WESTCON COMMERICAL INDUSTRIES, LTD has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WESTERN BUILDERS, LLC INSURANCE PROGRAM
| Measure | Date | Value |
|---|
| 2022: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 4 |
| Total of all active and inactive participants | 2022-01-01 | 4 |
| 2020: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 5 |
| Total of all active and inactive participants | 2020-01-01 | 5 |
| 2019: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 4 |
| Total of all active and inactive participants | 2019-01-01 | 4 |
| 2018: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 4 |
| Total of all active and inactive participants | 2018-01-01 | 4 |
| 2017: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 4 |
| Total of all active and inactive participants | 2017-01-01 | 4 |
| 2016: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 5 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 5 |
| 2015: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 5 |
| Number of retired or separated participants receiving benefits | 2015-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-10-01 | 0 |
| Total of all active and inactive participants | 2015-10-01 | 5 |
| Measure | Date | Value |
|---|
| 2022 : WESTERN BUILDERS, LLC INSURANCE PROGRAM 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $45,369 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $35,867 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $35,417 |
| Total plan assets at end of year | 2022-12-31 | $13,678 |
| Total plan assets at beginning of year | 2022-12-31 | $4,176 |
| Net income (gross income less expenses) | 2022-12-31 | $9,502 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $13,678 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $4,176 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $45,369 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $450 |
| 2020 : WESTERN BUILDERS, LLC INSURANCE PROGRAM 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $32,864 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $33,375 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $31,167 |
| Total plan assets at end of year | 2020-12-31 | $5,335 |
| Total plan assets at beginning of year | 2020-12-31 | $5,846 |
| Net income (gross income less expenses) | 2020-12-31 | $-511 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $5,335 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $5,846 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $32,864 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $2,208 |
| 2019 : WESTERN BUILDERS, LLC INSURANCE PROGRAM 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $33,420 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $31,188 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $32,452 |
| Total plan assets at end of year | 2019-12-31 | $5,846 |
| Total plan assets at beginning of year | 2019-12-31 | $3,614 |
| Net income (gross income less expenses) | 2019-12-31 | $2,232 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $5,846 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $3,614 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $33,420 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $-1,264 |
| 2018 : WESTERN BUILDERS, LLC INSURANCE PROGRAM 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $33,572 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $34,194 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $32,591 |
| Total plan assets at end of year | 2018-12-31 | $3,614 |
| Total plan assets at beginning of year | 2018-12-31 | $4,236 |
| Net income (gross income less expenses) | 2018-12-31 | $-622 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $3,614 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $4,236 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $33,572 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $1,603 |
| 2017 : WESTERN BUILDERS, LLC INSURANCE PROGRAM 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $31,302 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $29,872 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $28,571 |
| Total plan assets at end of year | 2017-12-31 | $4,236 |
| Total plan assets at beginning of year | 2017-12-31 | $2,806 |
| Net income (gross income less expenses) | 2017-12-31 | $1,430 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $4,236 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $2,806 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $31,302 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $1,301 |
| 2016 : WESTERN BUILDERS, LLC INSURANCE PROGRAM 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $24,776 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $22,459 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $20,838 |
| Total plan assets at end of year | 2016-12-31 | $2,806 |
| Total plan assets at beginning of year | 2016-12-31 | $489 |
| Net income (gross income less expenses) | 2016-12-31 | $2,317 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $2,806 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $489 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $24,776 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $1,621 |
| 2015 : WESTERN BUILDERS, LLC INSURANCE PROGRAM 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $4,765 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $4,276 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $4,296 |
| Total plan assets at end of year | 2015-12-31 | $489 |
| Total plan assets at beginning of year | 2015-12-31 | $0 |
| Net income (gross income less expenses) | 2015-12-31 | $489 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $489 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $4,765 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $-20 |
| 2022: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: WESTERN BUILDERS, LLC INSURANCE PROGRAM 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | First time form 5500 has been submitted | Yes |
| 2015-10-01 | Submission has been amended | No |
| 2015-10-01 | This submission is the final filing | No |
| 2015-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-10-01 | Plan is a collectively bargained plan | No |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan funding arrangement – Trust | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement - Trust | Yes |
| ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60186 ) |
| Policy contract number | W4508 |
| Policy instance | 2 |
| Insurance contract or identification number | W4508 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $812 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 677814 |
| Policy instance | 1 |
| Insurance contract or identification number | 677814 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $34,605 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60186 ) |
| Policy contract number | W4508 |
| Policy instance | 2 |
| Insurance contract or identification number | W4508 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $1,566 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 677814 |
| Policy instance | 1 |
| Insurance contract or identification number | 677814 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $29,432 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60186 ) |
| Policy contract number | W4508 |
| Policy instance | 2 |
| Insurance contract or identification number | W4508 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $1,834 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 677814 |
| Policy instance | 1 |
| Insurance contract or identification number | 677814 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $27,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60186 ) |
| Policy contract number | W4508 |
| Policy instance | 2 |
| Insurance contract or identification number | W4508 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $1,573 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 677814 |
| Policy instance | 1 |
| Insurance contract or identification number | 677814 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $459 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $22,293 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $459 | | Insurance broker organization code? | 3 |
|
| ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60186 ) |
| Policy contract number | W4508 |
| Policy instance | 2 |
| Insurance contract or identification number | W4508 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 | | Insurance broker name | WESTERN INSURANCE CONSULTANTS |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 677814 |
| Policy instance | 1 |
| Insurance contract or identification number | 677814 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $292 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $23,624 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $292 | | Insurance broker organization code? | 3 | | Insurance broker name | WESTERN INSURANCE CONSULTANTS |
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| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 677814 |
| Policy instance | 1 |
| Insurance contract or identification number | 677814 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2015-10-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $4,296 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 | | Insurance broker name | WESTERN INSURANCE CONSULTANTS |
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