plan benefit arrangement – InsuranceYes
2000-01-01Plan benefit arrangement – General assets of the sponsorYes
1999: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1999 form 5500 responses
1999-01-01Type of plan entitySingle employer plan
1999-01-01Submission has been amendedNo
1999-01-01This submission is the final filingNo
1999-01-01This return/report is a short plan year return/report (less than 12 months)No
1999-01-01Plan is a collectively bargained planNo
1999-01-01Plan funding arrangement – InsuranceYes
1999-01-01Plan funding arrangement – General assets of the sponsorYes
1999-01-01Plan benefit arrangement – InsuranceYes
1999-01-01Plan benefit arrangement – General assets of the sponsorYes
1998: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1998 form 5500 responses
1998-01-01Type of plan entitySingle employer plan
1998-01-01Submission has been amendedNo
1998-01-01This submission is the final filingNo
1998-01-01This return/report is a short plan year return/report (less than 12 months)No
1998-01-01Plan is a collectively bargained planNo
1998-01-01Plan funding arrangement – InsuranceYes
1998-01-01Plan funding arrangement – General assets of the sponsorYes
1998-01-01Plan benefit arrangement – InsuranceYes
1998-01-01Plan benefit arrangement – General assets of the sponsorYes
1997: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1997 form 5500 responses
1997-01-01Type of plan entitySingle employer plan
1997-01-01Submission has been amendedNo
1997-01-01This submission is the final filingNo
1997-01-01This return/report is a short plan year return/report (less than 12 months)No
1997-01-01Plan is a collectively bargained planNo
1997-01-01Plan funding arrangement – InsuranceYes
1997-01-01Plan funding arrangement – General assets of the sponsorYes
1997-01-01Plan benefit arrangement – InsuranceYes
1997-01-01Plan benefit arrangement – General assets of the sponsorYes
1996: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1996 form 5500 responses
1996-01-01Type of plan entitySingle employer plan
1996-01-01Submission has been amendedNo
1996-01-01This submission is the final filingNo
1996-01-01This return/report is a short plan year return/report (less than 12 months)No
1996-01-01Plan is a collectively bargained planNo
1996-01-01Plan funding arrangement – InsuranceYes
1996-01-01Plan funding arrangement – General assets of the sponsorYes
1996-01-01Plan benefit arrangement – InsuranceYes
1996-01-01Plan benefit arrangement – General assets of the sponsorYes
1995: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1995 form 5500 responses
1995-01-01Type of plan entitySingle employer plan
1995-01-01Submission has been amendedNo
1995-01-01This submission is the final filingNo
1995-01-01This return/report is a short plan year return/report (less than 12 months)No
1995-01-01Plan is a collectively bargained planNo
1995-01-01Plan funding arrangement – InsuranceYes
1995-01-01Plan funding arrangement – General assets of the sponsorYes
1995-01-01Plan benefit arrangement – InsuranceYes
1995-01-01Plan benefit arrangement – General assets of the sponsorYes
1994: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1994 form 5500 responses
1994-01-01Type of plan entitySingle employer plan
1994-01-01Submission has been amendedNo
1994-01-01This submission is the final filingNo
1994-01-01This return/report is a short plan year return/report (less than 12 months)No
1994-01-01Plan is a collectively bargained planNo
1994-01-01Plan funding arrangement – InsuranceYes
1994-01-01Plan funding arrangement – General assets of the sponsorYes
1994-01-01Plan benefit arrangement – InsuranceYes
1994-01-01Plan benefit arrangement – General assets of the sponsorYes
1993: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1993 form 5500 responses
1993-01-01Type of plan entitySingle employer plan
1993-01-01Submission has been amendedNo
1993-01-01This submission is the final filingNo
1993-01-01This return/report is a short plan year return/report (less than 12 months)No
1993-01-01Plan is a collectively bargained planNo
1993-01-01Plan funding arrangement – InsuranceYes
1993-01-01Plan funding arrangement – General assets of the sponsorYes
1993-01-01Plan benefit arrangement – InsuranceYes
1993-01-01Plan benefit arrangement – General assets of the sponsorYes
1992: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1992 form 5500 responses
1992-01-01Type of plan entitySingle employer plan
1992-01-01Submission has been amendedNo
1992-01-01This submission is the final filingNo
1992-01-01This return/report is a short plan year return/report (less than 12 months)No
1992-01-01Plan is a collectively bargained planNo
1992-01-01Plan funding arrangement – InsuranceYes
1992-01-01Plan funding arrangement – General assets of the sponsorYes
1992-01-01Plan benefit arrangement – InsuranceYes
1992-01-01Plan benefit arrangement – General assets of the sponsorYes
1991: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1991 form 5500 responses
1991-01-01Type of plan entitySingle employer plan
1991-01-01Submission has been amendedNo
1991-01-01This submission is the final filingNo
1991-01-01This return/report is a short plan year return/report (less than 12 months)No
1991-01-01Plan is a collectively bargained planNo
1991-01-01Plan funding arrangement – InsuranceYes
1991-01-01Plan funding arrangement – General assets of the sponsorYes
1991-01-01Plan benefit arrangement – InsuranceYes
1991-01-01Plan benefit arrangement – General assets of the sponsorYes
1990: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1990 form 5500 responses
1990-01-01Type of plan entitySingle employer plan
1990-01-01Submission has been amendedNo
1990-01-01This submission is the final filingNo
1990-01-01This return/report is a short plan year return/report (less than 12 months)No
1990-01-01Plan is a collectively bargained planNo
1990-01-01Plan funding arrangement – InsuranceYes
1990-01-01Plan funding arrangement – General assets of the sponsorYes
1990-01-01Plan benefit arrangement – InsuranceYes
1990-01-01Plan benefit arrangement – General assets of the sponsorYes
1989: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1989 form 5500 responses
1989-01-01Type of plan entitySingle employer plan
1989-01-01Submission has been amendedNo
1989-01-01This submission is the final filingNo
1989-01-01This return/report is a short plan year return/report (less than 12 months)No
1989-01-01Plan is a collectively bargained planNo
1989-01-01Plan funding arrangement – InsuranceYes
1989-01-01Plan funding arrangement – General assets of the sponsorYes
1989-01-01Plan benefit arrangement – InsuranceYes
1989-01-01Plan benefit arrangement – General assets of the sponsorYes
1988: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. SECTION 125 PLAN 1988 form 5500 responses
1988-01-01Type of plan entitySingle employer plan
1988-01-01First time form 5500 has been submittedYes
1988-01-01Submission has been amendedNo
1988-01-01This submission is the final filingNo
1988-01-01This return/report is a short plan year return/report (less than 12 months)No
1988-01-01Plan is a collectively bargained planNo
1988-01-01Plan funding arrangement – InsuranceYes
1988-01-01Plan funding arrangement – General assets of the sponsorYes
1988-01-01Plan benefit arrangement – InsuranceYes
1988-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number11416
Policy instance 1
Insurance contract or identification number11416
Number of Individuals Covered367
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,218
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $193,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,218
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30023075
Policy instance 2
Insurance contract or identification number30023075
Number of Individuals Covered248
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,457
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $32,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,457
Insurance broker organization code?3
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number11416
Policy instance 1
Insurance contract or identification number11416
Number of Individuals Covered343
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,392
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $173,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,392
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INSURANCE LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30023075
Policy instance 2
Insurance contract or identification number30023075
Number of Individuals Covered239
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,460
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $32,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,460
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INSURANCE, LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05997054
Policy instance 1
Insurance contract or identification numberTM05997054
Number of Individuals Covered651
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,256
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $98,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,256
Insurance broker organization code?3
Insurance broker nameLARRY DYKES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30023075
Policy instance 2
Insurance contract or identification number30023075
Number of Individuals Covered172
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $955
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $15,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $955
Insurance broker organization code?3
Insurance broker nameLARRY W DYKES
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG55695
Policy instance 1
Insurance contract or identification numberG55695
Number of Individuals Covered345
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $3,491
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $109,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,491
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INSURANCE AGENCY INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG55695
Policy instance 2
Insurance contract or identification numberG55695
Number of Individuals Covered353
Insurance policy start date2012-02-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,382
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $102,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,824
Insurance broker organization code?3
Insurance broker nameLARRY W DYKES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30023075
Policy instance 3
Insurance contract or identification number30023075
Number of Individuals Covered140
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $445
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $13,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $445
Insurance broker organization code?3
Insurance broker nameLARRY DYKES

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