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HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 401k Plan overview

Plan NameHURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN
Plan identification number 501

HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:HURON CASTING, INC.
Employer identification number (EIN):382116352
NAIC Classification:331500

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01MATTHEW DAVIS, SENIOR VICE PRES. MATTHEW DAVIS, SENIOR VICE PRES.2018-07-30
5012015-01-01MATTHEW DAVIS, SENIOR VICE PRES. MATTHEW DAVIS, SENIOR VICE PRES.2016-07-29
5012014-01-01MATTHEW DAVIS, SENIOR VICE PRES. MATTHEW DAVIS, SENIOR VICE PRES.2015-07-31
5012013-01-01MATTHEW DAVIS, SENIOR VICE PRES. MATTHEW DAVIS, SENIOR VICE PRES.2014-07-31
5012012-01-01MATTHEW DAVIS, SENIOR VICE PRES. MATTHEW DAVIS, SENIOR VICE PRES.2013-10-08
5012011-01-01MATTHEW DAVIS, SENIOR VICE PRES. MATTHEW DAVIS, SENIOR VICE PRES.2012-10-10
5012010-01-01MATTHEW DAVIS, CFO MATTHEW DAVIS, CFO2011-08-01
5012009-01-01MATTHEW DAVIS, CFO MATTHEW DAVIS, CFO2010-10-11

Plan Statistics for HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN

401k plan membership statisitcs for HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN

Measure Date Value
2023: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01825
Total number of active participants reported on line 7a of the Form 55002023-01-01784
Number of retired or separated participants receiving benefits2023-01-016
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01790
2022: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01820
Total number of active participants reported on line 7a of the Form 55002022-01-01820
Number of retired or separated participants receiving benefits2022-01-013
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01823
2021: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01846
Total number of active participants reported on line 7a of the Form 55002021-01-01823
Number of retired or separated participants receiving benefits2021-01-019
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01832
2020: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01875
Total number of active participants reported on line 7a of the Form 55002020-01-01744
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01744
2019: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01817
Total number of active participants reported on line 7a of the Form 55002019-01-01817
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01817
2018: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01703
Total number of active participants reported on line 7a of the Form 55002018-01-01815
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 participants2018-01-01815
2017: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01559
Total number of active participants reported on line 7a of the Form 55002017-01-01672
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01672
2015: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01717
Total number of active participants reported on line 7a of the Form 55002015-01-01642
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01642
2014: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01719
Total number of active participants reported on line 7a of the Form 55002014-01-01717
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01717
2013: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01882
Total number of active participants reported on line 7a of the Form 55002013-01-01719
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01719
2012: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01656
Total number of active participants reported on line 7a of the Form 55002012-01-01882
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01882
2011: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01475
Total number of active participants reported on line 7a of the Form 55002011-01-01656
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01656
2010: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01422
Total number of active participants reported on line 7a of the Form 55002010-01-01475
Total of all active and inactive participants2010-01-01475
2009: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01475
Total number of active participants reported on line 7a of the Form 55002009-01-01422
Total of all active and inactive participants2009-01-01422

Financial Data on HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN

Measure Date Value
2011 : HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$1,079,361
Total of all expenses incurred2011-12-31$1,079,361
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$792,037
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,079,361
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$287,324
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31No
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$6,032
Administrative expenses (other) incurred2011-12-31$78,030
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net assets at end of year (total assets less liabilities)2011-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$479,471
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$1,079,361
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$306,534
Contract administrator fees2011-12-31$209,294
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
2010 : HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$955,286
Total of all expenses incurred2010-12-31$955,286
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$746,958
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$955,286
Value of total assets at end of year2010-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$208,328
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$2,428
Administrative expenses (other) incurred2010-12-31$46,986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net assets at end of year (total assets less liabilities)2010-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$458,468
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$955,286
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$286,062
Contract administrator fees2010-12-31$161,342
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No

Form 5500 Responses for HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN

2023: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2015: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: HURON CASTING/AXIS MACHINING/ARENAC CASTING/ BLUE DIAMOND EMPLOYEE MEDICAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10323761001
Policy instance 2
Insurance contract or identification number10323761001
Number of Individuals Covered260
Insurance policy start date2023-01-01
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 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 $15,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017674-00
Policy instance 1
Insurance contract or identification number01-017674-00
Number of Individuals Covered784
Insurance policy start date2023-01-01
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 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
Other welfare benefits providedAD&D
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 $64,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10323761001
Policy instance 2
Insurance contract or identification number10323761001
Number of Individuals Covered897
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 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 $55,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017674-00
Policy instance 1
Insurance contract or identification number01-017674-00
Number of Individuals Covered820
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 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
Other welfare benefits providedAD&D
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 $77,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10323761001
Policy instance 2
Insurance contract or identification number10323761001
Number of Individuals Covered881
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 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 $42,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017674-00
Policy instance 1
Insurance contract or identification number01-017674-00
Number of Individuals Covered823
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 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
Other welfare benefits providedAD&D
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 $64,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017674-00
Policy instance 1
Insurance contract or identification number01-017674-00
Number of Individuals Covered829
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $4
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $69,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4
Additional information about fees paid to insurance brokerEMPLOYEE LIFE INSURANCE
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 96196
Policy instance 2
Insurance contract or identification numberCLI 96196
Number of Individuals Covered258
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSTOP LOSS HEALTH INSURANCE
Insurance broker organization code?3
ARDELLIS INSURANCE LTD. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number715/1-10171-00/
Policy instance 3
Insurance contract or identification number715/1-10171-00/
Number of Individuals Covered744
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSTOP LOSS HEALTH INSURANCE
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017674-00
Policy instance 1
Insurance contract or identification number01-017674-00
Number of Individuals Covered829
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $7,319
Total amount of fees paid to insurance companyUSD $611
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $80,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 96196
Policy instance 2
Insurance contract or identification numberCLI 96196
Number of Individuals Covered817
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARDELLIS INSURANCE LTD. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number715/1-10171-00/
Policy instance 3
Insurance contract or identification number715/1-10171-00/
Number of Individuals Covered817
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 96196
Policy instance 2
Insurance contract or identification numberCLI 96196
Number of Individuals Covered815
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSTOP LOSS HEALTH INSURANCE
Insurance broker organization code?5
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05998608
Policy instance 1
Insurance contract or identification numberTM05998608
Number of Individuals Covered804
Insurance policy start date2018-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $1,982
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $17,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,982
Additional information about fees paid to insurance brokerEMPLOYEE LIFE INSURANCE
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 96196
Policy instance 2
Insurance contract or identification numberCLI 96196
Number of Individuals Covered672
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $108,596
Total amount of fees paid to insurance companyUSD $230,566
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $108,596
Amount paid for insurance broker fees230566
Additional information about fees paid to insurance brokerSTOP LOSS HEALTH INSURANCE
Insurance broker organization code?5
Insurance broker nameASR HEALTH BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05998608
Policy instance 1
Insurance contract or identification numberTM05998608
Number of Individuals Covered716
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of fees paid to insurance companyUSD $5,201
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5201
Additional information about fees paid to insurance brokerEMPLOYEE LIFE INSURANCE
Insurance broker organization code?3
Insurance broker nameMETROPOLITAN LIFE INSURANCE
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05998608
Policy instance 1
Insurance contract or identification numberTM05998608
Number of Individuals Covered642
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,862
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,862
Additional information about fees paid to insurance brokerEMPLOYEE LIFE INSURANCE
Insurance broker organization code?3
Insurance broker nameMETROPOLITAN LIFE INSURANCE
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 96196
Policy instance 2
Insurance contract or identification numberCLI 96196
Number of Individuals Covered642
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $106,884
Total amount of fees paid to insurance companyUSD $264,237
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106,884
Amount paid for insurance broker fees264237
Additional information about fees paid to insurance brokerSTOP LOSS HEALTH INSURANCE
Insurance broker organization code?5
Insurance broker nameASR HEALTH BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05998608
Policy instance 1
Insurance contract or identification numberTM05998608
Number of Individuals Covered717
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,857
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,857
Additional information about fees paid to insurance brokerEMPLOYEE LIFE INSURANCE
Insurance broker organization code?3
Insurance broker nameMETROPOLITAN LIFE INSURANCE
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberCLI 96196
Policy instance 2
Insurance contract or identification numberCLI 96196
Number of Individuals Covered717
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $105,311
Total amount of fees paid to insurance companyUSD $4,391
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $105,311
Amount paid for insurance broker fees4391
Additional information about fees paid to insurance brokerSTOP LOSS HEALTH INSURANCE
Insurance broker organization code?5
Insurance broker nameASR HEALTH BENEFITS
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number001040-03
Policy instance 1
Insurance contract or identification number001040-03
Number of Individuals Covered719
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05998608
Policy instance 2
Insurance contract or identification numberTM05998608
Number of Individuals Covered779
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $5,438
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,438
Additional information about fees paid to insurance brokerEMPLOYEE LIFE INSURANCE
Insurance broker organization code?3
Insurance broker nameMETROPOLITAN LIFE INSURANCE
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number001040-03
Policy instance 2
Insurance contract or identification number001040-03
Number of Individuals Covered882
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000416E
Policy instance 1
Insurance contract or identification numberG000416E
Number of Individuals Covered781
Insurance policy start date2012-03-01
Insurance policy end date2013-03-01
Total amount of commissions paid to insurance brokerUSD $4,028
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,028
Additional information about fees paid to insurance brokerADMINISTRATION SYSTEM RESEARCH
Insurance broker organization code?3
Insurance broker nameUNITED OF OMAHA LIFE INS
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number001040-03
Policy instance 2
Insurance contract or identification number001040-03
Number of Individuals Covered654
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000416E
Policy instance 1
Insurance contract or identification numberG000416E
Number of Individuals Covered797
Insurance policy start date2011-03-01
Insurance policy end date2012-03-01
Total amount of commissions paid to insurance brokerUSD $3,182
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000416E
Policy instance 1
Insurance contract or identification numberG000416E
Number of Individuals Covered499
Insurance policy start date2010-03-01
Insurance policy end date2011-03-01
Total amount of commissions paid to insurance brokerUSD $1,934
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,934
Additional information about fees paid to insurance brokerADMINISTRATION SYSTEM RESEARCH
Insurance broker organization code?3
Insurance broker nameUNITED OF OMAHA LIFE INS
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number001040-03
Policy instance 2
Insurance contract or identification number001040-03
Number of Individuals Covered475
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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